The Basics of OCD

You've probably heard people jokingly proclaim themselves "OCD" as they straighten an askew picture on the wall or wipe their shopping cart handle down with antibacterial wipes, but are they just perfectionists or do they really have OCD? How common is obsessive-compulsive disorder (OCD)? What factors lead to a diagnosis? 

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by two core symptoms—obsessions and compulsions.

Obsessions are thoughts, images, or ideas that won't go away, are unwanted, and cause extreme distress. For example, you might worry constantly about becoming contaminated with a deadly disease; that you will do something terrible, like scream out an obscenity at a funeral; or that something horrible will happen to a loved one.

Other common obsessions include repeated doubts, such as believing you may hit someone with your car; a need for order; aggressive or disturbing ideas such as thoughts of murdering your partner or child; and disturbing sexual and religious imagery.

Compulsions are behaviors that you feel you must carry out over and over. For instance, if you're obsessed with contamination, you might wash your hands over and over again. Other common compulsions include cleaning, counting, checking, requesting or demanding reassurance, and ensuring order and symmetry.

OCD cannot be diagnosed using a blood test, though a blood test may be used to rule out physical problems that could be causing symptoms.OCD is ultimately diagnosed based on the frequency, severity, and nature of symptoms using the clinical judgment of qualified mental health professionals. Obsessions and compulsions are usually continual and long-lasting and may negatively affect relationships, work, school, and other areas of life.

People with OCD may spend an hour or more a day either thinking about their obsession or engaging in behaviors that temporarily relieve the anxiety caused by their obsession, (i.e., scrubbing their hands until they're raw because they feel dirty). However, it is possible to have only the obsessions or only the compulsions and still be diagnosed with OCD. The key component of a diagnosis is that the OCD is interfering with your quality of life.

OCD affects about 1.2% of adults and is sometimes diagnosed in childhood. There is no difference in the rate of OCD among men and women. People of all cultures and ethnicity are affected.

No one knows exactly what causes obsessive-compulsive disorder, though there is evidence of a genetic component. If a parent, sibling, or child is diagnosed with OCD, there is a higher risk of developing the disorder, especially if the relative was diagnosed as a child or teenager.

There is also evidence that certain parts of the brain simply do not function correctly. Research on genetics and brain abnormalities is ongoing. 

OCD is not curable, but it responds to treatment with medication, particularly a class of antidepressants known as selective serotonin reuptake inhibitors (SSRI), as well as psychotherapy.

Exposure therapy may be particularly helpful to people whose OCD significantly impacts their quality of life.

Many people with OCD find that they get the best result by combining medical and psychological treatment.