Obsessive Compulsive Disorder (OCD) Guides & Articles

Imogen Sharma
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Erin George, MFT
Medical Editor

What Is Obsessive Compulsive Disorder?

According to the National Institute of Mental Health, obsessive-compulsive disorder (OCD) is a mental health disorder characterized by obsessions, anxiety, and compulsions. 1 It's a relatively common chronic condition occurring in around 2% of the population. 2

Obsessions take place in the mind and may manifest as intrusive thoughts, urges, or mental images. They revolve around intense fears concerning themes such as violence, sex, religion, harm, contamination, loss of control, and symmetry. 3 The anxiety caused by obsessions triggers compulsions, which are repetitive behaviors, such as counting, checking, arranging, and cleaning. 4

Obsessions cause intense anxiety to build up until carrying out the associated compulsive behavior provides temporary relief. However, every time someone completes the obsession-compulsion cycle, it's reinforced in the brain. Many people with OCD understand their symptoms aren't rational, but self-awareness is rarely enough to overcome them. 5 Knowing they're doing something beyond their control tends to enhance the anxiety associated with the condition and negatively impacts self-esteem, leading to isolation and other mental health disorders, such as depression. 6

While most people double-check or worry excessively from time to time, people with OCD experience debilitating distress and struggle chronically as a result. They spend at least an hour each day checking or performing routines and often experience profound suffering and shame without professional OCD treatment. 7

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What Causes OCD?

A mixture of biological, genetic, and environmental factors contribute to the onset of obsessive-compulsive disorder. It's not fully clear whether someone is born with nontypical brain function as a result of biology and genes or whether OCD develops as a result of environmental factors that influence brain function and behavior.

However, most experts now agree that biology and genetics are the underlying cause of OCD, and life experience dictates whether someone develops it and how their symptoms present. 8 The disorder can run in families, but even identical twins have the potential to differ—one might develop OCD, while the other one may not. 5 It's these types of inconsistencies that make pinning down specific causes challenging.

Related Disorders

Studies show that various areas of the brain exhibit underactivation in OCD patients. 9 There's some overlap of symptoms with other mental health and neurodevelopmental disorders, such as: 10

  • Tourette syndrome and tic disorders
  • Obsessive-compulsive personality disorder (OCPD)
  • Autism spectrum disorder (ASD)
  • Impulse control disorders
  • Schizophrenia and psychotic disorders
  • Hoarding disorder
  • Body dysmorphic disorder (BDD)
  • Body-focused repetitive disorders (BFRD)
  • Olfactory reference syndrome (ORS)
  • Emetophobia
  • Misophonia
  • Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS)

Do I have OCD? What Are OCD Symptoms?

For someone to get an OCD diagnosis, they must have obsessions, compulsions, or both. Obsessions are persistent thoughts, ideas, impulses, or mental pictures that feel entirely outside a person's control. They aren't general worries about daily life and often seem absurd, repulsive, excessive, and senseless, and they're intrusive and unpleasant to the person with the condition. 11 Trying to suppress or ignore the obsessions tends to make them stronger, making the feeling of relief upon acting out a compulsion stronger.

Examples of obsessive symptoms of OCD include:

  • Fear of harming others or themselves on purpose
  • Fear of hurting others or themselves by mistake
  • Fear of contamination from unsanitary surfaces
  • Religious, superstitious, or moral obsessions
  • Obsession with symmetry and exactness

Compulsions are behaviors performed according to rigid rules that feel purposeful to the person with OCD. They revolve around trying to resolve or prevent the subject of the obsession but aren't typically logically connected to it—or are excessive.

For example, someone with OCD may believe they or people they love will die if they don't perform a compulsive ritual or behavior, such as:

  • Checking whether lights are off, gas is shut off, or doors are locked
  • Hand-washing and cleaning
  • Thinking neutralizing thoughts to counteract obsessive thoughts
  • Arranging and ordering
  • Hoarding
  • Seeking reassurance

Some lesser-known signs of OCD include obsessions with figuring things out, rereading obsessions, rewriting compulsions, obsessive slowness, confessing, and policing others.

