Obsessive-Compulsive Disorder: Commonly Asked Questions and Answers

The information below will provide an understanding of obsessive-compulsive disorder, or OCD, who it affects, and how it is treated.

What is obsessive-compulsive disorder?

OCD is a serious and often debilitating chronic anxiety disorder, but like all anxiety disorders, it is treatable.

The term “anxiety disorders” describes a group of conditions, including generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD), social anxiety disorder (SAD), and specific phobias.

Those suffering from OCD experience unwanted and intrusive thoughts (obsessions), which may cause them to repeatedly perform ritualistic behaviors and routines (compulsions) to ease their anxiety or distress. Some people spend hours at a time performing complicated rituals involving hand washing, counting, or checking to ward off persistent, unwelcome thoughts, feelings, or images. Others live in terror that they will accidentally do something wrong, such as harm someone, blurt out an improper statement, become contaminated or sick, or throw something out by mistake.

What are common obsessions and compulsions?

Each person with OCD is different, but many share similar obsessions and related compulsions.

Obsessions

• Constant, irrational worry about dirt, germs, or contamination.
• Excessive concern with order, arrangement, or symmetry.
• Fear that negative or aggressive thoughts or impulses will cause personal harm or harm to a loved one.
• Preoccupation with losing or throwing away objects with little or no value.
• Excessive concern about accidentally or purposefully injuring another person.
• Feeling overly responsible for the safety of others.
• Distasteful religious and sexual thoughts or images.
• Doubting that is irrational or excessive.

Compulsions

• Cleaning – Repeatedly washing one’s hands, bathing, or cleaning household items, often for hours at a time.
• Checking – Checking and re-checking several or hundreds of times a day that the doors are locked, the stove is turned off, the hair dryer is unplugged, etc.
• Repeating – Inability to stop repeating a name, phrase, or simple activity (such as going through a doorway over and over).
• Hoarding – Difficulty throwing away useless items such as old newspapers or magazines, bottle caps, or rubber bands.
• Touching and arranging
• Mental rituals – Endless reviewing of conversations, counting; repetitively calling up “good” thoughts to neutralize “bad” thoughts or obsessions; or excessive praying and using special words or phrases to neutralize obsessions.

How can OCD affect your life?

OCD can be a frustrating disorder for those who have it, as well as for their family and friends. The seemingly unavoidable and uncontrollable obsessions and rituals can interfere substantially with schoolwork, job, family, and social activities, robbing valuable time. Although people with OCD know their obsessions and compulsions are irrational, they feel as if they have little or no control over them. They may spend several hours every day focusing on obsessive thoughts and performing rituals. Trying to concentrate on normal daily activities can be difficult. If left untreated, OCD may follow a progressive, deteriorating course that can become disabling.

Who can get OCD?

OCD occurs equally in men and women, and more than 2 million American adults have the disorder. The median age of onset is 19, with 25 percent of cases occurring by age 14. But children may have symptoms of OCD, too.

What causes OCD?

The disorder appears to run in families and may have a genetic link. Scientists have discovered that people with OCD and their close family members have distinctive patterns in their brain structure, specifically regions associated with suppressing responses and habits.

Why is it important to treat OCD?

OCD is a chronic condition, and symptoms may vary. But treatment can improve a person’s quality of life and provide tools to help manage symptoms and regain lost time.

The presence of other conditions can make it more difficult to detect and treat OCD. It’s not uncommon for OCD to occur with other anxiety disorders, such as social anxiety disorder, panic disorder, and specific phobias, as well as Tourette’s syndrome or other related disorders. Untreated OCD may also lead to the development of additional mental health issues such as depression and affect physical well-being. Sometimes people with OCD have problems with alcohol or substance abuse or dependence and eating disorders.

Because people often go to extreme lengths to hide their behavior, even from friends and loved ones, effective treatment may be delayed. Nearly two-thirds of all people with diagnosable mental disorders (nearly a quarter of the U.S. population in any given year) do not seek treatment, often due to fear of stigma and resulting discrimination. On average, it takes several years from the time OCD symptoms appear for people to obtain appropriate treatment.

How is OCD treated?

The two types of treatment generally used to treat OCD are cognitive-behavioral therapy (CBT) and medication. For some people, a combination may be the most effective treatment. Any course of treatment should be tailored to an individual’s needs.

Exposure and response prevention (ERP) is often the most effective form of CBT. It involves the gradual exposure to feared obsessions to learn how to refrain from compulsive behavior. Common OCD medications are selective serotonin reuptake inhibitors (SSRIs), which work to reduce anxiety.

What if I have other anxiety disorders or depression?

It’s not unusual to have more than one anxiety disorder or to have an anxiety disorder and depression. Talk about all of your symptoms to your doctor or therapist, who will help you find treatment that will be tailored to your needs.

Read more about obsessive-compulsive disorder at www.treatocd.org or order free materials.