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.

 Causes

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.

 Treatment

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 with OCD.

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.

 Outcome

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.

 Getting Help

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