How to Treat OCD

Obsessive-compulsive disorder can significantly impair an individual's quality of life, so it's advised to seek treatment as soon as symptoms arise. Psychotherapy and medication are the preferred treatment methods for OCD, although practitioners may recommend transcranial magnetic stimulation (TMS) for those who don't respond to them. 12

What Medications Treat OCD?

A mental health professional would usually recommend a combination of talk therapy and medication as OCD treatment. Selective serotonin reuptake inhibitors (SSRIs) in higher doses than a doctor would prescribe for anxiety or depression, and other serotonergic antidepressants, are FDA-approved for this purpose. OCD medications include: 13

  • Clomipramine
  • Fluvoxamine
  • Lexapro
  • Celexa
  • Sertraline
  • Paroxetine

How to Treat OCD Thoughts

While there are several ways to help treat symptoms of OCD, a specially adapted form of cognitive behavioral therapy (CBT) is the go-to treatment for OCD, although there are other modalities available. 14

CBT with exposure and response prevention (ERP) gradually exposes patients to their obsessions without letting them resort to compulsions. This process always takes place at the patient's rate, and the therapist should never rush them. The cognitive therapy element helps the patient put space between emotion and action, recognize triggers, and find new ways to respond.

About Obsessive Compulsive Disorder Treatment

While medication can regulate brain circuits involved in triggering OCD thoughts and actions, talk therapy can be just as effective. Medication is usually the first-line approach, with therapy offered if the individual requires further support to relieve their symptoms. It's important to note that there isn't a cure for OCD, but it's possible to drastically reduce the distress it causes and improve quality of life.

An individual with OCD would typically attend therapy at least once per week or more often in extreme cases. 15 The duration of treatment depends on individual circumstances, but it usually takes at least 6 months of therapy or 3 months of medication for symptoms to ease. 16 If you need help finding treatment for OCD, there are several helpful options available.

How to Help a Loved One Diagnosed With OCD

One of the best ways to help someone with OCD is to make it clear that unconditional support is available. Seeing someone continually behave in a way that causes them distress can be frustrating. However, it's important to remember that they likely already feel intense shame and embarrassment, and telling them to stop won't help.

Instead, encourage them to open up and talk about their experiences, and show understanding and compassion when they do. Keep the following in mind:

  • Patience is crucial.
  • Not judging can help them feel less ashamed about sharing their thoughts and feelings.
  • Learning about OCD helps with understanding their behavior and separating the person from the disorder.
  • Getting treatment for any emotional issues can keep the relationship healthy.

Seeking professional help is the key to overcoming OCD, which can be a debilitating illness if left untreated.

Sources

  1. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd
  2. https://medlineplus.gov/genetics/condition/obsessive-compulsive-disorder
  3. https://medlineplus.gov/obsessivecompulsivedisorder.html
  4. https://www.nimh.nih.gov/health/publications/obsessive-compulsive-disorder-when-unwanted-thoughts-take-over
  5. https://medicine.yale.edu/psychiatry/ocd/aboutocd/faqs
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5353106
  7. https://www.mirecc.va.gov/visn22/Obsessive_Compulsive_Disorder.asp
  8. https://med.stanford.edu/ocd/about/understanding.html
  9. https://www.psychiatrictimes.com/view/exploring-neurobiology-ocd-clinical-implications
  10. https://iocdf.org/about-ocd/related-disorders
  11. https://med.stanford.edu/ocd/about/symptoms.html
  12. https://my.clevelandclinic.org/health/diseases/9490-ocd-obsessive-compulsive-disorder
  13. https://iocdf.org/about-ocd/ocd-treatment/meds
  14. https://iocdf.org/about-ocd/ocd-treatment/
  15. https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd/treatments-for-ocd
  16. https://beyondocd.org/expert-perspectives/articles/ten-things-you-need-to-know-to-overcome-ocd