Obsessive Compulsive Disorder
What is an Obsessive Compulsive Disorder?
People with obsessive-compulsive disorder (OCD) suffer intensely from recurrent unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Obsessions might include thoughts about contamination, repeated doubts about whether one did or did not do something (like lock a door or turn off the water,) a need to have things in a particular order, aggressive or horrific impulses, and/or sexual imagery (e.g., a recurrent pornographic image.) Rituals, such as hand-washing, counting, checking or cleaning, are often performed in hope of preventing obsessive thoughts or making them go away. Performing these rituals, however, provides only temporary relief, and not performing them increases anxiety. Left untreated, obsessions and the need to perform rituals can take over a person's life. OCD is often a chronic, relapsing illness.
OCD symptoms cause distress, take up a lot of time (more than an hour a day), or significantly interfere with the person's work, social life or relationships.
What things put a person at higher risk of experiencing an Obsessive Compulsive Disorder?
There is growing evidence that OCD has a biological basis. OCD is no longer attributed to family problems or to attitudes learned in childhood. Instead, the search for causes now focuses on the interaction between biological factors and environmental influences.
Genetics are thought to be very important in OCD. If you, or your parent or sibling, have OCD, there's close to a 25 percent chance that another of your immediate family members will have it.
Research suggests that OCD involves problems in communication between parts of the brain. These problems may be caused by insufficient levels of certain brain chemicals, called neurotransmitters. Drugs that increase the brain concentration of these chemicals often help improve OCD symptoms.
Can Obsessive Compulsive Disorder be treated?
The most common treatment for OCD is a combination of cognitive-behavioral psychotherapy (CBT) and medication.
A type of behavioral therapy known as “exposure and response prevention” (E/RP) is very useful for treating OCD. In this approach, a person is deliberately and voluntarily exposed to whatever triggers the obsessive thoughts (exposure) and is then taught techniques to avoid performing the compulsive rituals (response prevention). The cognitive portion of CBT is often added to E/RP to help challenge the irrational beliefs associated with OCD.
How does Obsessive Compulsive Disorder progress?
Obsessive Compulsive Disorder usually begins in adolescence or earl adulthood, although it may begin in childhood, with an earlier onset for males than females. Onset is gradual but acute onset has been noted. A majority of individuals have a chronic waxing and waning course, with exacerbation of symptoms that may be related to stress. About 15% of OCD patients show progressive deterioration in school, occupational, and/or social functioning.
Do people with Obsessive Compulsive Disorder get better?
OCD is a long-term (chronic) illness with periods of severe symptoms followed by times of improvement. However, a completely symptom-free period is unusual. Most people improve with treatment.
Response to treatment varies from person to person. Several studies suggest that medication and behavior therapy are equally effective in alleviating symptoms of OCD. Furthermore, the combination of medications and therapy has been found in many cases to be superior to either treatment on its own.
A small percentage of people with OCD find that neither medication nor behavioral treatment produces any significant change. Most people who receive effective treatments find their symptoms reduced by about 40 percent to 50 percent. That can often be enough to change their lives, to transform them into individuals who can go back to school, work and their families. Another percentage of people are fortunate to have a complete remission of their symptoms when treated with effective medication and/or behavior therapy.
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