http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder- ocd/index.shtml What is Obsessive-Compulsive Disorder (OCD)? Everyone double checks things sometimes. or e!ample" you might double check to make sure the stove or iron is turned o## be#ore leaving the house. $ut people %ith obsessive- compulsive disorder(OCD) #eel the need to check things repeatedly" or have certain thoughts or per#orm routines and rituals over and over. &he thoughts and rituals associated %ith OCD cause distress and get in the %ay o# daily li#e. &he #re'uent upsetting thoughts are called obsessions. &o try to control them" a person %ill #eel an over%helming urge to repeat certain rituals or behaviors called compulsions. eople %ith OCD cant control these obsessions and compulsions. *ost o# the time" the rituals end up controlling them. or e!ample" i# people are obsessed %ith germs or dirt" they may develop a compulsion to %ash their hands over and over again. +# they develop an obsession %ith intruders" they may lock and relock their doors many times be#ore going to bed. $eing a#raid o# social embarrassment may prompt people %ith OCD to comb their hair compulsively in #ront o# a mirror-sometimes they get ,caughtin the mirror and cant move a%ay #rom it. er#orming such rituals is not pleasurable. /t best" it produces temporary relie# #rom the an!iety created by obsessive thoughts. Other common rituals are a need to repeatedly check things" touch things (especially in a particular se'uence)" or count things. 0ome common ob sessions include having #re'uent thoughts o# violence and harming loved ones" persistently thinking about per#orming se!ual acts the person dislikes" or having thoughts that are prohibited by religious belie#s. eople %ith OCD may also be preoccupied %ith order and symmetry " have di##iculty thro%ing things out (so they accumulate)" or hoard unneeded items. 1ealthy people also have rituals" such as checking to see i# the stove is o## several times be#ore leaving the house. &he di## erence is that people %ith OCD per#orm their rituals even though doing so inter#eres %ith daily li#e and they #ind the repetition distressing. /lthough most adults %ith OCD recogni2e that %hat they are doing is senseless" some adults and most children may not reali2e that their behavior is out o# the ordinary. Causes OCD sometimes runs in #amilies" but no one kno%s #or sure %hy some people have it %hile others dont. 3esearchers have #ound that several parts o# the brain are involved in #ear and an!iety. $y learning more about #ear and an!iety in the brain" scientists may be able to create better treatments. 3esearchers are also looking #or %ays in %hich stress and environmental #actors may play a role. 0igns 4 0ymptoms
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What is Obsessive-Compulsive Disorder (OCD)?Everyone double checks things sometimes. or e!ample" you might double check to make
sure the stove or iron is turned o## be#ore leaving the house. $ut people %ith obsessive-
compulsive disorder (OCD) #eel the need to check things repeatedly" or have certain thoughts
or per#orm routines and rituals over and over. &he thoughts and rituals associated %ith OCD
cause distress and get in the %ay o# daily li#e.
&he #re'uent upsetting thoughts are called obsessions. &o try to control them" a person %ill
#eel an over%helming urge to repeat certain rituals or behaviors called compulsions. eople
%ith OCD cant control these obsessions and compulsions. *ost o# the time" the rituals end
up controlling them.
or e!ample" i# people are obsessed %ith germs or dirt" they may develop a compulsion to
%ash their hands over and over again. +# they develop an obsession %ith intruders" they may
lock and relock their doors many times be#ore going to bed. $eing a#raid o# social
embarrassment may prompt people %ith OCD to comb their hair compulsively in #ront o# a
mirror-sometimes they get ,caught in the mirror and cant move a%ay #rom it. er#orming
such rituals is not pleasurable. /t best" it produces temporary relie# #rom the an!iety created
by obsessive thoughts.
Other common rituals are a need to repeatedly check things" touch things (especially in a
particular se'uence)" or count things. 0ome common obsessions include having #re'uent
thoughts o# violence and harming loved ones" persistently thinking about per#orming se!ualacts the person dislikes" or having thoughts that are prohibited by religious belie#s. eople
%ith OCD may also be preoccupied %ith order and symmetry" have di##iculty thro%ing things
out (so they accumulate)" or hoard unneeded items.
1ealthy people also have rituals" such as checking to see i# the stove is o## several times
be#ore leaving the house. &he di##erence is that people %ith OCD per#orm their rituals even
though doing so inter#eres %ith daily li#e and they #ind the repetition distressing. /lthough
most adults %ith OCD recogni2e that %hat they are doing is senseless" some adults and most
children may not reali2e that their behavior is out o# the ordinary.
Causes
OCD sometimes runs in #amilies" but no one kno%s #or sure %hy some people have it %hile
others dont. 3esearchers have #ound that several parts o# the brain are involved in #ear and
an!iety. $y learning more about #ear and an!iety in the brain" scientists may be able to create
better treatments. 3esearchers are also looking #or %ays in %hich stress and environmental
• 1ave repeated thoughts or images about many di##erent things" such as #ear o# germs"
dirt" or intruders6 acts o# violence6 hurting loved ones6 se!ual acts6 con#licts %ith religious
belie#s6 or being overly tidy
• Do the same rituals over and over such as %ashing hands" locking and unlockingdoors" counting" keeping unneeded items" or repeating the same steps again and again
• Cant control the un%anted thoughts and behaviors
• Dont get pleasure %hen per#orming the behaviors or rituals" but get brie# relie# #rom
the an!iety the thoughts cause
• 0pend at least 7 hour a day on the thoughts and rituals" %hich cause distress and get in
the %ay o# daily li#e.
