Obsessive-Compulsive Disorder

mooshee.com - People with obsessive-compulsive disorder (OCD) have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. Most of the time, the rituals end up controlling them.

For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again if the have obsessive-compulsive disorder. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Being afraid of social embarrassment may prompt people with obsessive-compulsive disorder to comb their hair compulsively in front of a mirror-sometimes they get "caught" in the mirror and can't move away from it. Performing such rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts.

Other common rituals are a need to repeatedly check things in obsessive-compulsive disorder, touch things (especially in a particular sequence), or count things. Some common obsessions include having frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts the person dislikes, or having thoughts that are prohibited by religious beliefs. People with OCD may also be preoccupied with order and symmetry, have difficulty throwing things out (so they accumulate), or hoard unneeded items.

Healthy people also have rituals, such as checking to see if the stove is off several times before leaving the house. The difference is that people with obsessive-compulsive disorder perform their rituals even though doing so interferes with daily life and they find the repetition distressing. Although most adults with obsessive-compulsive disorder recognize that what they are doing is senseless, some adults and most children may not realize that their behavior is out of the ordinary.

Obsessive-compulsive disorder affects about 2.2 million American adults, and the problem can be accompanied by eating disorders, other anxiety disorders, or depression. It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood. One-third of adults with obsessive-compulsive disorder develop symptoms as children, and research indicates that obsessive-compulsive disorder might run in families.

The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. If obsessive-compulsive disorder becomes severe, it can keep a person from working or carrying out normal responsibilities at home. People with obsessive-compulsive disorder may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves.

Obsessive-Compulsive Disorder usually responds well to treatment with certain medications and/or exposure-based psychotherapy, in which people face situations that cause fear or anxiety and become less sensitive (desensitized) to them. NIMH is supporting research into new treatment approaches for people whose obsessive-compulsive disorder does not respond well to the usual therapies. These approaches include combination and augmentation (add-on) treatments for obsessive-compulsive disorder, as well as modern techniques such as deep brain stimulation.

Facts About OCD

• Approximately 3.3 million American adults ages 18 to 54, or about 2.3 percent of people in this age group in a given year, have OCD.
• The first symptoms of OCD often begin during childhood or adolescence.
• OCD is equally common in males and females.
• OCD is sometimes accompanied by depression, eating disorders, substance abuse, or other anxiety disorders. Symptoms of OCD can also coexist and may even be part of a spectrum of other brain disorders, such as Tourette's syndrome. Appropriate diagnosis and treatment of other co-occurring disorders are important to successful treatment of OCD.

Treatments for OCD

Treatments for OCD include medications and behavioral therapy, a specific type of psychotherapy. The combination of these treatments is often most effective.

Several medications have been proven helpful for people with OCD: clomipramine, fluoxetine, fluvoxamine, sertraline, and paroxetine. If one drug does not work, others should be tried. A number of additional medications are currently being studied.

A type of 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, and then is taught techniques to avoid performing the compulsive rituals and to deal with the anxiety.

Research Findings

There is growing evidence that OCD represents abnormal functioning of brain circuitry, probably involving a part of the brain called the striatum. OCD is not caused by family problems or attitudes learned in childhood, such as an inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable.

 

Brain imaging studies using a technique called positron emission tomography (PET) have compared people with and without OCD. Those with OCD have patterns of brain activity that differ from people with other mental illnesses or people with no mental illness at all. In addition, PET scans show that in individuals with OCD, both behavioral therapy and medication produce changes in the striatum. This is graphic evidence that both psychotherapy and medication affect the brain.

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Source: National Institutes of Health, David Satcher, M.D., Ph.D.
Surgeon General, U.S. Public Health Service.
Adapted and Published: www.mooshee.com
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