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Obsessive compulsive disorder

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What is obsessive compulsive disorder?

Obsessive compulsive disorder (OCD) is a disabling anxiety disorder. People with OCD experience recurring intrusive thoughts and images, known as obsessions, and perform certain repetitive behaviors, known as compulsions.

OCD is estimated to affect 2-3% of people at some point in their lives. It most commonly develops in late adolescence.

Causes and risk factors

It is not known exactly what causes OCD. It is thought to develop from a combination of genetic, environmental and biological factors. As with many conditions that affect the mind, it is thought that people with OCD have an imbalance of certain chemicals in the brain that affect mood. People who have a close family member with OCD may be more likely to develop the condition. It is likely that each person's OCD is the result of several interacting factors and is affected by stressful life events, hormone changes and personality traits.

There is no specific test that can be used to diagnose OCD. A doctor can generally diagnose the condition based on a person's thoughts and behaviors.

Signs and symptoms

Obsessions

An obsession is a recurring and unwanted thought, idea, image or impulse. A person with OCD may find their obsessive thoughts very difficult to dismiss and they may be constantly on their mind. This can be distressing and can lead to considerable anxiety.

Some of the common obsessions that are associated with OCD include:

Compulsions

Compulsions are behaviors that are carried out according to specific rules. A person with OCD may feel an intense need to carry out certain actions to try and relieve the anxiety that builds up from their obsessive thoughts. Some people with OCD may believe that if they do not carry out certain actions, something bad will happen. Carrying out a compulsion may provide temporary relief from the obsessive thoughts and anxiety.

Some common compulsive behaviors that are associated with OCD include:

Someone with OCD may spend hours of their day carrying out these activities, over and over again.

The cycle of obsessive compulsive disorder. 

Avoidance

Most people with OCD realize that their thoughts and behaviors are not normal and feel embarrassed about their condition. This may lead to people deliberately avoiding things or places that trigger their obsessive thoughts. This can be debilitating, as some people may avoid leaving their home, or carrying out normal daily activities.

Types of treatment

There is no cure for OCD, but there is treatment available to help people manage the condition. It is usually treated with a combination of medication and therapy.

Medication

The symptoms of OCD may be reduced with medication known as antidepressants. These work by helping to restore the balance of chemicals in the brain that affect a person's mood. Common antidepressants used to treat OCD include selective serotonin re-uptake inhibitors (SSRIs) such as paroxetine.

Antidepressants generally need to be taken for at least two weeks before any improvement in symptoms is noticed. Medication may also need to be continued even after the symptoms have disappeared, to prevent them from coming back. When stopping antidepressant medication, the dose usually needs to be reduced gradually over time to prevent any withdrawal responses.

Side effects

As with many medications, some people may experience some side effects when taking antidepressants. Some common side effects include nausea, dizziness and tiredness. Some antidepressants can have more serious side effects if they are taken with certain other medications or herbal remedies, or when combined with alcohol. A doctor will work with their patient to find the medication that is best for them.

Very rarely, some antidepressants may increase suicidal thoughts and the risk of suicide. The risk is highest in the first week after starting antidepressant treatment, or when the dose of antidepressants is changed. If someone experiences suicidal thoughts, it is important to contact a doctor immediately.

Psychotherapy

A common type of psychotherapy that is used to help manage OCD is called cognitive behavior therapy. This is a type of 'talking therapy' that aims to teach people with OCD how to change their thinking patterns and gain control over their compulsions and anxiety. Cognitive behavior therapy may also involve gradually exposing a person with OCD to situations that usually trigger their obsessions and helping to reduce their anxiety and compulsions.

Cognitive behavior therapy aims for positive changes in thinking. 

Support groups

Attending support groups allows people affected by OCD, as well as their families, to learn more about the condition and how to manage it.

Potential complications

OCD is a disabling condition that is often associated with other mental health conditions, such as depression and other anxiety disorders. Without treatment, OCD can affect a person's ability to carry out everyday tasks and activities and interfere with their relationships with family and friends.

