Obsessive-compulsive disorder (OCD) causes people to have persistent, upsetting thoughts (obsessions) and to use rituals or repetitive behaviours (compulsions) to control the anxiety resulting from these thoughts. These patterns of behaviour interfere with the daily lives of those people living with OCD.
For example, a person obsessed with germs or dirt, may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Although the performance of these rituals is not pleasurable, it provides a temporary relief from the anxiety that results from the obsessive thoughts.
Some other common compulsions can include touching things, often in a particular sequence, or checking things repeatedly. Having frequent thoughts of violence or even harming loved ones are other common obsessions, as are recurring thoughts about performing disliked sexual acts, or acts prohibited by religious beliefs. Sometimes people with OCD hoard things as they find it difficult to dispose of items, whether needed or not. And, in some cases, people may have a preoccupation with order and symmetry.
Healthy people also have rituals, such as checking to see if the stove is off several times before leaving the house, however the difference with OCD is that people perform their rituals even when they find them distressing and an interference with daily life. Most adults with OCD recognize that what they are doing is unnecessary or even senseless, however, some adults and most children may not realize their behavior is out of the ordinary.
Common Obsessions
• Fear of dirt or germs
• Disgust with bodily waste or fluids
• Concern with order, symmetry (balance) and exactness
• Worry that a task has been done poorly, even when the person knows this is not true
• Fear of thinking evil or sinful thoughts
• Thinking about certain sounds, images, words or numbers all the time
• Need for constant reassurance
• Fear of harming a family member or friend Common Compulsions
• Cleaning and grooming, such as washing hands, showering or brushing teeth over and over again
• Checking drawers, door locks and appliances to be sure they are shut, locked or turned off
• Repeating, such as going in and out of a door, sitting down and getting up from a chair, or touching certain objects several times
• Ordering and arranging items in certain ways
• Counting over and over to a certain number
• Saving newspapers, mail or containers when they are no longer needed
• Seeking constant reassurance and approval
OCD can be accompanied by eating disorders, other anxiety disorders, or depression. It affects men and women fairly equally usually appears in childhood, adolescence, or early adulthood. One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families.
The symptoms of OCD may come and go or gradually ease or worsen over time. Severe OCD can be so debilitating as to prevent a person from working or carrying on daily life. It is not unusual for people to cope with OCD by simply avoiding situations that might trigger their obsessions. In some cases people turn to alcohol or drugs as a means to alleviate anxiety or fear, however this can cause more complications and be more detrimental in the long-term.
Treatment OCD usually responds well to treatment with medication and/or exposure-based psychotherapy (talk therapy where people face situations that cause their fear or anxiety, allowing them to become desensitized to them). Current research is utilizing deep brain stimulation as another possible treatment for OCD.
