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What is OCD?

Obsessive-compulsive disorder, frequently abbreviated as OCD, is a mental disorder involving recurrent obsessions that drive certain compulsions. Obsessions can include intrusive thoughts or sensations, while compulsions can manifest as repetitive behaviors, although each individual will display slightly different symptoms.

It’s important to note that even those without OCD may display negative thoughts or repetitive behaviors. But for those with OCD, thoughts and behaviors are consistent and interfere with a person’s daily life. That’s why it’s essential to seek treatment if you are in the 2-3% of the adult population that suffers from OCD.

Is OCD related to other conditions (anxiety, Tourette’s, bipolar, etc.)?

The only condition experts believe relates closely to OCD is body dysmorphic disorder. All other related conditions, such as Tourette’s Syndrome and trichotillomania, are considered separate conditions. However, many people with OCD are comorbid with these and other ailments, meaning they are diagnosed with OCD as well as one or more conditions. In fact, over 90% of US adults with diagnosed OCD live with at least one other comorbid condition.

Causes

Who is at risk for OCD?

OCD symptoms usually begin to show in childhood, the teenage years, or early adulthood. The average age for diagnosis is around 19, but diagnoses into adulthood are not unheard of. Generally, the onset occurs earlier in boys than in girls. However, women are slightly more at risk than men.

Why does OCD develop?

While the precise causes of OCD remain unknown, risk factors include:

Genetics: If you have a first-degree relative who has developed OCD, particularly in childhood, you are more susceptible to developing the condition. Experts are still conducting more research into the genetic linkages of OCD.
Environment: Childhood trauma and other events in early life may make an individual more likely to develop OCD. More research is needed to understand the exact nature of these connections.
Physical brain structure: Researchers have noted differences in the physical brain in those diagnosed with OCD. The frontal cortex and subcortical structures are areas particularly affected.

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Symptoms

What are the types of OCD?

While there are no official subtypes of OCD, many people’s symptoms manifest under four main categories, which are:

Worries about contamination & constant cleaning
Taboo impulses and thoughts
Hoarding or collection
Symmetry, arrangement & ordering

What are the symptoms of OCD?

Because OCD affects both the brain and the body, we’ve divided OCD symptoms into two categories: obsessions and compulsions.

Obsessions

Many people with OCD are aware that their obsessive thoughts or mental images are unreasonable. However, some may not be. The difficulty is that the person’s distress cannot be resolved through traditional paths of logic. Therefore, many people try to distract themselves from their OCD-based obsessions, examples of which may include:

Fear of contamination
Intrusive sounds, words, images, or other artifacts
Intrusive sexual thoughts
Fear of losing important things or people
Concern with order and symmetry

Compulsions

Compulsions arise as a response to obsessions. In an attempt to reduce the stress built up around an obsession, compulsions can serve as a makeshift outlet. They may relate to the obsession itself, or they could be entirely unrelated. If an individual has a severe case of OCD, their rituals may take up a substantially large part of their day, hampering their ability to lead a normal life. Examples of common compulsions include:

Fear of contamination
Intrusive sounds, words, images, or other artifacts
Intrusive sexual thoughts
Fear of losing important things or people
Concern with order and symmetry

How does OCD affect daily life?

OCD affects different individuals in different ways. Some people with OCD may be able to manage their daily lives and routines with little interference. Others may spend hours each day preoccupied with symptoms, and their family, relationships, health, and work-life may suffer.

Research by the World Health Organization has established that about half of all OCD cases are debilitating enough to be classified as severe. This makes it one of the most disabling illnesses in the world, which can cause reduced quality of life, lower financial earnings, and more. Fortunately, with proper diagnosis and treatment, many patients are able to find relief from their worst symptoms.

Diagnosis

How is OCD diagnosed?

A trained therapist or mental health professional can diagnose OCD. Because most people with OCD are comorbid with one or more conditions, diagnosis can sometimes be a challenge. That’s why it’s especially important to see a provider you trust, as OCD is also a disorder whose symptoms overlap with several other illnesses. When you visit a therapist for an OCD evaluation, they’ll be looking for three things to confirm your diagnosis:

Do you experience obsessions?
Do you perform compulsive behavior?
Do these obsessions and compulsions interfere with your daily life and the activities you value?

If your mental health professional finds that the answer to these three questions is a “yes,” they can officially diagnose you with OCD. Once you’ve been diagnosed, you can begin to explore treatment options to ease your symptoms and allow you to resume normal daily functioning.

Treatment

What treatment is available for OCD?

There are a few different treatment options available for OCD. You’ll work with your mental health provider to determine which option(s) work for you, but some of the most common are:

Cognitive-behavioral therapy: Cognitive-behavioral therapy, or CBT, is one of the most effective ways of managing OCD. A particular form of cognitive behavioral therapy known as exposure and response prevention (ERP) may prove especially helpful in some cases. Once you find the right therapist for you, you will meet at agreed-upon intervals to work on improving your OCD symptoms.
Medication: Several common antidepressants are also commonly prescribed for OCD, as they can help reduce obsessions and compulsions. These medications, known as SSRIs, are usually prescribed in higher dosages for those with OCD than for those with depression. In conjunction with therapy, medication may help you resume the activities you love.
Self-care: Fortunately, there are several things you can do from the comfort of your own home to relieve some of the stress surrounding your OCD. A healthy lifestyle with plenty of exercise and a well-balanced diet can help improve your mental state and overall well-being. Practicing relaxation exercises such as mindfulness, meditation, yoga, and massage can all be beneficial in relieving the symptoms of OCD and re-centering your mind.

Can OCD be cured?

With proper treatment, those with OCD may notice an increased level of functioning and higher satisfaction with daily life. By working with a skilled mental health professional, you can drastically decrease your OCD symptoms and resume an enjoyable daily routine.

References

Impact of OCD. OCDUK. https://www.ocduk.org/ocd/impact-of-ocd/

Related Disorders. OCDUK. https://www.ocduk.org/related-disorders/#:~:text=Despite%20a%20number%20of%20conditions,conditions%20in%20their%20own%20right.

U.S. Department of Health and Human Services. Obsessive-Compulsive Disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/

What Is Obsessive-Compulsive Disorder? https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-disorder

Information

Medically reviewed by:

Dr Roy Kedem, MD

Dr Roy Kedem started his premedical studies at Harvard, and research in genetics and gene sequencing at Harvard, Beth Israel. He attended medical school in the UK at the Cambridge Overseas Medical Program in 1998. Dr Kedem then completed his residency in Internal Medicine at Columbia College of Physicians and Surgeons in Stamford, Connecticut and his fellowship in Hospital Medicine at the Cleveland Clinic in Cleveland, Ohio.

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