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Obsessive Compulsive Disorder

This guide serves as a resource for the topic of obsessive compulsive disorder.

Introduction

Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that make them feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing, checking on things or cleaning, can significantly interfere with a person’s daily activities and social interactions.

A diagnosis of OCD requires the presence of obsessions and/or compulsions that are time-consuming (more than one hour a day), cause significant distress, and impair work or social functioning. OCD affects 2-3% of people in the United States, and among adults, slightly more women than men are affected. OCD often begins in childhood, adolescence, or early adulthood; the average age symptoms appear is 19 years old.

American Psychiatric Association

Obsessive compulsive disorder OCD. Torn pieces of paper with the words "bsessive compulsive disorder". Black and white image.

Image Credit: Dreamstine

Obsessive-compulsive disorder usually includes both obsessions and compulsions. But it's also possible to have only obsession symptoms or only compulsion symptoms. You may or may not realize that your obsessions and compulsions are excessive or unreasonable, but they take up a great deal of time and interfere with your daily routine and social, school or work functioning.

Examples of obsession signs and symptoms include:

  • Fear of being contaminated by touching objects others have touched
  • Doubts that you've locked the door or turned off the stove
  • Intense stress when objects aren't orderly or facing a certain way
  • Images of driving your car into a crowd of people
  • Thoughts about shouting obscenities or acting inappropriately in public
  • Unpleasant sexual images

OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors or mental acts are meant to reduce anxiety related to your obsessions or prevent something bad from happening. However, engaging in the compulsions brings no pleasure and may offer only a temporary relief from anxiety.

You may make up rules or rituals to follow that help control your anxiety when you're having obsessive thoughts. These compulsions are excessive and often are not realistically related to the problem they're intended to fix.

Examples of compulsion signs and symptoms include:

  • Hand-washing until your skin becomes raw
  • Checking doors repeatedly to make sure they're locked
  • Checking the stove repeatedly to make sure it's off
  • Counting in certain patterns
  • Silently repeating a prayer, word or phrase
  • Arranging your canned goods to face the same way

Mayo Clinic

Causes of Obsessive Compulsive Disorder:

The causes of OCD are not fully understood There are several theories about the causes of OCD, including:

  • Compulsions are learned behaviors, which become repetitive and habitual when they are associated with relief from anxiety. 
  • OCD is due to genetic and hereditary factors. 
  • Chemical, structural and functional abnormalities in the brain are the cause.
  • Distorted beliefs reinforce and maintain symptoms associated with OCD.

It is possible that several factors interact to trigger the development of OCD. The underlying causes may be further influenced by stressful life events, hormonal changes and personality traits.

Better Health Channel

Risk Factors

Factors that may increase the risk of developing or triggering obsessive-compulsive disorder include:

  • Family history. Having parents or other family members with the disorder can increase your risk of developing OCD.
  • Stressful life events. If you've experienced traumatic or stressful events, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD.
  • Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.

Mayo Clinic

 

Treatments for OCD:

The most effective treatments for OCD are Cognitive Behavior Therapy (CBT) and/or medication. More specifically, the most effective treatments are a type of CBT called Exposure and Response Prevention (ERP) which has the strongest evidence supporting its use in the treatment of OCD, and/or a class of medications called serotonin reuptake inhibitors, or SRIs.

Exposure and Response Prevention is typically done by a licensed mental health professional (such as a psychologist, social worker, or mental health counselor) in an outpatient setting. This means you visit your therapist’s office at a set appointment time once or a few times a week.  

Taken together, ERP and medication are considered the “first-line” treatments for OCD. About 70% of people will benefit from ERP and/or medication for their OCD.

Medications can only be prescribed by a licensed medical professionals (such as your physician or a psychiatrist), who would ideally work together with your therapist to develop a treatment plan.

If you or a loved one has tried traditional outpatient therapy and would like to try a more intensive level of care, there are options. The following lists therapy options from least intensive to most intensive:

