Obsessive Compulsive Disorder

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Introduction

What is obsessive compulsive disorder?

Obsessive compulsive disorder (OCD) is a mental health disorder in which you have undesired and recurrent thoughts, feelings or behaviors. You may feel like you are constantly thinking about something (obsession), or you may feel the need to perform a certain action over and over (compulsion).

Obsessive compulsive disorder is a type of anxiety disorder. If you do not engage in your obsessions or compulsions, you may feel anxious or panicked. Obsessive compulsive disorder and other anxiety disorders affect about 18% of Americans. Numerous psychiatric disorders co-occur in people with obsessive compulsive disorder at rates higher than in the general population, including major depressive disorder and other anxiety disorders. The cause of obsessive compulsive disorder is not known, but it may be related to chemical imbalances or heredity (Source: NIMH).

Symptoms of obsessive compulsive disorder include repeated thoughts or images, repeated performance of rituals such as hand washing, and unwanted or uncontrollable thoughts or behaviors. Some people may develop tics. These thoughts and rituals are time consuming, do not bring you pleasure, and may upset you or interfere with your daily life.

Treatment for obsessive compulsive disorder includes psychotherapy, such as talk or behavioral therapy, and medication. Medications for obsessive compulsive disorder include antidepressants and antianxiety medications. With treatment, it is possible to manage obsessive compulsive disorder, though it does not go away.

Seek immediate medical care (call 911) for serious symptoms such as hearing voices or seeing things that are not there (hallucinations), having thoughts of harming yourself or others, or an inability to care for your basic needs.

Seek prompt medical care if you experience recurrent, unwanted thoughts or behaviors that interfere with your daily life or cause you distress.

Symptoms

What are the symptoms of obsessive compulsive disorder?

Symptoms of obsessive compulsive disorder are due to improper thought patterns. You may have recurrent thoughts or feelings or engage in behaviors you cannot control. Symptoms are chronic (ongoing), but may improve or worsen at times.

Common symptoms of obsessive compulsive disorder

You may experience obsessive compulsive disorder symptoms daily or just once in a while. At times any of these obsessive compulsive disorder symptoms can be severe:

  • Anxiety

  • Motor or verbal tics

  • Nervousness

  • Repeated actions (rituals), such as hand washing, that do not bring you pleasure and take at least an hour a day

  • Repeated thoughts or feelings (obsessions) such as fear of dirt

  • Unwanted thoughts or feelings you believe you cannot control

Symptoms that might indicate a serious condition

In some cases, obsessive compulsive disorder can be a serious condition that should be immediately evaluated in an emergency setting. Seek immediate medical care (call 911) if you, or someone you are with, have any of these serious symptoms including:

  • Being a danger to yourself or others, including threatening, irrational or suicidal behavior

  • Hearing voices or seeing things that are not there (hallucinations)

  • Inability to care for your basic needs

Causes

What causes obsessive compulsive disorder?

The exact cause of obsessive compulsive disorder is not known. It is thought to be related, like many anxiety disorders, to an imbalance in brain chemicals (neurotransmitters). It is also suspected that obsessive compulsive disorder may run in families. In some cases, a person may develop obsessive compulsive disorder due to a brain injury or infection. Numerous psychiatric disorders co-occur in people with obsessive compulsive disorder at rates higher than in the general population, including major depressive disorder and other anxiety disorders.

Obsessive compulsive disorder may arise early in childhood or while you are a teenager. Most people are diagnosed by age 30. The condition may also be related to another anxiety disorder, and certain medications may also influence the development of obsessive compulsive disorder.  http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001926/

What are the risk factors for obsessive compulsive disorder?

A number of factors increase the risk of developing obsessive compulsive disorder. Not all people with risk factors will get obsessive compulsive disorder. Risk factors for obsessive compulsive disorder include:

  • Age under 30
  • Family history of anxiety disorders
  • Low individual serotonin levels
  • Personal history of anxiety disorders
  • Recent head injury or infection
Treatments

How is obsessive compulsive disorder treated?

There is no cure for obsessive compulsive disorder. Treatments for obsessive compulsive disorder are designed to manage symptoms and teach you strategies to deal with obsessions and compulsions. Usually, obsessive compulsive disorder is treated with medication, psychotherapy, or a combination of the two.

Medications for obsessive compulsive disorder

Medications for obsessive compulsive disorder include antidepressants and antianxiety medications including:

  • Antianxiety medications such as benzodiazepines, including alprazolam (Xanax), diazepam (Valium), and clonazepam (Klonopin)

  • Antipsychotic medications such as risperidone (Risperdal), quetiapine (Seroquel), and olanzapine (Zyprexa)

  • Selective serotonin reuptake inhibitors to balance levels of the neurotransmitter serotonin. These include citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Luvox), paroxetine (Paxil), and sertraline (Zoloft).

  • Tricyclic antidepressants, including clomipramine (less frequently used due to side effects)

Psychotherapy for obsessive compulsive disorder

Psychotherapy for obsessive compulsive disorder may help you deal with things that trigger your obsessions and compulsions. Therapy for obsessive compulsive disorder includes:

Complementary treatments

Some complementary treatments may help some people to better deal with obsessive compulsive disorder. These treatments, sometimes referred to as alternative therapies, are used in conjunction with traditional medical treatments. Complementary treatments are not meant to substitute for traditional medical care. Be sure to notify your doctor if you are consuming nutritional supplements or homeopathic (nonprescription) remedies as they may interact with the prescribed medical therapy.

Complementary treatments may include:

  • Acupuncture

  • Massage therapy

  • Nutritional dietary supplements, herbal remedies, tea beverages, and similar products

  • Yoga

What are the potential complications of obsessive compulsive disorder?

Usually, obsessive compulsive disorder does not turn into another type of disease. With treatment, it can be managed and you can lead a normal life. You can, however, develop complications depending on your compulsions, such as chapped skin if you wash your hands excessively.

Complications of untreated or poorly controlled obsessive compulsive disorder can be serious. You can help minimize your risk of serious complications by following the treatment plan you and your health care professional design specifically for you. Complications of obsessive compulsive disorder include:

  • Absenteeism from work or school (avoidant behavior)
  • Adverse effects of OCD treatment
  • Depression
  • Inability to participate normally in activities
  • Inability to perform daily tasks
  • Panic attacks
  • Social isolation
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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Nov 18
  1. Obsessive-compulsive disorder (OCD). National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/when-unwanted-thoughts-take-over-obsessive-compulsive-di....
  2. Obsessive-compulsive disorder. MedlinePlus, U.S. National Library of Medicine. https://medlineplus.gov/obsessivecompulsivedisorder.html
  3. Domino FJ (Ed.) Five Minute Clinical Consult. Philadelphia: Lippincott Williams & Wilkins
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