Obsessive-compulsive disorder

Obsessive-compulsive disorder (OCD) is a mental health condition that makes a person have thoughts (obsessions) and rituals (compulsions) over and over that they cannot control or stop. People with OCD often also have anxiety and depression. OCD, like anxiety and depression, is treatable.

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What is OCD?

OCD causes you to have the same thoughts (obsessions) and repeat the same behaviors (compulsions) over and over. Behaviors might include repeated handwashing, counting, constantly checking on a specific item (like whether the oven was left on), or cleaning. Sometimes the obsessions or compulsions are not logical or do not make sense. A person might have either obsessions or compulsions, but most people with OCD have both.

People with OCD repeat these rituals in the hope that their obsessive thoughts will stop. But the rituals give only short-term relief. Ignoring the urge to do the ritual makes people with OCD very anxious. Left untreated, obsessions and the need to perform rituals can take over a person’s life. Treatment can help.

What are the symptoms of OCD?

People with OCD often have intense, uncontrollable thoughts and behaviors. OCD symptoms can severely affect work or school, home life, and relationships.

Symptoms of OCD can include:1,2

  • Fear of germs or contamination
  • Unwanted or taboo thoughts about topics like sex, religion, or violence
  • Aggressive thoughts toward others or yourself
  • Excessive cleaning or handwashing, especially among women with OCD3
  • Ordering and arranging things in a particular, precise way
  • Repeatedly checking on things, such as whether the door is locked or whether the oven is off
  • Compulsive counting

For someone with OCD, the thoughts (obsessions) and behaviors (compulsions) happen daily, often many times in one day.

What causes OCD?

No one knows what causes OCD. Researchers think that genetics and environment play a role. Researchers are also studying how changes in the structure of the brain in people with OCD might lead to the condition.4

Who is at risk of OCD?

About 1 in 100 Americans has been diagnosed with OCD. Half of people with OCD have a severe form of it.5 People with OCD are at higher risk of other mental health conditions, especially depression and anxiety.6 Eating disorders are more common in women with OCD.7

If your parent or sibling has OCD, you are more likely to have it too. Also, people who were abused during childhood are more likely to develop OCD. Some women with OCD report that their symptoms get worse during their menstrual cycle, during pregnancy, or after pregnancy when hormone levels change.8

What other health problems are linked to OCD?

  • People with OCD sometimes have other mental health conditions, such as depression, eating disorders, substance abuse, or anxiety disorders. When a person also has other disorders, OCD is often difficult to diagnose and treat.
  • A person can have symptoms of OCD together with or as part of other brain disorders, such as Tourette’s syndrome.

Getting the right diagnosis and treatment of other disorders is important to finding a treatment for OCD that works.

How is OCD diagnosed?

A mental health professional can diagnose OCD. She or he will talk to you about your symptoms, thoughts, and behaviors. The mental health professional will also ask about your family’s medical history.

OCD can sometimes be hard to diagnose, because its symptoms are like those of other mental health conditions, such as anxiety disorders. It is possible to have both OCD and other conditions. Not everyone who experiences obsessions or compulsions has OCD. To have OCD, the condition must cause significant mental or emotional distress and interfere with your ability to achieve everyday tasks at work, school, or home.

On average, most people with OCD are diagnosed by 19 years old. But girls are usually diagnosed later than boys.9

How is OCD treated?

Both behavioral therapy and medicine can help people with OCD. A type of behavioral therapy known as “exposure and response prevention” is often used to treat OCD. In this type of therapy, a person is exposed to whatever triggers the obsessive thoughts and then is taught how to stop doing the usual compulsive rituals, how to deal with the anxiety this causes, and how to stop obsessive thoughts.

Did we answer your question about OCD?

For more information about OCD, call the OWH Helpline at 1-800-994-9662 or check out these resources from the following organizations:

Sources

  1. American Psychiatric Association. (2000). Diagnostic and Statistical Manual of Mental Disorders, 4th ed. Arlington, VA: American Psychiatric Association.
  2. Barrett, P.M., Healy, L.J. (2003). An examination of the cognitive processes involved in childhood obsessive-compulsive disorder. Behaviour Research and Therapy; 41(3): 285–299.
  3. Mathis, M.A., Alvarenga, P.D., Funaro, G., Torresan, R.C., Moraes, I., Torres, A.R., et al. (2011). Gender differences in obsessive-compulsive disorder: a literature review. Revista Brasileira de Psiquiatria; 33(4): 390–399.
  4. National Institute of Mental Health. (2016). Obsessive-Compulsive Disorder.
  5. Kessler, R.C., Chiu, W.T., Demler, O., Walters, E.E. (2005). Prevalence, Severity, and Comorbidity of Twelve-month DSM-IV Disorders in the National Comorbidity Survey Replication (NCS-R). Archives of General Psychiatry; 62(6): 617–627. 
  6. Goodwin, G.M. (2015). The overlap between anxiety, depression, and obsessive-compulsive disorder. Dialogues in Clinical Neuroscience; 17(3): 249–260.
  7. Pollack, L.O., Forbush, K.T. (2013). Why Do Eating Disorders and Obsessive Compulsive Disorder Co-Occur? Eating Behaviors; 14(2): 211–215.
  8. Vulinck, N.C., Denys, D., Bus, L., Westenburg, H.G. (2006). Female hormones affect symptom severity in obsessive-compulsive disorder. International Clinic Psychopharmacology; 21(3): 171–175.
  9. Ruscio, A.M., Stein, D.J., Chiu, W.T., Kessler, R.C. (2010). The Epidemiology of Obsessive-Compulsive Disorder in the National Comorbidity Survey Replication. Molecular Psychiatry; 15(1): 53–63.