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What is it?

Obsessive compulsive disorder (or OCD for short) is a type of anxiety disorder characterized by repetitive thoughts and behaviors.

Who gets it?

In the US, 2-3% of people have OCD. It may happen in children (around the age of 10) or in adults (starting around age 21).

What causes it?

The cause isn’t known for certain. Research shows that there might be a role for the substance serotonin in here (much like in major depression). Brain imaging of patients with OCD has also shown differences in the blood flow and metabolism in certain areas of the brain.

There probably is a role for genetics in this disease, since it’s more common among parents/children/siblings of people with the disorder.

OCD – The reason for it isn’t known. Photo by Simon Zirkunow

How does it feel?

People with OCD have two types of manifestations of the condition: obsessions and compulsions.

Obsessions are recurring and distressing thoughts, impulses or images that they can’t control. Examples include -

1. Fear of contamination – A fear of getting dirty or of getting contaminated by germs.
2. Need for symmetry, precise arranging of things  (If you’ve seen the movie Sleeping With the Enemy you got to see a freakish example of that).
3. Unwanted sexual or aggressive thoughts or images – This includes a fear of causing harm to another person or fear of thinking evil or sinful thoughts.
4. Doubts and need for constant reassurance – Recurring thoughts such as “did I lock the door?”, “did I turn off the gas?”
5. Fear of making a mistake

These thoughts are recurring and distressing, and cause anxiety. This anxiety leads to an urgent need to perform rituals or routines – which are the compulsions. Examples of these include -

1. Repeatedly bathing, showering or washing hands – In the case of fear of contamination. This might also include refusal to shake hands with someone else, or touching doorknobs.
2. Ordering, arranging, balancing, and straightening things until they are “just right” – In the case of need for symmetry and precise arrangement.
3. Being stuck on words, images or thoughts that won’t go away – Including repeating specific words, phrases or prayers. In the case of unwanted thoughts.
4. Repeatedly checking things – Such as doors or stoves, in the case of doubts.
5. Needing to perform a task a certain number of times – In the case of fear of making a mistake.

The quality of life of people with OCD is considerably decreased because of shame, distress and because of the time it takes to carry out the compulsions.

This video shows an example of a girl with OCD. Hers is manifested by a fear of contamination -

Here’s another example -

How is it discovered?

There’s no lab test that can confirm OCD. The diagnosis is made by watching the person with OCD and listening to their story, which will usually fit the above description.

How is it treated?

There are two types of treatments for OCD, which are usually combined -

1. Medications – Since, like in depression, there’s a role for serotonin here, also like in depression one of the treatments are selective serotonin reuptake inhibitors (SSRI). There are also other drugs that can be used here.
2. Cognitive-behavioral therapy – This teaches people with OCD to confront their fears and reduce anxiety without performing the rituals.

What happens after treatment?

Most people experience a significant improvement in their symptoms after starting treatment. However, OCD is a long-term condition.

Unfortunately, there is no way to prevent OCD. However, if you suspect you have it, starting treatment early might reduce the time suffering from its symptoms.

To get a better picture of this condition firsthand, you can visit The OCD Blog.

What next?

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