Obsessive-compulsive disorder (OCD) is a common mental health problem. Symptoms typically include recurring obsessive thoughts, and repetitive compulsions in response to the obsession. A common example is recurring obsessive thoughts about germs and dirt, with a compulsion to wash your hands repeatedly to "clean off the germs". However, there are many other examples. The usual treatments are cognitive behaviour therapy, a selective serotonin reuptake inhibitor (SSRI) antidepressant medicine, or both. Treatment often works well to reduce the symptoms and distress of OCD greatly.
What are obsessions?
Obsessions are unpleasant thoughts, images, or urges that keep coming into your mind. Obsessions are not simply worries about your life problems. Common obsessions include:.
•Fears about contamination with dirt, germs, viruses (eg HIV), etc.
•Worries about doors being unlocked, fires left on, causing harm to someone, etc.
•Intrusive thoughts or images of swearing, blasphemy, sex, someone harmed, etc.
•Fear of making a mistake or behaving badly.
•A need for exactness in how you order or arrange things.
These are examples. Obsessions can be about all sorts of things. Obsessive thoughts can make you feel anxious or disgusted. You normally try to ignore or suppress obsessive thoughts. For example, you may try to think other thoughts to 'neutralise' the obsession..
What are compulsions?
Compulsions are thoughts or actions that you feel you must do or repeat. Usually the compulsive act is in response to an obsession. A compulsion is a way of trying to deal with the distress or anxiety caused by an obsession.
For example, you may wash your hands every few minutes in response to an obsessional fear about germs. Another example is you may keep on checking that doors are locked in response to the obsession about doors being unlocked. Other compulsions include repeated cleaning, counting, touching, saying words silently, arranging and organising - but there are others..
OCD can make you feel really anxious and distressed. The compulsions that you have may help to relieve this distress temporarily but obsessions soon return and the cycle begins again.
The severity of OCD can range from mildly inconvenient, to causing severe distress. You know that the obsessions and compulsions are excessive or unreasonable. However, you find it difficult or impossible to resist them.
OCD affects people in different ways. For example, some people spend hours carrying out compulsions and, as a consequence, cannot get on with normal activities. Some people do their compulsions over and over again in secret (like 'rituals'). Other people may seem to cope with normal activities, but are distressed by their recurring obsessive thoughts. OCD can affect your work (or school-work in children), relationships, social life, and your quality of life.
Many people with OCD do not tell their doctor or anyone else about their symptoms. They fear that other people might think they are crazy. Some people with OCD may feel ashamed of their symptoms, especially if they contain ideas of harming others, or have a sexual element. As a result, many people with OCD also become depressed. However, if you have OCD, you are not crazy or mad. It is not your fault and treatment often works. If you are concerned that you may be depressed (for example if you have been feeling very down and you no longer take pleasure in the things that you used to enjoy) you should see your doctor..
What causes obsessive-compulsive disorder?
The cause of OCD is not clear. Slight changes in the balance of some brain chemicals (neurotransmitters) such as serotonin may play a role. This is why medication is thought to help (see below).
Also, the chance of developing OCD is higher than average in first-degree relatives of affected people (mother, father, brother, sister, child). So, there may be some genetic element to OCD. However, so far, no genes have been found to be linked with OCD.
Who gets obsessive-compulsive disorder?
It is thought that between 1 to 3 in 100 adults have OCD. Anyone at any age can develop OCD but it usually first develops between the ages of 18 and 30. About 2 in 100 children are also thought to have OCD.