Obsessive-compulsive disorder is characterized by anxious thoughts or rituals you feel you
can't control. If you have OCD, as it's called, you may be plagued by persistent,
unwelcome thoughts or images, or by the urgent need to engage in certain rituals. You
may be obsessed with germs or dirt, so you wash your hands over and over. You may be
filled with doubt and feel the need to check things repeatedly. You might be preoccupied
by thoughts of violence and fear that you will harm people close to you. You may spend
long periods of time touching things or counting; you may be preoccupied by order or
symmetry; you may have persistent thoughts of performing sexual acts that are repugnant to
you; or you may be troubled by thoughts that are against your religious beliefs.
The disturbing thoughts or images are called obsessions, and the rituals that are
performed to try to prevent or dispel them are called compulsions. There is no pleasure in
carrying out the rituals you are drawn to, only temporary relief from the discomfort
caused by the obsession.
A lot of healthy people can identify with having some of the symptoms of OCD, such as
checking the stove several times before leaving the house. But the disorder is diagnosed
only when such activities consume at least an hour a day, are very distressing, and
interfere with daily life.
Most adults with this condition recognize that what they're doing is senseless, but
they can't stop it. Some people, though, particularly children with OCD, may not realize
that their behavior is out of the ordinary.
OCD strikes men and women in approximately equal numbers and afflicts roughly 1 in 50
people. It can appear in childhood, adolescence, or adulthood, but on the average it first
shows up in the teens or early adulthood. A third of adults with OCD experienced their
first symptoms as children. The course of the disease is variable--symptoms may come and
go, they may ease over time, or they can grow progressively worse. Evidence suggests that
OCD might run in families.
Depression or other anxiety disorders may accompany OCD. And some people with OCD have
eating disorders. In addition, they may avoid situations in which they might have to
confront their obsessions. Or they may try unsuccessfully to use alcohol or drugs to calm
themselves. If OCD grows severe enough, it can keep someone from holding down a job or
from carrying out normal responsibilities at home, but more often it doesn't develop to
those extremes.
Research by NIMH-funded scientists and other investigators has led to the development
of medications and behavioral treatments that can benefit people with OCD. A combination
of the two treatments is often helpful for most patients. Some individuals respond best to
one therapy, some to another. Two medications that have been found effective in treating
OCD are clomipramine and fluoxetine. A number of others are showing promise, however, and
may soon be available.
Behavioral therapy, specifically a type called exposure and response prevention, has
also proven useful for treating OCD. It involves exposing the person to whatever triggers
the problem and then helping him or her forego the usual ritual--for instance, having the
patient touch something dirty and then not wash his hands. This therapy is often
successful in patients who complete a behavioral therapy program, though results have been
less favorable in some people who have both OCD and depression.
text taken from ANXIETY DISORDERS: DECADE OF THE BRAIN (NIMH).
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