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Obsessive Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD) is recognized by symptoms of uncontrollable obsession and/or compulsion. These thoughts or impulses recur often, intruding on other thoughts and activities and they can cause inappropriate or uncontrolled behavior. Because the patient is aware that their behavior is extreme or irrational, this condition often results in significant anxiety for the person suffering from the disorder. Medical research indicates that this condition does have a slight risk of hereditary and that the onset of OCD in childhood can run in families.

The obsessive and term ‘Obsessive-Compulsive’ refers to the two to components of this disorder. The disturbing thoughts and images that characterize the disorder are the ‘obsessions’; the rituals in which the patient engages in an effort to get rid of the obsessive thought or image are the ‘compulsions’. It is important to note that the patient feels no pleasure in carrying out the rituals, and only experiences temporary relief from the anxiety that occurs when the rituals are not performed. Most of us have had the experience of feeling we have to check the stove or the iron, several times before we leave the house. But for those with OCD, these activities take up at least an hour a day, and they are very upsetting, because they interfere with a person’s ability to live a normal life. OCD can cause people to avoid situations where they might have to confront their obsessions, or it may cause the patient to use alcohol or drugs to try to calm their symptoms. If the symptoms are severe, OCD can interfere with normal function at work and at home. Adult patients with OCD often suffer from depression as well, while children and adolescents with OCD may exhibit disruptive behavior, and suffer from learning disorders or have problems concentrating on schoolwork.

What are the symptoms?

The two components of this disorder (obsession and compulsion) exhibit different symptoms. Typically, the obsession results in a ritual performed by the patient to temporarily relieve the symptoms of the obsessive thought. Symptoms include:

Obsessive Thoughts

• Obsessed with germs or imagined dirt
• Obsessively thinking about possible harm or violence to others or to you
• Obsessive thought about distasteful sexual acts or ideas, ‘forbidden’ thoughts
• Unwelcome thoughts that are against religious beliefs or moral values

Compulsive Behaviors and Rituals

• Repeatedly washing hands or other body parts or surfaces
• Repeated checking of door locks, stove knobs and other items to be sure they are secure
• Constantly repeating things
• Constantly counting and/or rearranging things
• Obsessive cleaning and/or reorganization at work or at home
• Praying, counting or repeating words silently
• Hoarding or saving things

These obsessions and compulsions cause significant distress to the person suffering from the disorder, take up more than 1 hr per day and significantly interfere with their normal work, social and life routine.

How is it diagnosed and treated?

OCD is often undiagnosed and, therefore, left untreated. There are a number of reasons this disorder may go unnoticed. First, people who have OCD can be secretive and ashamed about their symptoms and some doctors are not vigilant in looking for the symptoms and making the appropriate diagnosis. But early diagnosis and treatment, including medication, will relieve the anxiety that goes along with OCD, and lessen the risk of developing depression, or the relationship and work-related problems that OCD can cause if it is left untreated. There is no one definitive test for OCD, but doctors will typically start the diagnostic process by looking at family history, current symptoms and recent medical and emotional issues. The clinical guidelines for OCD are relatively straightforward:

• Obsessive thoughts and compulsive behaviors or rituals must consume at least one hour each day
• These thoughts and behaviors must interfere with normal work, life and social routines

Effective treatment modalities are available for OCD. These include:

• Psychotherapy
• Therapy for the patient and family
• Education for family and patients
• Cognitive behavioral therapy lasting 12-20 weeks
• Medications - typically serotonin reuptake inhibitors (SSRIs) like Clomipramine, Fluoxetine, Fluvoxamine, Paroxetine Sertraline, and Citalopram

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