Obsessive-compulsive disorder (OCD) is marked by recurrent, repetitive thoughts (obsessions), behaviors (compulsions), or both that a person recognizes as unreasonable, unnecessary, or foolish yet are intrusive and cannot be resisted. People with obsessive-compulsive disorder do not necessarily have both obsessions and compulsions, but either one often interferes with day-to-day activities and relationships with others.
Obsessions are recurring and persistent thoughts, ideas, images, or impulses, sometimes of an aggressive or violent nature, that seem to invade a person’s consciousness. The sufferer will try to suppress or ignore these uncomfortable thoughts and often recognizes that they are unrealistic. Compulsions are ritualistic, repetitive, and purposeful behaviors that are performed according to certain rules or stereotypical patterns. The behavior, while clearly excessive, temporarily relieves the tension and discomfort brought on by the obsessive thinking.
It is estimated that about 2% of the population suffer from obsessive-compulsive disorder, making it the fourth most common anxiety disorder (after phobias, generalized anxiety disorder, and post-traumatic stress disorder). Obsessive-compulsive disorder most often starts in the teens or the early 20s. Embarrassed and upset by their behavior, most sufferers try to keep their obsessive-compulsive disorder secret; they often function with only minimal interference with daily activities. But obsessive thoughts or compulsive behaviors may be frequent or distressing enough to become incapacitating.
Symptoms of Obsessive-Compulsive Disorder
People with obsessive-compulsive disorder experience recurrent, disturbing thoughts, which can lead to bizarre, ritualized behaviors in an effort to alleviate the anxiety caused by the obsession. For example, an overwhelming fear of contamination may cause people with obsessive-compulsive disorder to excessively wash their hands or shower. Obsessive-compulsive disorder sufferers may spend several hours a day dwelling on obsessive thoughts and performing compulsive rituals. In most—but not all—cases of obsessive-compulsive disorder, obsessions and compulsions occur together.Unlike those with many other psychiatric conditions, patients with obsessive-compulsive disorder are often aware that their thoughts and actions are irrational, but they cannot control them. Most individuals with obsessive-compulsive disorder try to hide their symptoms from family and friends and are too embarrassed to seek help.
Outlined below are the most common obsessions and compulsive behaviors. While someone without obsessive-compulsive disorder may exhibit one of these obsessions or compulsions in moderation, a person with obsessive-compulsive disorder has symptoms that significantly interfere with daily life.
Obsessions Common to People Who Suffer From Obsessive-Compulsive Disorder:
- Fear of contamination, such as from dirt, germs, or disease
- Fear of harming oneself or others
- Overwhelming concern with order and neatness
- Fear of making a mistake, such as losing something valuable
- Constantly thinking about a certain sound, number, word, or image
- Fear of embarrassing oneself socially, either by saying the wrong thing or making sexual advances
Compulsive Behaviors Common to People Who Suffer From Obsessive-Compulsive Disorder:
- Hand washing, showering, or cleaning oneself repeatedly
- Checking and rechecking to see if doors are locked or appliances are turned off
- Counting to a certain number over and over again
- Repeating words or actions, such as touching a particular object numerous times a day
- Arranging items in a specific order
- Collecting and hoarding newspapers, items, or mail that is no longer needed
Probably the most common complication of obsessive-compulsive disorder is depression; other complications include alcoholism, abuse of sleeping pills or tranquilizers, and marked interference with normal social and occupational behaviors.
Although some people with obsessive-compulsive disorder experience spontaneous remission, in most, the illness has an episodic course with periods of partial remission. In about 10% of sufferers, the course of obsessive-compulsive disorder is chronic and unchanged. But many effective treatments—including behavior therapy and the antidepressants Prozac (fluoxetine), Celexa (fluvoxamine, citalopram), Paxil (paroxetine), Zoloft (sertraline), and Anafranil (clomipramine)—are now available to alleviate the symptoms of obsessive-compulsive disorder.
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