Obsessive-Compulsive Disorder (OCD): Symptoms, Behavior, and Treatment

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Obsessive-Compulsive Disorder (OCD)

SYMPTOMS AND TREATMENT OF COMPULSIVE BEHAVIOR AND OBSESSIVE THOUGHTS
Its normal, on occasion, to go back and double-check that the iron is unplugged or your car is locked. But in obsessive-compulsive disorder (OCD), obsessive thoughts and compulsive behaviors become so excessive that they interfere with daily life. And no matter what you do, you cant seem to shake them. If you or someone you love has obsessive-compulsive disorder, you may feel isolated and helpless, but there is help available. Many treatments and self-help strategies can reduce the symptoms of OCD.
IN THIS ARTICLE: What is OCD? Obsessions and compulsions Signs and symptoms Therapy Other treatments Self-help Helping a loved one Related links

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What is obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational but even so, you feel unable to resist them and break free. Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, you may check the stove twenty times to make sure its really turned off, youre your hands until theyre scrubbed raw, or drive around for hours to make sure that the bump you heard while driving wasnt a person you ran over.

Johns story
John is a 42-year-old accountant whose obsessive checking behaviors are gradually taking up more and more of his time. He spends at least an hour every morning checking and rechecking that the windows are latched, the security alarm is set, and the front door is locked. At work, John goes over his clients books again and again, out of fear that hes missed something or made a mathematical error. Consequently, his productivity has plummeted. Lately, John has also started to worry about his wifes safety, calling her every three hours to see if shes okay. Hes afraid that if he misses a call, something bad will happen to her.

Understanding obsessions and compulsions

Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. You dont want to have these ideas in fact, you know that they dont make any sense. But you cant stop them. Unfortunately, these obsessive thoughts are usually disturbing and distracting. Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if youre afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviors often end up causing anxiety themselves as they become more demanding and time-consuming. Most people with obsessive-compulsive disorder fall into one of the following categories: Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions. Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger. Doubters and sinners are afraid that if everything isnt perfect or done just right something terrible will happen or they will be punished. Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements. Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they dont need or use.

Just because you have obsessive thoughts or perform compulsive behaviors does NOT mean that you have obsessive-compulsive disorder. Many people have mild obsessions or compulsions that are strange or irrational, but theyre still able to lead their lives without much disruption. But with obsessive-compulsive disorder, these thoughts and behaviors cause tremendous distress, take up a lot of time, and interfere with your daily routine, job, or relationships.

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Signs and symptoms of obsessive-compulsive disorder (OCD)

Most people with obsessive-compulsive disorder (OCD) have both obsessions and compulsions, but some people experience just one or the other. The symptoms of OCD may wax and wane over time. Often, the symptoms get worse in times of stress.

Common obsessive thoughts in OCD include:

Fear of being contaminated by germs or dirt or contaminating others Fear of causing harm to yourself or others Intrusive sexually explicit or violent thoughts and images Excessive focus on religious or moral ideas Fear of losing or not having things you might need Order and symmetry: the idea that everything must line up just right. Superstitions; excessive attention to something considered lucky or unlucky

Common compulsive behaviors in OCD include:

Excessive double-checking of things, such as locks, appliances, and switches. Repeatedly checking in on loved ones to make sure theyre safe. Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety. Spending a lot of time washing or cleaning. Ordering, evening out, or arranging things just so. Praying excessively or engaging in rituals triggered by religious fear. Accumulating junk such as old newspapers, magazines, and empty food containers, or other things you dont have a use for.

Obsessive-compulsive disorder (OCD) symptoms in children

While the onset of obsessive-compulsive disorder usually occurs during adolescence or young adulthood, younger children sometimes have symptoms that look like OCD. However, the symptoms of other disorders, such as ADD, autism, and Tourettes syndrome can also look like obsessive-compulsive disorder, so a thorough medical and psychological exam is essential before any diagnosis is made. Its also important to note that OCD is an anxiety disorder, and in children, the symptoms of anxiety usually change over time. So a child with OCD symptoms will not necessarily have OCD as an adult. Whats most important is to make environmental and behavioral changes to reduce your childs anxiety.