  • Traditional Outpatient – Patients see a therapist for individual sessions as often as recommended by their therapist generally one or two times a week for 45-50 minutes. (Most Therapists in the Resource Directory as well as “Specialty Outpatient Clinics” offer this type of treatment).
  • Intensive Outpatient – Patients may attend groups and one individual session per day several days per week. Clinics designated as “Intensive Treatment Programs” in the Resource Directory offer this level of treatment.
  • Day Program – Patients attend treatment during the day (typically group and individual therapy) at a mental health treatment center usually from 9am – 5pm up to five days a week. Many clinics designated as “Intensive Treatment Programs” in the Resource Directory offer this level of treatment.
  • Partial Hospitalization – Same as the Day Program but patients attend the treatment at a mental health hospital. Several clinics designated as “Intensive Treatment Programs” in the Resource Directory offer this level of treatment.
  • Residential – Patients are treated while living voluntarily in an unlocked mental health treatment center or hospital. Clinics designated as “Residential” in the Resource Directory offer this level of treatment.
  • Inpatient – This is the highest level of care for a mental health condition. Treatment is provided on a locked unit in a mental health hospital on a voluntary or sometimes involuntary basis. Patients are admitted into this level of care if they are unable to care for themselves or are a danger to themselves or others. The goals of inpatient treatment are to stabilize the patient, which generally takes several days to a week, and then transition the patient to a lower level of care.

OCD treatment can be difficult, and requires a lot of courage and determination. Having a support network to talk to during treatment can make all the difference.  Consider accessing a support group in your area.

International OCD Foundation

 

 

 

There are many ways that you can manage OCD and help yourself in addition to seeking therapy. Some suggestions are:

  • Refocus your attention (like doing some exercise or playing a computer game). Being able to delay the urge to perform a compulsive behavior is a positive step.
  • Write down obsessive thoughts or worries. This can help identify how repetitive your obsessions are. 
  • Anticipate urges to help ease them. For instance, if you compulsively check that the doors are locked, try and lock the door with extra attention the first time. When the urge to check arises later, it will be easier to re-label that urge as ‘just an obsessive thought’.
  • Set aside time for a daily worry period. Instead of trying to suppress obsessions or compulsions, set aside a period for obsessing, leaving the rest of the day free of obsessions and compulsions. When thoughts or urges appear in your head during the day, write them down and postpone them to your worry period – save them for later and continue to go about your day.
  • Take care of yourself. Although stress doesn’t cause OCD, it can trigger the onset of obsessive and compulsive behavior or make it worse. Try to practice relaxation (such as mindfulness meditation or deep breathing) techniques for at least 30 minutes a day.

Better Health Channel

The Technology Related Assistance to Individuals with Disabilities Act of 1988 described an assistive technology device as "any item, piece of equipment, or product system, whether acquired commercially off the shelf, modified, or customized, that is used to increase, maintain, or improve functional capabilities of individuals with disabilities."

Due to obsessions and compulsions, people who have obsessive compulsive disorder may have trouble concentrating. In classrooms and meetings, this may cause those with OCD to not follow what is being said or not be able to take accurate notes. A recording device can allow a person with OCD to go over recorded moments with less pressure and more control.

Many smartphones have recording capabilities, but often the sound recordings are not high quality. There are a number of portable digital voice recorders on the market that can be used for this purpose.

Mobile Applications:

Illinois University Library LibGuide on OCD

 

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Databases

eBooks + books

Discover eBook collections or find print books/materials through the catalog for each campus:

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Suggested Websites

American Psychological Association

The leading scientific and professional organization representing psychology in the United States, with more than 122,000 researchers, educators, clinicians, consultants and students as its members.

Beyond OCD: Just for Teens

We aim to connect people dealing with OCD and anxiety with the resources and information they need to thrive.

International OCD Foundation

Helps those affected by obsessive compulsive disorder (OCD) and related disorders to live full and productive lives.

Medline Plus

Presents high-quality, relevant health and wellness information that is trusted, easy to understand, and free of advertising.

Mental Health America

The nation's leading community-based nonprofit dedicated to addressing the needs of those living with mental illness and to promoting the overall mental health of all.

National Alliance on Mental Illness

Dedicated to building better lives for the millions of Americans affected by mental illness.

National Institute of Mental Health

Transforms the understanding and treatment of mental illnesses through basic and clinical research, paving the way for prevention, recovery, and cure.

PsychCentral

An independent mental health information and news website.

Videos

In the video, I talk about my life with obsessive-compulsive disorder and a bit about how I came to write my forthcoming book, Turtles All the Way Down. Regardless of where you live, if you are concerned about your mental health, please ask your doctor or someone you trust to help you find treatment options. There is hope.

There’s a common misconception that if you like to meticulously organize your things, keep your hands clean, or plan out your weekend to the last detail, you might be OCD. In fact, OCD (Obsessive Compulsive Disorder) is a serious psychiatric condition that is frequently misunderstood by society and mental health professionals alike. Natascha M. Santos debunks the myths surrounding OCD.