Obsessive Compulsive Disorder
Obsessive compulsive disorder (OCD) is a common anxiety disorder involving disturbing repetitive thoughts and rituals designed to try to alleviate such thoughts. The thoughts are obsessions; the rituals are compulsions. OCD affects millions of people and may be associated with other types of psychiatric disorders.
In some cases, patients are able to perform well in school or the workplace in spite of the disorder, but in some cases the OCD is severe enough to interfere with work, concentration, and relationships. An enormous amount of time and attention may be used by patients with OCD in order to keep up with the ritualized behavior they cannot help but believe protects them. They may have difficulty finishing a routine task, such as showering, toileting, eating, or leaving the house because they cannot stop engaging in ritualized behavior.
Common Obsessions and Compulsions
Patients with OCD frequently have obsessions relative to germs or contamination, disorder or disobedience, harming others, humiliation, saying profane words or committing forbidden sexual acts. The compulsive acts they repeat in order to keep these disturbing thoughts at bay may involve one or more of the following:
- Repeated bathing or hand washing
- Locking doors a certain number of times
- Rechecking appliances to make sure they are turned off
- Rewashing or even discarding items because they seem unclean
- Counting, performing tasks a certain number of times
- Arranging things in a particular sequence or pattern
- Touching things in a certain order
- Not throwing certain things away
- Repeating words or prayers
Signs of OCD in a patient include obsessional thoughts that cannot be quelled and repetitive behaviors that cannot be avoided without a high level of anxiety.
Causes of OCD
The true cause of OCD is not known, but certain biological and environmental factors play a role. In many cases, OCD seems to run in families. Most cases develop in childhood, adolescence or early adulthood. It is believed that abnormalities in the neurotransmitters in the brain exist in patients with OCD. It has also been hypothesized that OCD may be precipitated by certain infections or by extreme stress.
Treatment of OCD
Obsessive compulsive disorder can be exhausting and even disabling, and is sometimes complicated by the fact that patients are embarrassed and reluctant to seek treatment. Help is readily available, however. There are several successful treatment options. These treatments, often used in combination, may include:
- Medications, such as antidepressants and tranquilizers
- Psychotherapy, particularly cognitive behavioral therapy
- Exposure and response prevention (ERP) therapy
- Deep brain stimulation (used experimentally in severe cases)
Medication usage, particularly the prescription of antidepressants, has to be monitored closely. In the case of children and adolescents, such medications may precipitate suicidal thoughts, especially during the early days of treatment. Also, antidepressant medication, though its benefits may be great, can require a month or more to provide symptom relief.