Disorders

Obsessive-Compulsive Disorder

Obsessive-compulsive disorder, or OCD, involves fretful thoughts or rituals one feels cannot be controlled. A person with OCD may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals. Someone with OCD may:

• be obsessed with germs or dirt, will wash his or her hands repeatedly.
• be racked with doubt and feel the need to check things repeatedly
• have frequent thoughts of violence, and fear bringing harm to loved ones
• spend long periods touching things or counting
• be pre-occupied by order or symmetry
• have persistent thoughts of performing sexual acts that are repugnant or
• be troubled by thoughts that are against one's religious beliefs.

The disturbing thoughts or images are called obsessions, and the rituals performed to try to prevent or get rid of them are called compulsions. For people with OCD, there is no pleasure in carrying out the rituals, only temporary relief from the anxiety that occurs when the rituals are not performed.

Healthy people can identify with some OCD symptoms, such as checking a stove several times before leaving a home. But for people with OCD, such activities consume at least an hour a day, are very distressing, and interfere with daily life.

Most adults with this condition realize what they're doing is senseless, but cannot stop. Some people, though, particularly children with OCD, may not realize that their behavior is out of the ordinary.

OCD afflicts about 2.2 million or 1 percent of adult Americans, striking men and women in approximately equal numbers. The condition usually first appears in childhood, adolescence, or early adulthood. One-third of adults with OCD report having experienced their first symptoms as children. Disease course is variable—symptoms may come and go, they may ease over time, or they can grow progressively worse. Research evidence suggests that OCD might run in families.

Depression or other anxiety disorders may accompany OCD, and some people with OCD also have eating disorders. In addition, people with OCD 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.

OCD generally responds well to treatment with medications or carefully targeted psychotherapy.