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Obsessive Compulsive Disorder
By Jennifer Ferrell-Hanington, Psy.D.
Licensed Psychologist
Obsessive Compulsive Disorder (OCD) is characterized by excessive worries (obsessions) and repetitive behaviors (compulsions).
Not all obsessive-compulsive behaviors represent an illness. It is important to seek professional help only when these symptoms become excessive, become unrealistic, create significant distress, or interfere with normal functioning.
OCD was once thought to be a rare condition. However, in the United States, 1 in 40 adults currently suffers from OCD, and five million people at any time are experiencing obsessive compulsive symptoms.
Most individuals usually begin exhibiting OCD in adolescence or early adulthood. With appropriate treatment, symptoms can often be managed successfully and sufferers may obtain long-term symptom relief.
What are the symptoms?
Obsessions are recurrent, intrusive, and distressful thoughts. Common obsessions include:
· Worry about germs, contamination, and dirt
· Fear of inadvertently harming another person, although being aware that this is not realistic
· Unrealistic concern about order, arrangement, or symmetry
· Worry about discarding useless possessions
Compulsions are behaviors that are repetitive and are often performed in order to relieve the anxiety associated with the obsessive thoughts. Common compulsions include:
· Excessive handwashing or cleaning
· Repeated checking, e.g. whether stove is turned off or whether doors are locked
· Counting objects over and over again
· Arranging and ordering objects
· Hoarding and saving useless objects
Behaviors such as gambling, abusing alcohol/drugs are often referred to as “compulsive”. However, these activities provide a certain level of pleasure, unlike OCD compulsions that are not inherently pleasurable.
What treatment is available?
¨ Psychotherapy
Cognitive behavioral psychotherapy is the treatment of choice for those with OCD.
The behavioral focus of this treatment helps people learn how to change their thoughts and feelings by first changing their behavior. This treatment teaches people how to decrease their anxiety by repeated exposures to the feared situations, while refraining from the compulsive behaviors. Cognitive therapy helps people alter their style of thinking in order to assess situations more realistically.
¨ Medication
Medications have been developed that can alleviate symptoms of OCD. The medications that are most effective primarily affect a chemical in the brain called serotonin.
A combination of psychotherapy and medication is usually the most effective treatment.
The use of medication is usually based on the severity of the symptoms. Psychotherapy has been found to produce a 50%-80% reduction in symptoms and symptom relief is often long lasting. Fewer than 20% of those treated with medication alone obtain complete symptom relief.
Sources:
Guide for Patients and Families, Journal of Clinical Psychiatry, 1997:58 (suppl 4).
The Obsessive-Compulsive Foundation, P.O. Box 70, Milford, CT 06460-0070, (203) 878-5669 Obsessive Compulsive Foundation