Obsessive-compulsive disorder (OCD) is a type of anxiety disorder which causes unreasonable thoughts and fears (obsessions) that lead to repetitive behaviors (compulsions). A person who has obsessive-compulsive disorder realizes that their obsessions aren’t reasonable, may try to ignore them or stop them, but that only increases distress and anxiety. In an effort to release the stress of avoiding the abnormal behaviors, the OCD sufferer feels forced to perform the compulsive acts.
People with obsessive-compulsive disorder are often driven by themes such as fear of getting contaminated by germs. To ease the fear of contamination, OCD patients may compulsively wash their hands until they’re sore and chapped. This can lead to ritualistic behavior and may become a vicious cycle.
The symptoms of obsessive-compulsive disorder include both obsessions and compulsions. OCD obsessions are the repeated and persistent focus on unwanted ideas, thoughts, images or impulses. OCD patients may act in ways that they know make no sense. Typical themes that OCD sufferers focus on are fear of contamination or dirt, having things orderly and symmetrical, aggressive or horrific impulses, and sexual images or thoughts. Symptoms of these themes may include: fear of being contaminated by shaking hands or by touching objects others have touched, fear that the door has been left unlocked or that the stove has been left on, intense distress when objects aren’t orderly or facing the right way, images of abuse, uncontrollable urges to shout obscenities in inappropriate situations, and excessively replaying pornographic mental images.
Physical symptoms of OCD obsessions can include dermatitis because of frequent hand washing, skin lesions because of picking at skin, and hair loss or bald spots because of hair pulling.
Those who have obsessive-compulsive disorder feel an uncontrollable urge to perform repetitive behaviors in order to prevent or reduce the anxiety or the distress induced by the accompanying obsessions. OCD causes people to make up rules or rituals to follow which help control the anxiety experienced due to obsessive thoughts. As with OCD obsessions, compulsions generally have themes, such as washing and cleaning, counting and checking, need for orderliness, demanding reassurances, and the need to perform the same act repeatedly.
The physical symptoms of compulsive behavior include hand washing until the skin becomes raw, checking doors repeatedly to make sure they’re locked, checking the stove repeatedly to make sure it’s off, counting in patterns, and insistence of symmetry in surroundings (like making sure all canned goods face in the same direction).
People who consider themselves to be perfectionists do not have obsessive-compulsive disorder unless the need to be perfect makes those people unable to function normally. Obsessive-compulsive disorder can be so severe and time-consuming that it becomes disabling. It is common for people with OCD to be ashamed and embarrassed about the condition, but treatment can help.
The main treatments for obsessive-compulsive disorder are medications, psychotherapy (talk therapy), and cognitive behavioral therapy (CBT). Some patients have found that they receive the most benefit when these treatments are combined.
Psychotherapy involves discussing feelings and memories with a doctor, individually or in group sessions. Cognitive behavioral therapy involves re-training thought patterns and routines so that compulsive behaviors are no longer necessary. One style of CBT is exposure and response prevention, and involves gradually exposing the patient to a feared object or obsession, such as dirt, and teaching healthy ways to cope with the ensuing anxiety.
Certain medications can help control the obsessions and compulsions experienced by OCD sufferers. Most commonly, antidepressants are used such as Clomipramine (Anafranil), Fluvoxamine, Fluoxetine (Prozac), Paroxetine (Paxil), and Sertraline (Zoloft). These treatments of OCD are closely monitored to determine how they are affecting the patients in terms of progress achieved, or of possible side effects experienced. Sometimes the treatments must be modified so that they are tailored for the best results in each patient.