Obsessive-compulsive disorder (OCD), one of the anxiety disorders, is a potentially disabling illness that traps people in endless cycles of repetitive thoughts and behaviors. People with OCD are plagued by recurring and distressing thoughts, fears, or images (obsessions) they cannot control. The anxiety (nervousness) produced by these thoughts leads to an urgent need to perform certain repetitive behaviors, rituals, or routines (compulsions). The compulsions are performed in an attempt to prevent the obsessive thoughts or make them go away; not performing the rituals increases the anxiety.
Performing the compulsions may lessen or relieve the anxiety temporarily; however, the person is “compelled” to perform the behaviors again when the obsessions return. This OCD cycle may progress to the point of taking up hours of the person’s day and significantly interfering with normal activities. People with OCD are often aware that their obsessions and compulsions are senseless or unrealistic, but they cannot stop themselves.
OCD afflicts about 2.2 million adults in the United States. The disorder usually first appears in childhood, adolescence or early adulthood. It occurs about equally in men and women, and affects people of all races and socioeconomic backgrounds.
Although the exact cause of OCD is not fully understood, studies have shown that a combination of biological and environmental factors may be involved.
The brain is a very complex structure. It contains billions of nerve cells — called neurons — that must communicate and work together for the body to function normally. The neurons communicate via electrical signals. Special chemicals, called neurotransmitters, help move these electrical messages from neuron to neuron. Research has found that patients with OCD have over activity in specific portions of their brain circuits. These circuits become even more active when the patient is experiencing their OCD symptoms. Effective treatment with either medication or behavior therapy can normalize this over activity.
People with a tendency toward developing OCD may be impacted by environmental stressors. Certain environmental factors also might cause a worsening of symptoms. These factors include:
The symptoms of OCD may vary. Common obsessions include:
Common compulsions include:
There is no laboratory test for OCD. The provider bases the diagnosis on an assessment of the patient’s symptoms, and the impact on the patient’s overall functioning. Diagnostic and Statistical Manual of Mental Disorders, 5th Edition (DSM-V) is used as a guideline. DSM-V, compiled by the American Psychiatric Association, is the standard reference manual for the diagnosis of recognized mental illnesses in the United States.
OCD will not go away by itself, so it is important to seek treatment. The person might be referred to a healthcare professional who is specially trained to diagnose and treat mental illnesses.
The most effective approach to treating OCD combines medications with cognitive-behavior therapy.
In severe cases of OCD and in people who do not respond to treatment, (ECT) or surgery might be used to treat OCD. During ECT, electrodes are attached to the patient’s head, and a series of electric shocks are delivered to the brain, which induce seizures. The seizures cause the release of neurotransmitters in the brain.
OCD cannot be prevented. However, early diagnosis and treatment can help reduce the time a person spends battling this disorder.
In most cases, OCD can be successfully treated with medication, CBT or both. With ongoing treatment, most people can achieve long-term relief from symptoms and return to normal or near-normal functioning.
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This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or healthcare provider. Please consult your healthcare provider for advice about a specific medical condition. This document was last reviewed on: 06/02/2014