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Obsessive Compulsive Disorder

separator People who have obsessive compulsive disorder (OCD) suffer from unwanted thoughts and the need to act in compulsive ways. They often think that performing certain rituals, such as excessive washing, will help prevent the obsessive thoughts or make the thoughts go away. But performing the rituals doesn’t bring the relief that patients expect, or if it does, the relief is temporary.

Four major symptom patterns

OCD can be grouped into four categories, or symptom patterns:

Obsession with contamination.
This is the most common pattern. People who are obsessed with contamination either wash compulsively or try to avoid the contamination. Usually, the contamination they fear is something nearly impossible to avoid, such as dust or germs. People who wash to get rid of contamination wash so frequently that they can actually rub the skin off their hands. Patients with this pattern usually believe that contamination is spread extremely easily at the slightest contact.

Obsession with doubt. In this pattern, people first doubt that they’ve done something they should have done, such as turn off the iron or lock the door. This is followed by a compulsion to keep checking on the situation. They may return to the house over and over to make sure the door is locked, the iron is turned off, etc.

Obsessive thoughts. This pattern has obsessive thoughts without compulsive behavior. The repetitious thoughts are usually extremely disturbing to the patient.

Obsession with symmetry or precision. In this pattern, the need to be precise and perfect can lead to compulsively slow behavior. Patients may take hours to eat one meal, shave, dress, etc.

Some of the telltale signs that a person is suffering from OCD would include extreme focus on things like:
  • Disgust with bodily fluids (urine, stool, saliva)
  • Excessive praying that is not a usual part of the person’s religion
  • Obsession with lucky and unlucky numbers
  • Random rituals, such as licking, spitting, dressing in a specific order, going in and out of the door a certain number of times, etc.
  • Hoarding and collecting
  • Obsessive cleaning
  • Ordering and arranging things over and over again

People who have OCD often have other mental disorders as well. About 67 percent of them suffer from major depression. Other common disorders that people with OCD experience include alcohol use disorders, specific phobia, panic disorder and eating disorder.

Frustration for friends and family
When a friend or loved one has OCD, you may want to say to them, “Just stop washing your hands! Stop checking on the stove!” To people who don’t have the condition, it seems like it should be an easy thing to stop. But it’s not that simple. Imaging scans of people with OCD show increased activity in specific areas of the brain. It’s a condition that needs treatment, not one that people can simply will themselves to stop.

The good news is that people with OCD often respond quite well to treatment. As recently as the 1980s, OCD was seen as an uncommon disorder that was difficult to treat. Today, it’s actually known to be fairly common and to be responsive to treatment.

Having OCD can affect your job, your relationships and just about all aspects of your life. If you think you could possibly have OCD, a talk with your doctor can help you determine whether it’s appropriate to seek treatment from a healthcare provider who treats OCD itself.

For most people, combination treatment produces the best results. This type of treatment would include taking medication and participating in behavioral therapy. The therapy that often works well for OCD patients is called “exposure and response prevention.” The person with OCD agrees to be exposed to the very situation that triggers the compulsive thoughts and behaviors. Then the patient works with a therapist to learn how to deal with the anxiety that the situation produces and how to avoid performing the compulsive rituals.

The American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Washington, D.C., 2000; H. Kaplan, B. Sadock, J. Grebb, Synopsis of Psychiatry, Williams and Wilkins, 1994; The National Mental Health Association.
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