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Obsessive Compulsive Disorder (OCD)

Approximately five million people in the U.S. suffer from obsessive compulsive disorder (OCD). OCD affects equal numbers of men and women, most commonly in their 20s or 30s, although it can affect people at any age.

OCD is a disorder characterized by anxiety-provoking, repetitive, intrusive thoughts (obsessions) and/or behaviors that are performed over and over without the individual's control (compulsions). OCD often goes unrecognized and untreated because individuals with the disorder hide their symptoms and are embarrassed about their obsessive thoughts and compulsive behaviors. The OCD Treatment Program at Cleveland Clinic offers support to individuals struggling with the symptoms of OCD.

Obsessions

Obsessions are unwanted, recurrent thoughts that won't leave an individual's mind. Such thoughts can be frightening, disgusting, trivial or painful. Most people with obsessive thoughts recognize that their obsessions don't make sense, but are unable to ignore or stop the thoughts. Obsessions may occur periodically, or, more typically, may be almost constant. Some common obsessions include:

  • Fear of getting dirty or contaminated by things or people
  • Disgust over body wastes or secretions
  • Extreme concern with order, symmetry or exactness
  • Fear of thinking evil or sinful thoughts
  • Fear of making a mistake
  • Recurring thoughts about hurting or killing others or oneself
  • Fear that some disaster will occur
  • Fear of causing harm to another
  • Recurring thoughts or images of a sexual nature
  • Fear of committing a crime, such as a theft
  • Concern that a task has been done poorly or incorrectly, even when the person knows this is not the case
  • Fear of losing important things that will be needed later
  • Extreme concern with certain sounds, images, words or numbers

Obsessive thoughts can cause extreme anxiety. Feelings of dread and upset can build to an unbearable level. In fact, OCD is considered an anxiety disorder.

Compulsions

To relieve the anxiety associated with obsessive thoughts, some people with OCD feel compelled to do something to avoid a dreaded event or prevent or undo harm to themselves or others. Compulsions are repetitive impulses to perform a specific activity or ritual in a particular way to decrease anxiety. These activities or rituals are usually repeated over and over again and often take more and more time, interfering with daily activities.

  • Cleaning and grooming behaviors such as hand washing, showering or brushing one’s teeth in a particular way
  • Touching certain objects in a particular way
  • Cleaning items in the house repeatedly
  • Arranging or organizing things in particular way
  • Checking locks, electrical outlets, stoves, light switched repeatedly
  • Counting over and over to a certain number
  • Hoarding items such as old newspapers, mail or containers

These and other similar rituals have to be performed by certain rules, and may be very simple or very complex. Rituals do reduce anxiety, discomfort or feelings of disgust, but only briefly. The tension and anxiety return, causing the individual to start his/her rituals all over again. At times, family members are included in these rituals. This interferes with family functioning and can be highly disruptive to the well-being of family members.

How We Can Help

The OCD Treatment Program provides a multi-disciplinary team approach to the evaluation and treatment of obsessive compulsive disorder. Together, the patient, his/her family and the Clinic's treatment team can make a difference. The first step to successful recovery begins with a comprehensive assessment of the patient's condition. The program psychiatrist gathers information about the patient's symptoms and medical history.

Treatment

OCD is thought to have both behavioral and biochemical features. Our treatment approach emphasizes both the behavior and body chemistry of OCD patients. Behavioral therapy teaches patients ways to reduce anxiety from their obsessions and reduce or eliminate rituals.

Drug therapy can also be helpful in reducing OCD symptoms when used in conjunction with behavioral therapy. Drug therapy is designed to correct what is thought to be an imbalance of serotonin, a chemical in the brain. Medication alters the body's serotonin level.While medication is an essential part of treatment, the combination of behavioral therapy and medication is the most effective method of reducing symptoms. In patients treated with this combination therapy approach, symptoms are often reduced within three months.

About the OCD Treatment Team

Our multidisciplinary team of specialists is committed to providing comprehensive care in a compassionate setting. The OCD Treatment Team includes psychiatrists and psychologists who address the complex needs of those struggling with OCD in a supportive and structured way. Such an approach can help OCD patients reclaim their lives.

For more information

Our multidisciplinary team of specialists is committed to providing comprehensive care in a compassionate setting. The OCD Treatment Team includes psychiatrists and psychologists who address the complex needs of those struggling with OCD in a supportive and structured way. Such an approach can help OCD patients reclaim their lives.

In addition, financial counselors are available to help with questions about insurance coverage. Many health benefit plans will cover the cost of an evaluation and treatment for OCD. We'd be happy to help you assess your coverage.