Therapy for obsessive-compulsive disorder (OCD)

There are many effective treatments for obsessive-compulsive disorder (OCD), ranging from therapy to selfhelp and medication. However, the treatment for OCD with the most research supporting its effectiveness is cognitive-behavioral therapy. Cognitive-behavioral therapy for obsessive-compulsive disorder involves two components: Exposure and response prevention Cognitive therapy

Exposure and response prevention for OCD

Exposure and response prevention involves repeated exposure to the source of your obsession. Then you are asked to refrain from the compulsive behavior youd usually perform to reduce your anxiety. For example, if you are a compulsive hand washer, you might be asked to touch the door handle in a public restroom and then be prevented from washing up. As you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way, you learn that you dont need the ritual to get rid of your anxiety that you have some control over your obsessive thoughts and compulsive behaviors. Studies show that exposure and response prevention can actually retrain the brain, permanently reducing the occurrence of obsessive-compulsive disorder symptoms. This type of OCD therapy can even extinguish compulsive behaviors entirely.

Cognitive therapy for OCD

The cognitive therapy component for obsessive-compulsive disorder (OCD) focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior.

Four Steps for Conquering Obsessive Thoughts and Compulsive Urges

Psychiatrist Jeffrey Schwartz, author of Brain Lock: Free Yourself from Obsessive-Compulsive Behavior, offers the following four steps for dealing with OCD: 1. RELABEL Recognize that the intrusive obsessive thoughts and urges are the result of OCD. 2. REATTRIBUTE Realize that the intensity and intrusiveness of the thought or urge is caused by

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OCD; it is probably related to a biochemical imbalance in the brain. 3. REFOCUS Work around the OCD thoughts by focusing your attention on something else, at least for a few minutes. Do another behavior. 4. REVALUE Do not take the OCD thought at face value. It is not significant in itself. Source: Westwood Institute for Anxiety Disorders

Other treatments for obsessive-compulsive disorder (OCD)

In addition to cognitive-behavioral therapy, the following treatments are also used for obsessive-compulsive disorder (OCD): Medication Antidepressants are sometimes used in conjunction with therapy for the treatment of obsessive-compulsive disorder. However, medication alone is rarely effective in relieving the symptoms of OCD. Family Therapy Because OCD often causes problems in family life and social adjustment, family therapy is often advised. Family therapy promotes understanding of the disorder and can help reduce family conflicts. It can also motivate family members and teach them how to help their loved one. Group Therapy Group therapy is another helpful obsessive-compulsive disorder treatment. Through interaction with fellow OCD sufferers, group therapy provides support and encouragement and decreases feelings of isolation.

Getting therapy for anxiety

Obsessive-compulsive disorder (OCD) is an anxiety disorder, so many of the therapies that are used for other types of anxiety are also helpful when it comes to OCD. To learn more about effective therapies for anxiety, see Therapy for Anxiety Disorders.

Self-help for obsessive-compulsive disorder (OCD)

If you have obsessive-compulsive disorder (OCD), you can help yourself in many ways. Educating yourself about the disorder is a vital first step. Its also important to practice the cognitive-behavioral techniques youve learned from therapy on your own. Renowned OCD researcher Jeffrey Schwartz emphasizes the importance of self-treatment on a day-to-day basis.

Dealing with and obsessive thoughts and compulsive behaviors:

Educate yourself. Learn everything you can about OCD. Read books on the disorder and talk to your therapist and doctor. The more you know, the better able you will be to manage your symptoms. You can find many books about OCD at local or online bookstores. Practice the skills youve learned in therapy. Using the skills youve learned in therapy, actively work toward eliminating your obsessions and compulsive behaviors. This is a challenge that requires commitment and daily practice. Stay connected to family and friends. Obsessions and compulsions can consume your life to the point of social isolation. In turn, social isolation can aggravate your OCD. Its important to have a network of family and friends you can turn to for help and support. Involving others in your treatment can help guard against setbacks and keep you motivated. Join an OCD support group. Youre not alone in your struggle with OCD, and participating in a support group is an effective reminder of that. In a support group, you can share your experience and learn from others who are going through the same thing you are. Click here to search the Obsessive Compulsive Foundations support group database. Practice relaxation techniques. Meditation, yoga, deep breathing, and other stress relief techniques may help reduce the symptoms of anxiety brought on by OCD. Mindfulness meditation may be particularly helpful to OCD sufferers. To learn more about how relaxation techniques may help the symptoms of obsessive-compulsive disorder (OCD), see Stress Relief: Yoga, Meditation, and Other Relaxation Techniques.

Helping a loved one with obsessive-compulsive disorder (OCD)

If your friend or family member has OCD, your most important job is to educate yourself about the disorder. Learn everything you can about the disorder and make sure your loved one has access to information about it as well. Share what youve learned with your friend or family member and let them know there is help available. Simply knowing the condition is treatable may provide enough motivation to get them into a therapists office.

