Show Medically reviewed by Alex Klein, PsyD — Written by Hannah Nichols — Updated on September 29, 2020
Obsessive-compulsive disorder (OCD) is a mental health condition that involves distressing, intrusive, obsessive thoughts and repetitive, compulsive physical or mental acts. Approximately 2% of the population have OCD. About half of the time, the symptoms appear during childhood or adolescence, and this rarely happens after the age of 40. OCD is an anxiety disorder, and it is one of several conditions involving obsessive thoughts and compulsive behavior. Having OCD can significantly affect a person’s quality of life and their well-being.
OCD is a mental health condition that involves an obsession or compulsion, distressing actions, and repetitive thoughts. It can be challenging for a person with OCD to carry out routine tasks. A person with OCD typically:
What is obsessive-compulsive personality disorder? OCD can affect different people in different ways. It may involve: Concern with checkingA person with OCD may feel the need to check repeatedly for problems. This might include:
Fears of contaminationSome people with OCD feel a continual, overwhelming need to wash. They may fear that objects that they touch are contaminated. This can lead to:
Some people experience a sense of contamination if they feel that someone has mistreated or criticized them. They may try to remove this feeling by washing. HoardingThis involves a person feeling unable to throw away used or useless possessions. Intrusive thoughtsThis involves feeling unable to prevent repetitious unwanted thoughts These may involve violence, including suicide or harming others. The thoughts can cause intense distress, but the person is unlikely to act in a way that reflects this violence. A person with this type of OCD may fear that they are a pedophile, even with no evidence to support this. Symmetry and orderlinessA person with this type of OCD may feel that they need to arrange objects in a certain order to avoid discomfort or harm. They may repeatedly rearrange the books on a shelf, for example. OCD involves obsessions, compulsions, or both. These can cause distress and interfere with the person’s ability to perform routine activities. Below, learn more about obsessions and compulsions. ObsessionsWhile everyone worries, in people with OCD, worries and anxiety can take over, making it hard to carry out everyday tasks. Common topics of this anxiety include:
CompulsionsNot every repetitious behavior is a compulsion. Most people use repetitive behaviors, such as bedtime routines, to help them manage everyday life. For a person with OCD, however, the need to perform repetitious behavior is intense, it occurs frequently, and it is time-consuming. The behavior may take on a ritualistic aspect. Some examples include:
The first signs of OCD often appear in adolescence, but they sometimes emerge in childhood. Complications among young people, including children, with OCD include:
When OCD begins in childhood, it may be more common in males than females. By adulthood, however, it affects males and females at equal rates. Experts do not know what causes OCD, but there are various theories. Genetic, neurological, behavioral, cognitive, and environmental factors may all contribute. Genetic causesOCD appears to run in families, suggesting a possible genetic link, which experts are investigating. Imaging studies have suggested that the brains of people with OCD function with characteristic differences. Genes that affect how the brain responds to the neurotransmitters dopamine and serotonin, for example, may play a role in causing the disorder. Autoimmune-related causesSometimes, symptoms of OCD appear in children after an infection, such as:
Clinicians sometimes call this occurrence of OCD symptoms pediatric acute-onset neuropsychiatric syndrome (PANS). In a child with PANS, the symptoms start suddenly and reach full intensity within 24–72 hours. They may then disappear but return at a later date. Behavioral causesOne theory suggests that a person with OCD learns to avoid fear associated with certain situations or objects by performing rituals to reduce the perceived risk. The initial fear may begin around a period of intense stress, such as a traumatic event or significant loss. Once the person associates an object or circumstance with this feeling of fear, they begin to avoid that object or situation in a way that comes to characterize OCD. This may be more common among people with a genetic predisposition for the disorder. Cognitive causesAnother theory is that OCD starts when people misinterpret their own thoughts. Most people have unwelcome or intrusive thoughts at times, but for people with OCD, the importance of these thoughts becomes more intense or extreme. Take the example of a person caring for an infant while under intense pressure and having intrusive thoughts of accidentally harming the baby. A person might usually disregard these thoughts, but if the thoughts persist, they may take on unwarranted significance. A person with OCD may become convinced that the action in the thought is likely to happen. In response, they take excessive, continual action to prevent the threat or danger. Environmental causesStressful life events may trigger OCD in people with a predisposition, genetic or otherwise. Many people have reported that the symptoms appeared within 6 months of events such as:
Also, OCD may occur alongside post-traumatic stress disorder, or PTSD. Doctors look for specific criteria when diagnosing OCD, including:
Many other disorders, such as depression and anxiety, have similar features to OCD, and they can also occur alongside OCD. There are effective treatments for OCD. The right approach depends on the person’s set of symptoms and the extent that they affec the person’s life and well-being. Some effective options include: Cognitive behavioral therapyThis type of psychotherapy, sometimes called CBT, can help a person change the way that they think, feel, and behave. It may involve two different treatments: exposure and response prevention (ERP) and cognitive therapy. ERP involves:
Cognitive therapy starts by encouraging the person to identify and reevaluate their beliefs about the consequences of engaging or refraining from engaging in compulsive behavior. Next, the therapist encourages the person to:
Here, find some tips for coping with OCD during the COVID-19 pandemic. MedicationsA number of drugs can help treat OCD, including selective serotonin reuptake inhibitors (SSRIs), which are a type of antidepressant. Some examples include: A doctor may prescribe a higher dosage to treat OCD, compared with depression. Still, a person may not notice results for up to 3 months. About half of all people with OCD do not respond to SSRI treatment alone, and doctors may also prescribe antipsychotic medications. Also, in 2010, some researchers noted that the tuberculosis drug D-cycloserine (Seromycin) alongside CBT may help treat OCD. It may also help people with social anxiety. Here, find more strategies for managing OCD. If a person with mild OCD does not receive treatment, the symptoms may still improve. However, without treatment, symptoms of moderate or severe OCD do not improve and may worsen. Treatment can be effective, but it is an ongoing process. In some people, OCD symptoms reappear later in life. Anyone who may be experiencing OCD should receive professional care and guidance. Last medically reviewed on September 29, 2020
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Which medication does the nurse anticipate the healthcare provider will prescribe for a client who is beginning treatment for obsessive compulsive disorder?
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