Obsessive-Compulsive Disorder (OCD) – Topic Overview What is obsessive-compulsive disorder (OCD)? Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. If you have OCD, you have repeated, upsetting thoughts called obsessions. You do the same thing over and over again to try to make the thoughts go away. Those repeated actions are called compulsions. Examples of obsessions are a fear of germs or a fear of being hurt. Compulsions include washing your hands, counting, checking on things or cleaning. OCD is a chronic or longterm illness that can take over your life, hurt your relationships, and limit your ability to go to work or school. Researchers think brain circuits may not work properly in people who have OCD. It tends to run in families. The symptoms often begin in children or teens. Treatments that combine medicines and therapy are often effective. What causes OCD? Experts don’t know the exact cause of obsessive-compulsive disorder. Research suggests that there may be a problem with the way one part of the brain sends information to another part. Not having enough of a brain chemical called serotonin may help cause the problem. Some experts believe that a problem related to infections, such as strep throat or scarlet fever, can suddenly bring on the disorder or make it symptoms worse in some children. What are the symptoms? Symptoms of obsessive-compulsive disorder tend to come and go over time and range from mild to severe. Anxiety is the most common symptom. For example, you may have an overall sense that something terrible will happen if you don’t do a certain task, such as check again and again to see whether the stove is on. If you fail to check, you may suddenly feel tense or anxious or have a nagging sense that you left something undone. Symptoms of the disorder include: Obsessions. These are unwanted thoughts, ideas, and impulses that you have again and again. They won’t go away. They get in the way of your normal thoughts and cause anxiety or fear. The thoughts may be sexual or violent, or they make you worry about the illness or infection. Examples include: a fear of harm to yourself or a loved one; a driving need to do things perfectly or correctly; a fear of getting dirty or infected. Compulsions. These are behaviors that you repeat to try to control the obsessions. Some people have behaviors that are rigid and structured, while others have very complex behaviors that change. Examples include: washing or checking that something has been done; counting often while doing another compulsive action, such as hand-washing; repeating things or always moving items to keep them in perfect order; hoarding; praying. The obsessions or compulsions usually take up a lot of time - more than one hour a day. They greatly interfere with your normal routine at work or school, and they affect social activities and relationships. Sometimes, people may understand that their obsessions and compulsions are not real. But at other times, they may not be sure, or they may believe strongly in their fears. How common is OCD? For many years, OCD was thought to be rare. Some recent studies show that as many as 3 million Americans, ages 18 to 54 may have OCD at any one time. This is about 2.3% of the people in this age group. OCD affects men and women equally. What causes OCD? No one has found a single, proven cause for OCD. Some research shows that it may have to do with chemicals in the brain that carry messages from one nerve cell to another. One of these chemicals, called serotonin, helps to keep people from repeating the same behaviors over and over again. A person who has OCD may not have enough serotonin. Many people who have OCD can function better when they take medicines that increase the amount of serotonin in their brain. Are other illnesses associated with OCD? People, who have OCD often have other kinds of anxiety, like phobias (such as fear of spiders or fear of flying) or panic attacks. People who have OCD also may have depression, attention deficit hyperactivity disorder (ADHD), an eating disorder or a learning disorder such as dyslexia. Having one or more of these disorders can make diagnosis and treatment more difficult, so it’s important to talk to your doctor about any symptoms you have, even if you’re embarrassed. How is OCD diagnosed? Your doctor can check for obsessivecompulsive disorder by asking about your symptoms and your past health. He or she may also do a physical exam. It’s important to talk to your doctor if you think you have OCD. Many people with the disorder go without treatment because they are afraid or embarrassed to talk to a doctor. Several medicines are available to treat OCD. These medicines include: clomipramine, (brand name: Anafranil), fluoxetine (brand name: Prozac), sertraline (brand name: Zoloft), paroxetine (brand name: Paxil), and fluvoxamine (brand name: Luvox). These drugs can cause side effects such as dry mouth, nausea and drowsiness. Sometimes, they also affect a person’s sexual performance. It may be several weeks before you see an improvement in your behavior. Other cognitive therapy may also help change the false beliefs that lead to OCD behaviors.