Obsessive-compulsive disorder (OCD)
Obsessive-compulsive disorder (OCD)
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by unreasonable thoughts and fears (obsessions) that lead you to do repetitive behaviors (compulsions). With obsessive-compulsive disorder, you may realize that your obsessions aren't reasonable, and you may try to ignore them or stop them. But that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts in an effort to ease your stressful feelings.
Obsessive-compulsive disorder often centers around themes, such as a fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they're sore and chapped. Despite your efforts, thoughts of obsessive-compulsive behavior keep coming back. This leads to more ritualistic behavior — and a vicious cycle that's characteristic of obsessive-compulsive disorder.
Obsessive-compulsive disorder symptoms include both obsessions and compulsions.
Obsessions often have themes to them, such as:
Obsession symptoms and signs may include:
As with obsessions, compulsions typically have themes, such as:
Compulsion symptoms and signs may include:
Symptoms usually begin gradually and tend to vary in severity throughout your life. Symptoms generally worsen during times when you're experiencing more stress. OCD is considered a lifelong illness.
When to see a doctor
Obsessive-compulsive disorder can be so severe and time-consuming that it literally becomes disabling. You may be able to do little else but spend time on your obsessions and compulsions — washing your hands for hours each day, for instance. With OCD, you may have a low quality of life because the condition rules most of your days. You may be very distressed, but you seem powerless to stop your urges. Most adults can recognize that their obsessions and compulsions don't make sense. Children, however, may not understand what's wrong.
If your obsessions and compulsions are affecting your life, see your doctor or mental health provider. People with OCD may be ashamed and embarrassed about the condition. But even if your rituals are deeply ingrained, treatment can help.
The cause of obsessive-compulsive disorder isn't fully understood. Main theories include:
Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include:
Complications that obsessive-compulsive disorder may cause or be associated with include:
Preparing for your appointment
In some cases, a health care provider or other professional may ask you about your mood, thoughts or behavior. Your doctor may bring it up during a routine medical appointment, especially if you seem to be agitated or distressed. Or you may decide to schedule an appointment with your family doctor to talk about your concerns. In either case, because obsessive-compulsive disorder often requires specialized care, you may be referred to a mental health provider, such as a psychiatrist or psychologist, for evaluation and treatment. In other cases, you may seek out a mental health provider on your own first.
What you can do
For OCD, basic questions to ask may include:
In addition to the questions that you've prepared to ask your doctor, don't hesitate to ask questions whenever you don't understand something being discussed.
What to expect from your doctor
Tests and diagnosis
If your doctor or mental health provider believes you may have obsessive-compulsive disorder, he or she typically runs a series of medical and psychological tests and exams. These can help pinpoint a diagnosis, rule out other problems that could be causing your symptoms and check for any related complications.
These exams and tests generally include:
Diagnostic criteria for obsessive-compulsive disorder
For OCD to be diagnosed, you must first meet these general criteria:
Your obsessions must meet these specific criteria:
Compulsions must meet these specific criteria:
Treatments and drugs
Obsessive-compulsive disorder treatment can be difficult, and treatment may not result in a cure. You may need treatment for the rest of your life. However, OCD treatment can help you bring symptoms under control so that they don't rule your daily life.
Main obsessive-compulsive disorder treatments
Which option is best for you depends on your personal situation and preferences. Often, treatment is most effective with a combination of medications and psychotherapy.
Psychotherapy for obsessive-compulsive disorder
One CBT approach in particular is called exposure and response prevention. This therapy involves gradually exposing you to a feared object or obsession, such as dirt, and teaching you healthy ways to cope with your anxiety. Learning the techniques and new thought patterns takes effort and practice. But you may enjoy a better quality of life once you learn to manage your obsessions and compulsions.
Therapy may take place in individual, family or group sessions.
Medications for obsessive-compulsive disorder
Antidepressants that have been specifically approved by the Food and Drug Administration (FDA) to treat OCD include:
However, many other antidepressants and other psychiatric medications on the market also may be used to treat OCD off-label. Off-label use is a common and legal practice of using a medication to treat a condition not specifically listed on its prescribing label as an FDA-approved use.
Choosing a medication
With obsessive-compulsive disorder, it's not unusual to have to try several medications before finding one that works well to control your symptoms. Your doctor also might recommend combining medications, such as antidepressants and antipsychotic medications, to make them more effective in controlling your symptoms.
Don't stop taking your medication without talking to your doctor, even if you're feeling better. You may have a relapse of OCD symptoms if you stop taking your medication. Also, some medication needs to be tapered off, rather than stopped abruptly, to avoid withdrawal symptoms.
Medication may be continued for one to two years before your doctor will try to gradually taper your dosage. If your symptoms return on a lower dose, you may need to take medication indefinitely.
Medication side effects and risks
Some medications can have dangerous interactions with other medications, foods or other substances. Tell your doctors about all medications and over-the-counter substances you take, including vitamins, minerals and herbal supplements.
Other treatment options
Because these treatments haven't been thoroughly tested for use in obsessive-compulsive disorder, make sure you understand all the pros and cons and possible health risks.
Lifestyle and home remedies
Obsessive-compulsive disorder is a chronic condition, which means it may always be part of your life. While you can't treat OCD on your own, you can do some things for yourself that will build on your treatment plan:
Coping and support
Coping with obsessive-compulsive disorder can be challenging. Medications can have unwanted side effects, and you might feel angry or resentful about having a condition that can require long-term treatment. Here are some ways to help cope with OCD:
There's no sure way to prevent obsessive-compulsive disorder. However, getting treatment as soon as possible may help prevent OCD from worsening.
Last Updated: 2010-12-15
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