Obsessive-Compulsive Disorder, OCD, is an anxiety
disorder and is characterized by recurrent,
unwanted thoughts (obsessions) and/or repetitive
behaviors (compulsions). Repetitive behaviors such
as handwashing, counting, checking, or cleaning
are often performed with the hope of preventing
obsessive thoughts or making them go away.
Performing these so-called "rituals," however,
provides only temporary relief, and not performing
them markedly increases anxiety.
Growing evidence reveals that OCD has a
biological basis. OCD is no longer attributed to
family problems or to attitudes learned in
childhood. Instead, the search for causes now
focuses on the interaction between biological
factors and environmental influences.
Research suggests that OCD involves problems in
communication between parts of the brain. These
problems may be caused by insufficient levels of
certain brain chemicals, called neurotransmitters.
Drugs that increase the brain concentration of
these chemicals often help improve OCD symptoms.
Signs & Symptoms
People with OCD may be plagued by persistent,
unwelcome thoughts or images, or by the urgent
need to engage in certain rituals. They may be
obsessed with germs or dirt, and wash their hands
over and over. They may be filled with doubt and
feel the need to check things repeatedly.
Effective treatments for obsessive-compulsive
disorder are available, and research is yielding
new, improved therapies that can help most people
with OCD and other anxiety disorders lead
productive, fulfilling lives.
The most common treatment for OCD is a
combination of cognitive-behavioral psychotherapy
(CBT) and medication.
Behavioral therapy known as “exposure and
response prevention” is very useful for
treating OCD. In this approach, a person is
deliberately and voluntarily exposed to whatever
triggers the obsessive thoughts (exposure) and is
then taught techniques to avoid performing the
compulsive rituals (response prevention). The
cognitive portion of CBT is often added to E/RP to
help challenge the irrational beliefs associated
Several medications have been proven effective
in helping people with OCD, particularly those
that increase the level of the neurotransmitter,
serotonin. These are called selective serotonin
reuptake inhibitors (SSRI) and include Prozac,
Paxil and Zoloft.
While as many as 25% of patients refuse CBT,
those who complete CBT report a 50% to 80%
reduction in OCD symptoms after 12 to 20 sessions.
Just as important, people with OCD who respond to
CBT usually stay well, often for years to come.
When someone is being treated with medication,
using CBT with the medication may help prevent
relapse when the medication is stopped.
Unfortunately, it is sometimes difficult to
find CBT therapists in a patient’s area, and
therapy can be time-consuming and expensive. For
patients who cannot get or afford CBT, medication
alone may still be effective.
Locate mental health services in your area,
affordable healthcare, NIMH clinical trials, and
listings of professionals and organizations.
Some Other Helpful
- National Institutes of Health (ww.nlm.nih.gov/medlineplus)