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Obsessive-Compulsive Disorder (OCD)

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KEY POINTS

  • Obsessive-compulsive disorder (OCD) is a condition in which you constantly think about something (obsessions) that causes anxiety. You may do certain actions over and over (compulsions) to help control the anxiety.
  • Treatment may include exposure and response prevention therapy, medicines, and learning ways to relax.

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What is obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder (OCD) is a condition that affects your thoughts and actions. If you have OCD, you have constant unwanted thoughts about something that causes anxiety. You may do certain actions over and over to help control the anxiety. For example, if you constantly worry about germs or getting sick, you may wash your hands every hour. The constant thoughts are called obsessions. The actions are called compulsions. You may spend hours each day doing certain actions over and over. These are called rituals. You may have only obsessions, only compulsions, or both.

The actions are called compulsions. You may spend hours each day doing certain actions over and over. These are called rituals.

You may always have this condition, but treatment can help you recognize and manage the symptoms. In some people, OCD occurs in episodes, with years free of symptoms before a relapse. Advances in therapy and new medicines are helping many people with OCD.

What is the cause?

The exact cause of this disorder is not known. What is known is that:

  • The brain makes chemicals that affect thoughts, emotions, and actions. Without the right balance of these chemicals, there may be problems with the way you think, feel, or act. People with this disorder may have too little or too much of some of these chemicals.
  • OCD tends to run in families.
  • People with this disorder may have differences in certain parts of their brains. These differences may mean that some parts of the brain are more active or less active than in other people.
  • OCD may develop or get worse after a strep infection.
  • OCD often occurs along with mood disorders such as other anxiety disorders, depression, and bipolar disorder.
  • Children who have been diagnosed with Tourette syndrome are more likely to develop OCD. Children with Tourette syndrome may have repeated, brief movements of the face, hands, or legs that they can’t control. They may also say words or make other sounds that they can’t control.

Males with OCD usually begin having symptoms from 6 to 15 years of age. Females usually first have symptoms in their early 20s.

What are the symptoms?

If you have OCD, you usually know that your obsessions or compulsions interfere with your daily life. You may know that your thoughts and actions are not normal, but it is very hard for you to stop.

Examples of obsessions often seen in OCD include:

  • You may be fearful of germs or disease.
  • You may fear dropping your baby accidentally or starting a fire by leaving the stove on.
  • You may have unwanted thoughts to push a family member down the stairs or do something harmful even though you don’t want to and are alarmed at the thought of such action.
  • You may get very anxious if things are out of place or not in the order that feels right to you.

Examples of OCD compulsions include:

  • Cleaning: Fearing germs, you may shower several times a day or wash your hands until your skin is cracked and painful.
  • Repeating: You may repeat a name or phrase many times. You may repeatedly ask for reassurance that something will or will not happen.
  • Completing: You may do things in an exact order and repeat each step until things are done perfectly.
  • Checking: If you fear harming yourself or others by forgetting to lock the door or unplug the toaster, you will check over and over again to see that it is done.

Along with OCD, you may have other problems such as:

  • General anxiety much of the time
  • Depression
  • Eating disorders
  • Post-traumatic stress disorder
  • Abuse of marijuana, alcohol, or sedatives to try to control your symptoms

OCD symptoms often create problems in relationships and daily living. For example, people with OCD may insist that their laundry be washed multiple times, check their work repeatedly, or get angry if household items are not in order. OCD can make it hard to get to school or work and once there, it can make it hard to concentrate and perform well.

How is it diagnosed?

Your healthcare provider or therapist will ask about your symptoms. He will make sure you do not have a medical illness or drug or alcohol problem that could cause the symptoms.

How is it treated?

Medicines

Several types of medicines can help treat OCD. Your healthcare provider will work with you to select the best medicine. You may need to take more than one type of medicine.

Therapy

Behavior therapy is helpful in treating OCD. The type of behavior therapy most often used to treat OCD is called exposure and response prevention. It consists of having you confront your fears by gradually increasing your exposure to them. If, for example, you wash your hands all the time because you fear being dirty, your healthcare provider may stand at the sink with you and prevent you from washing your hands until the anxiety goes away. This process also involves learning ways to relax, such as breathing exercises. With help from your therapist, you learn to overcome your anxiety.

Other treatments

N-acetylcysteine may be helpful as an add-on treatment for OCD. Claims have been made that certain herbal and dietary products help control OCD symptoms. Supplements are not tested or standardized and may vary in strength and effects. They may have side effects and are not always safe. Talk with your provider before you try herbs or dietary supplements to treat your condition.

Learning ways to relax may help. Yoga and meditation may also be helpful. You may want to talk with your healthcare provider about using these methods along with medicines and psychotherapy.

How can I take care of myself?

  • Get support. Talk with family and friends. Consider joining a support group in your area. Realize you are not alone and that your OCD can be managed. You may be able to face situations that make you anxious if someone you trust is with you. There are millions of people affected by OCD, and there are national groups devoted to helping people with this condition. Remember that over 90% of people with OCD can manage this disorder with proper treatment.
  • Learn to manage stress. Ask for help at home and work when the load is too much to handle. Find ways to relax. For example take up a hobby, listen to music, watch movies, or take walks. Try yoga, meditation, or deep breathing exercises when you feel stressed.
  • Take care of your physical health. Try to get at least 7 to 9 hours of sleep each night. Eat a healthy diet and don't skip meals. Low blood glucose can make you feel more nervous. Limit caffeine. If you smoke, quit. Avoid alcohol and drugs. Exercise according to your healthcare provider's instructions. Regular exercise can help calm you and make it easier for you to deal with stress.
  • Check your medicines. To help prevent problems, tell your healthcare provider and pharmacist about all the medicines, natural remedies, vitamins, and other supplements that you take.
  • Learn about your condition. Knowing how OCD affects you helps you better understand how treatments, medicines, and lifestyle changes can help. Know what symptoms you should call your healthcare provider or therapist about.
  • Contact your healthcare provider or therapist if you have any questions or your symptoms seem to be getting worse.

For more information, contact:

Developed by RelayHealth.
Adult Advisor 2016.4 published by RelayHealth.
Last modified: 2016-03-28
Last reviewed: 2016-02-15
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Copyright © 2016 RelayHealth, a division of McKesson Technologies Inc. All rights reserved.
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