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What is OCD?

OCD stands for Obsessive-Compulsive Disorder.  It is a common, chronic and long-lasting disorder involving a person having uncontrollable, reoccurring thoughts and behaviors.

About 3.3 million adults and about 1 million children and adolescents in the US have it.

And, there is no lab test to diagnose it.  Therefore, the doctor assesses the symptoms for a diagnosis.

Signs and Symptoms of OCD

Those who have OCD may have symptoms of obsessions, compulsions, or both.

Obsessions are anxiety causing repeated thoughts, urges, or mental images.

Common symptoms of obsession include:

• Germs or Contamination fear.
• Thoughts involving Sex, Religion, or Harm.
• Aggressive thoughts about self or others.
• Seeing things in perfect order.
• Making a mistake fear.
• Being embarrassed fear.
• Behaving in a socially unacceptable manner fear.
• Thinking evil fear.
• Sinful thoughts fear.
• Excessive doubt and need for constant reassurance.

Compulsions are repetitive behaviors done in response to obsessive thoughts.

Common symptoms of compulsions include:

• Excessive cleaning and/or handwashing.
• Arranging things in a particular order.
• Repeatedly checking on things.
• Counting.
• Refusing to shake hands or touch doorknobs.
• Eating foods in a specific order.
• Being stuck on words, images or thoughts that won’t go away.
• Collecting or hoarding items with no value.

Not all habits are compulsions.  Besides, many people double check things from time to time.

Specifically, someone with OCD:

• Is unable to control their thoughts or behaviors.
• May spend at least 1 hour performing these compulsions.
• Sometimes feel brief relief from the anxiety the thoughts cause.
• Has significant problems in their daily life.

Moreover, some people with OCD also have a Tic Disorder.

Motor Tics are sudden, brief, repetitive movements which include:

• Eye blinking.
• Facial grimacing.
• Shoulder shrugging.
• Head jerking.
• Shoulder jerking.

And Vocal Tics include:

• Repetitive throat-clearing.
• Sniffing.
• Grunting sounds.

Sometimes these symptoms happen again, ease over time, or worsen.  And, some avoid things causing their obsessions.  While others calm themselves with Alcohol or Drugs.

Frequently, people with OCD recognize their behaviors.  However, they don’t realize the severity level.  While others recognize these symptoms especially in children.

If left untreated, it interferes with day-to-day life.  Therefore, it is best to talk to a doctor about symptoms.

Risk Factors

Genetics

Studies show people with first-degree relatives (parent, sibling, or child) with OCD have a higher risk for developing it.  Also, risk increases if developed as a child or a teen.

Brain Structure and Functioning

Differences in the Frontal Cortex and the Subcortical structures of the brain of patients with OCD were studied. Furthermore, Imaging studies revealed an unclear connection between symptoms and abnormalities in the brain. As a result, research continues.

Environment

Those who experienced physical or sexual abuse in childhood or other trauma have a higher chance of OCD development.

Even more, these factors worsen symptoms:

• Changes in living situation.
• Death of a loved one.
• Illness.
• Work or school-related changes or problems.
• Relationship concerns

Some children may develop or have the symptoms after a Streptococcal Infection.  This is called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).

Treatments and Therapies

Treatment involves medication, psychotherapy, or both.  While most respond to treatment, others continue having symptoms.

Additionally, some may have other mental disorders which include Anxiety, Depression, and Body Dysmorphic Disorder.  Body Dysmorphic Disorder is a disorder in which someone believes something is wrong with a body part.

Therefore, these mental disorders and others must be considered in treatment decision-making.

Medications

Serotonin reuptake inhibitors (SRIs) and Selective serotonin reuptake inhibitors (SSRIs) are antidepressants used in reducing symptoms.

Also, the following medications have worked:

• Clomipramine (a member of “tricyclic” antidepressants)
• Fluoxetine
• Fluvoxamine
• Sertraline
• Luvox
• Prozac
• Zoloft
• Anafranil (a member of “tricyclic” antidepressants)
• Abilify (an atypical antipsychotic)
• Risperidone (an Antipsychotic medication)

Additionally, higher doses of SRIs are needed to treat OCD than of depression.  Sometimes it takes 8 to 12 weeks to start working.

When prescribed a medication, it is important to:

• Talk to your doctor and understand the risks and benefits of the medication.
• Not stop taking a medication without doctor’s approval.
• Report concerns about side effects to your doctor.
• Report serious side effects to the US Food and Drug Administration (FDA) Med/Watch Adverse Event Reporting program.

For information on other medications used in treatment, visit the National Institute of Mental Health (NIMH) Mental Health Medications webpage.

Also, visit the FDA website for the most up-to-date medical information.

Psychotherapy

Research shows that psychotherapy can work as well medication for many with OCD.

These include:

• Cognitive Behavior Therapy (CBT).
• Habit reversal training.
• Exposure and Response Prevention (EX/RP), a type of CBT.

Cognitive behavioral therapy teaches people to confront their fears and reduce anxiety without performing ritual behaviors.  Also called exposure therapy or exposure-response prevention therapy.

Other Treatments

Electroconvulsive therapy (ECT) is used in severe cases.  A small current passes through electrodes placed on the scalp on a sleeping patient under general anesthesia.  As a result, a brief seizure occurs.

New approaches, supported by NIMH, to treat those still having symptoms include:

• Augmentation treatments.
• Deep brain stimulation (DBS).

DBS involves implanting small electrodes into brain areas that are part of the brain circuitry associated with the symptoms.

You can get more information on mental health and locate treatment service in your area, by calling the Substance Abuse and Mental Health Services Administration (SAMHSA) Treatment Referral Helpline at 1-800-662-HELP (4357) or going to their website.

Studies

Research studies called Clinical Trials look for new ways to prevent, detect, or treat diseases and conditions.  During these clinical trials, new drugs, new ways to use existing treatments, surgical procedures or devices are tested.  Possibly resulting in a safe new treatment.

In fact, the primary purpose of a clinical trial is gaining new scientific knowledge to better help others in the future.

So that a proper decision is made, it is best to discuss interest in a clinical trial with a licensed health professional.

To find a clinical trial near you visit ClinicalTrials.gov.

In Conclusion

OCD can be successfully treated with medication, cognitive behavioral therapy, or both.  However, it cannot be prevented.  Furthermore, early diagnosis and treatment reduce the suffering time.