How to Relate to Your Family Member with OCD

View your relatives obsessive-compulsive behaviors as symptoms, not character flaws. Remember that your relative is a person with a disorder, but who is healthy and able in many other ways. Focus on the whole person. Do not allow OCD to take over family life. As much as possible, keep stress low and family life normal.

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Do not participate in your relatives rituals. If you have helped with rituals in the past, it may take time and practice to change this pattern. In order for people with OCD to make progress, family and friends must resist helping with ritual behaviors. Supporting the rituals, including reassurance rituals, hinders progress. Communicate positively, directly and clearly. State what you want to happen, rather than criticizing your relative for past behaviors. Avoiding personal criticism can help your relative feel accepted while he or she is making difficult changes. Mix humor with caring. Support doesnt always have to be serious. People with OCD know how absurd their fears are. They can often see the funny side of their symptoms, as long as the humor does not feel disrespectful. Family members say that humor can often help their relative become more detached from symptoms. Source: Centre for Addiction and Mental Health

The way you react to your loved ones OCD symptoms has a big impact. Negative comments or criticism can make OCD worse, while a calm, supportive environment can help improve the outcome of treatment. Theres no point in scolding someone with OCD or telling the person to stop performing rituals. They cant comply, and the pressure to stop will only make the behaviors worse. The best way to help a loved one cope with OCD is to be as kind and patient as possible. Praise any successful attempt to resist OCD, and focus attention on positive elements in the persons life.

Related Articles
Therapy for Anxiety Disorders Cognitive Behavioral Therapy, Exposure Therapy, and Other Options How to Stop Worrying Self-Help Strategies for Anxiety Relief

More Helpguide Articles:

Quick Stress Relief: How to Manage and Relieve Stress in the Moment Antidepressant Medications: What You Need to Know About Depression Medications Relaxation Techniques for Stress Relief: Relaxation Exercises to Reduce Stress, Anxiety, and Depression

Related links for obsessive-compulsive disorder (OCD)

General information about obsessive-compulsive disorder (OCD)
Obsessive-Compulsive Disorder: An Information Guide Guide to the symptoms, causes, and treatment of OCD for people with the disorder and their loved ones. (Centre for Addiction and Mental Health) OCD Guides Download PDF guides for adults, teens, college students, and parents of children with OCD. The guides offer encouraging information about OCD and its treatment. (OCD Chicago) What is Obsessive Compulsive Disorder (OCD)? Learn about obsessive-compulsive disorder, including its common signs and symptoms and other problems that can resemble OCD. (Obsessive Compulsive Foundation) What You Need to Know About Obsessive Compulsive Disorder (PDF) Learn all about obsessive-compulsive disorder, including the signs, symptoms, and how it's treated. (International OCD Foundation)

Signs and symptoms of obsessive-compulsive disorder (OCD)

Obsessions and Compulsions Overview of the symptoms of obsessive-compulsive disorder. Includes descriptions of common obsessions and compulsions. (OCD Chicago) Obsessive-Compulsive Disorder in Children Guide to obsessive-compulsive disorder in children, including common symptoms and behaviors. (KidsHealth)

Treatment for obsessive-compulsive disorder (OCD)

Treatment Guidelines for Obsessive-Compulsive Disorder Guide for people with OCD and their family members. Includes in-depth treatment advice. (Expert Consensus Guidelines) How to Find the Right Therapist Guide to finding professional help for obsessive-compulsive disorder. Includes questions to ask a potential therapist. (Obsessive Compulsive Foundation) OCD Medication Fact sheet on medication for obsessive-compulsive disorder. Includes information about side effects and treatment success rates. (Understanding OCD)

Self-help and helping a loved one with obsessive-compulsive disorder (OCD)

What to Do During Obsessing and Stopping Your Compulsions. Offers self-help skills you can practice on your own and use to combat obsessions and compulsions. (Anxieties.com) Dr. Jeffrey Schwartz' Four Steps Overview of Dr. Jeffrey Schwartz four steps for dealing with obsessive thoughts and compulsive behaviors. (Westwood Institute for Anxiety Disorders)

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Family and Friends - Information on how to take care of yourself while helping a loved one with obsessivecompulsive disorder. (OCD UK) Help for Partners and Families Advice on how to support a loved one with obsessive-compulsive disorder. (Centre for Addiction and Mental Health)

Melinda Smith, M.A., and Ellen Jaffe-Gill, M.A., created this article, with contributions from Jeanne Segal, Ph.D. Last reviewed: May 2010.
2001-2011. All rights reserved. This reprint is for information and support only and NOT a substitute for professional diagnosis and treatment. Visit http://www.helpguide.org/ for more information and related articles.

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