Who +s /t 3isk?
or many people" OCD starts during childhood or the teen years. *ost people are diagnosed
by about age 78. 0ymptoms o# OCD may come and go and be better or %orse at di##erent
times.
OCD a##ects about 9.9 million /merican adults. +t strikes men and %omen in roughly e'ual
numbers and usually appears in childhood" adolescence" or early adulthood. One-third o#
adults %ith OCD develop symptoms as children" and research indicates that OCD might run
in #amilies.
Diagnosis
&he course o# the disease is 'uite varied. 0ymptoms may come and go" ease over time" or get
%orse. +# OCD becomes severe" it can keep a person #rom %orking or carrying out normal
responsibilities at home. eople %ith OCD may try to help themselves by avoiding situations
that trigger their obsessions" or they may use alcohol or drugs to calm themselves.
OCD can be accompanied by eating disorders" other an!iety disorders" or depression.
irst" talk to your doctor about your symptoms. :our doctor should do an e!am to make sure
that another physical problem isnt causing the symptoms. &he doctor may re#er you to a
mental health specialist.
&reatments
OCD is generally treated %ith psychotherapy" medication" or both.
Psychotherapy. / type o# psychotherapy called cognitive behavior therapy is especially
use#ul #or treating OCD. +t teaches a person di##erent %ays o# thinking" behaving" andreacting to situations that help him or her #eel less an!ious or #ear#ul %ithout having
obsessive thoughts or acting compulsively. One type o# therapy called e!posure and response
prevention is especially help#ul in reducing compulsive behaviors in OCD.
Medication. Doctors also may prescribe medication to help treat OCD. &he most commonly
prescribed medications #or OCD are anti-an!iety medications and antidepressants. /nti-
an!iety medications are po%er#ul and there are di##erent types. *any types begin %orkingright a%ay" but they generally should not be taken #or long periods.
/ntidepressants are used to treat depression" but they are also particularly help#ul #or OCD"
probably more so than anti-an!iety medications. &hey may take several %eeks;7< to 79
%eeks #or some;to start %orking. 0ome o# these medications may cause side e##ects such as
headache" nausea" or di##iculty sleeping. &hese side e##ects are usually not a problem #or most
people" especially i# the dose starts o## lo% and is increased slo%ly over time. Talk to your
doctor about any side effects you may have.
+ts important to kno% that although antidepressants can be sa#e and e##ective #or many
people" they may be risky #or some" especially children" teens" and young adults. / =black bo!=;the most serious type o# %arning that a prescription drug can have;has been added to
the labels o# antidepressant medications. &hese labels %arn people that antidepressants may
cause some people to have suicidal thoughts or make suicide attempts. /nyone taking
antidepressants should be monitored closely" especially %hen they #irst start treatment %ith
medications.
0ome people %ith OCD do better %ith cognitive behavior therapy" especially e!posure and
response prevention. Others do better %ith medication. 0till others do best %ith a
combination o# the t%o. &alk %ith your doctor about the best treatment #or you.
OCD usually responds %ell to treatment %ith certain medications and>or e!posure-based psychotherapy" in %hich people #ace situations that cause #ear or an!iety and become less
sensitive (desensiti2ed) to them. +*1 is supporting research into ne% treatment approaches
#or people %hose OCD does not respond %ell to the usual therapies. &hese approaches
include combination and augmentation (add-on) treatments" as %ell as modern techni'ues
such as deep brain stimulation.
@iving With
=+ couldnt do anything %ithout rituals. &hey invaded every aspect o# my li#e. Counting really bogged me do%n. + %ould %ash my hair three times as opposed to once because three %as a
good luck number and one %asnt. +t took me longer to read because +d count the lines in a
paragraph. When + set my alarm at night" + had to set it to a number that %ouldnt add up to a
bad number.=
=Aetting dressed in the morning %as tough" because + had a routine" and i# + didnt #ollo% the
routine" +d get an!ious and %ould have to get dressed again. + al%ays %orried that i# + didnt
do something" my parents %ere going to die. +d have these terrible thoughts o# harming my
parents. + kne% that %as completely irrational" but the thoughts triggered more an!iety and
more senseless behavior. $ecause o# the time + spent on rituals" + %as unable to do a lot o#
Obsessive-Compulsive Disorder (OCD)Symptoms and Treatment of Compulsive Behavior and Obsessive Thoughts
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It’s normal, on occasion, to go back and double-check that the iron is unplugged or
your car is locked. But if you suffer from obsessive-compulsive disorder (!"#,obsessive thoughts and compulsive behaviors become so e$cessive they interfere
%ith your daily life. &o matter %hat you do, you can’t seem to shake them. But help
is available. 'ith treatment and self-help strategies, you can break free of the
un%anted thoughts and irrational urges and take back control of your life.
%bsessie&co#!u$sie disorder (%CD) sy#!to#s in chi$dren
'hile the onset of obsessive-compulsive disorder usually occurs during adolescence
or young adulthood, younger children sometimes have symptoms that look like !".o%ever, the symptoms of other disorders, such as /"", autism, and 1ourette’s
syndrome, can also look like obsessive-compulsive disorder, so a thorough medical
and psychological e$am is essential before any diagnosis is made.
herapy as treatment for obsessive-compulsive disorder (OCD)
1he most effective treatment for obsessive-compulsive disorder is often cognitive-
behavioral therapy. /ntidepressants are sometimes used in con2unction %ith therapy,
although medication alone is rarely effective in relieving the symptoms of !".