Program for Anxiety and Traumatic Stress Studies

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Obsessive-Compulsive Disorder

What is OCD?

OCD is an anxiety problem in which people are in severe emotional pain or they are unable to function becauseof obsessions and compulsions.

What are the symptoms of OCD?

The two main symptoms of OCD are obsessions and compulsions. Obsessions are thoughts, impulses or images that come to mind over and over again, and that seem foolish to the person and cause a lot of anxietyor distress. The person tries to stop these thoughts, impulses or images or to make up for them by some other thought or action. The person can tell that the obsessions are products of his or her own mind.

Compulsions are attempts to reduce anxiety or preventsome feared event or situation by carrying out certain acts over and over and over again. Common compulsions are hand washing, putting things in order, checking things, praying, counting, and repeating words silently.

Some or all of the time, the person with OCD feels that the obsessions and compulsions are foolish or excessive-yet the person usually cannot avoid them forlong without great effort.

The obsessions or compulsions of OCD cause emotional pain, take up a lot of time, or strongly disrupt the person's normal routine of work, school or social life.

What causes OCD?

The exact cause of OCD is unknown, but probably involves abnormal activity in specific areas of the brain and is related to poor functioning of the brain chemical called serotonin. In addition, it seems that OCD runs in some families for genetic reasons.

What happens to people who have OCD?

OCD can begin at any age, even as early as age 2. Without treatment, OCD is usually a lifelong illness with periods of time when the symptoms get better and periods when they are worse. With treatment, many people find their obsessions and compulsions can be reduced so that they no longer interfere with functioning or cause severe pain.

What is the treatment for OCD?

Treatment usually consists of cognitive-behavior therapy and/or medicine.

Cognitive-behavior therapy helps people reduce the anxiety associated with obsessions and reduce or eliminate compulsions. Techniques of cognitive-behavior therapy usually include facing the very situations that are most feared (this is called exposure), without resorting to compulsive rituals (this is called response prevention). Other cognitive-behavioral techniques to address specific obsessions or compulsions are sometimes used.

The medicines that have been most helpful in reducing the symptoms of OCD are the SSRI antidepressants. Less often, people are helped by other medicines.

What can I do to help get my OCD under control?

To make the fullest possible recovery, a person with OCD can do the following things:

  • If medicine has been prescribed, take it regularly, exactly the way it has been prescribed.
  • If you're in cognitive-behavior therapy, carry out each homework assignment the way it has been prescribed.
  • Exercise regularly.
  • Eat a well-balanced diet.
  • Get enough sleep.
  • Join a self-help group for people with this disorder so you can give and receive support, advice and information.
  • Educate yourself and your family about this disorder.

What happens if the symptoms return after I get them under control?

There may be times after recovery when symptoms (obsessions and/or compulsions) return. This is not uncommon. If the symptoms increase in number and interfere with your ability to function, this is called relapse. If relapse occurs, it is important to be aware of the returning symptoms as early as possible and to act by seeing your therapist and considering a return to or increase in medicines and/or cognitive-behavior therapy.

Where can I get more information about OCD?

There are several good books about OCD:

Lee Baer. Getting Control: Overcoming Your Obsessions and Compulsions. NAL-Dutton, 2000.

Padmal DeSilva, Stanley Rachman and Jack Rachman. Obsessive-Compulsive Disorder: The Facts. Oxford, 1998.

Edna Foa and Reid Wilson. Stop Obsessing: How to Overcome Your Obsessions and Compulsions. Bantam, 2001.

Jack Gorman. The Essential Guide to Psychiatric Drugs. St. Martin's Press, 1998.

James Leckman and Donald J. Cohen. Tourette's Syndrome, Tics, Obsessions, Compulsions. John Wiley and Sons, 1999.

John March and Karen Mulle. OCD in Children and Adolescents. Guilford Press, 1998.

Judith Rappaport. The Boy Who Couldn't Stop Washing: The Experience and Treatment of Obsessive Compulsive Disorder. Penguin, 1989.

David Sheehan. The Anxiety Disease. Bantam, 1986.

Gail Steketee. When Once is not Enough: Help for Obsessive-Compulsives. New Harbinger Press, 1990.

The following organizations can provide help, information and support:

Obsessive-Compulsive Disorder Foundation, Inc. Call them at 203-878-5669 or reach them online at www.ocfoundation.org.

Anxiety Disorder Association of America (ADAA). Call them at 301-231-9350 or reach them online at www.adaa.org.

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