Obsessive-Compulsive Disorder
What is Obsessive-Compulsive Disorder?
Obsessive-compulsive disorder (OCD), one of the anxiety disorders, is a potentially disabling condition that can persist throughout a person’s life. The individual who suffers from OCD becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to overcome. OCD occurs in a spectrum from mild to severe; if severe and untreated, it can destroy a person’s capacity to function at work, school, or even home.
How common is Obsessive-Compulsive Disorder?
For many years, mental health professionals thought of OCD as a rare disease, because only a minority of their patients had the condition. The disorder often went unrecognized because many of those afflicted with OCD, in efforts to keep their repetitive thoughts and behaviors secret, failed to seek treatment. However, a survey conducted in the early 1980s by the National Institute of Mental Health showed that OCD affects more than 2% of the population, making it more common than such severe mental illnesses as schizophrenia, bipolar disorder, or panic disorder. OCD strikes people of all ethnic groups. Men and women are equally affected.
Key Features of Obsessive-Compulsive Disorder
Obsessions
Obsessions are unwanted ideas or impulses that repeatedly well up in the mind of the person with OCD. Common are persistent fears that harm may come to self or a loved one, an unreasonable concern with becoming contaminated, or an excessive need to do things correctly or perfectly. Again and again, the individual experiences a disturbing thought, such as, “My hands may be contaminated–I must wash them,” “I may have left the gas on,” or “I am going to injure my child.” These thoughts are intrusive, unpleasant, and produce a high degree of anxiety. Sometimes, the obsessions are of a violent or a sexual nature, or they concern illness.
Compulsions
In response to their obsessions, most people with OCD resort to repetitive behaviors called compulsions. The most common of these are washing and checking. Other compulsive behaviors include counting (often while performing another compulsive action such as hand-washing), repeating, hoarding, and endlessly rearranging objects in an effort to keep them in precise alignment. Mental problems, such as mentally repeating phrases, making lists, or checking, are also common. These behaviors generally are intended to ward off harm to self or others. Some people with OCD have regimented rituals; others have rituals that are complex and changing. Performing rituals may give the person with OCD some relief from anxiety, but it is only temporary.
How is Obsessive-Compulsive Disorder treated?
OCD is treated with either psychotherapy (counseling) or medications, or with both treatments combined.
Psychotherapy
The most effective psychotherapy for OCD is cognitive-behavioral therapy. In this technique, your therapist will have you practice exposing yourself to those situations that make you anxious and cause you to act out a compulsion (such as checking or washing). Your therapist will help you to prevent the OCD response. Some of the exposure is done in the therapist’s office, but most of it is done at home and is assigned as “homework.” Cognitive-behavioral therapy is very effective, especially for those patients who suffer primarily from compulsions. In such patients, therapy is often more effective than medication.
Medications
Many effective medications for OCD exist. The most commonly prescribed are the SSRIs, which have names like Prozac, Zoloft, Paxil, and Luvox. These are popular because they have very few side effects when compared with older medications. Another effective medication is Anafranil, which tends to have more side effects than the SSRIs. When someone begins taking an OCD medication, improvement generally will not begin to show up immediately. With most of these medications, it takes from 1 to 3 weeks before changes begin to occur. If there is little or no change in symptoms after 5-6 weeks, a different medication may be tried. Because there is no way of determining beforehand which medication will be effective, the doctor may have to prescribe first one, then another, until an effective medication is found. Treatment is continued for a minimum of several months and may last up to a year or more.
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Funders
La Concordia Wellness Center is a 501(c)(3) nonprofit organization. Tax ID# 88-3030525. No goods or services are provided in exchange for these contributions, and all donations made to La Concordia Wellness Center are tax deductible.
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