Prognosis

OCD is a long-term condition that usually requires lifelong management. With treatment, most people with OCD will be able to better manage or eliminate their symptoms.

There is no known way to prevent OCD. Recognizing the signs of the condition and seeking treatment early may help prevent it from getting worse.

References

  1. Slade T. Johnston A.Teesson M. et al. (2009) The mental health of Australians 2. Report on the 2007 national survey of mental health and wellbeing. Department of Health and Ageing. Accessed 28 June 2014 from link here
  2. Slade T Johnston A Teesson M et al. The mental health of Australians 2: Report on the 2007 National Survey of Mental Health and Wellbeing. Canberra: Department of Health and Ageing; 2009.
  3. RACGP - Obsessive-compulsive disorder The role of the GP. Accessed 26 June 2014 from link here
  4. Heyman I. Mataix-Cols D. & Fineberg N.A. (2006). Obsessive-compulsive disorder. BMJ?: British Medical Journal 333: 424429.
  5. Obsessive Compulsive Disorder. Accessed 28 June 2014 from link here
  6. Obsessive compulsive disorder. Better Health Channel. Accessed 28 June 2014 from link here
  7. beyondblue. Obsessive compulsive disorder (OCD). Accessed 28 June 2014 from link here

10 Most frequently asked questions (FAQs)

What is obsessive compulsive disorder (OCD)?
Obsessive compulsive disorder (OCD) is an anxiety disorder. It is characterized by unwanted and intrusive thoughts, known as obsessions, and repetitive or compulsive behavior.
What are compulsions?
Compulsions are behaviors that are carried out according to specific rules. Compulsions are common in people with obsessive compulsive disorder (OCD). A person with OCD may feel an intense need to carry out certain compulsions to try and relieve anxiety that builds up from unwanted and intrusive thoughts.
What is an obsession?
An obsession is a recurring and unwanted thought, idea, image or impulse that generally occurs in someone with obsessive compulsive disorder (OCD). Obsessive thoughts are often intrusive and may be constantly on a person's mind. This can be distressing and lead to considerable anxiety.
What causes obsessive compulsive disorder (OCD)?
It is not known exactly what causes obsessive compulsive disorder (OCD). As with many mental illnesses, it is thought that chemical, structural and functional abnormalities in the brain may contribute to the development of OCD. It is also thought that genetic factors play a role in the development of OCD. It is likely that each person's OCD is the result of several interacting factors and is affected by stressful life events, hormonal changes and personality traits.
How is obsessive compulsive disorder (OCD) treated?
Unfortunately, there is no cure for obsessive compulsive disorder. There are treatment options that are available to help people with OCD manage or eliminate their symptoms. The most effective treatment involves a combination of medication, cognitive behavior therapy and support programs.
Is there a cure for obsessive compulsive disorder (OCD)?
Unfortunately, there is no known cure for obsessive compulsive disorder (OCD). There are medications and therapy treatments available that can help people manage their symptoms.
What are the symptoms of obsessive compulsive disorder (OCD)?
The main signs of obsessive compulsive disorder are recurring intrusive thoughts and images, known as obsessions, and repetitive behaviors, known as compulsions. Common obsessions for people with OCD include fear of being contaminated by germs and fear of harm coming to themselves or others. To try and relieve anxiety associated with these fears, people with OCD perform certain repeated behaviors, such as repeatedly checking something, or excessive hand washing.
What is the difference between a worry and an obsession?
A worry usually involves a real-life problem, such as money or a job interview, while an obsession is usually something that reflects an unrealistic fear, such as being contaminated with germs.
How common is obsessive compulsive disorder (OCD)?
In Australia, it is estimated the around 2-3% of the population will be affected by OCD at some point during their lives.
Can obsessive compulsive disorder (OCD) be prevented?
Unfortunately, there is no known way to prevent obsessive compulsive disorder (OCD). Recognizing the signs of the condition and seeking treatment early may help prevent it from getting worse.

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About this article

Title: Obsessive compulsive disorder

Author: Dr Joanne Van der Velden PhD, BSc (Hons)

First Published: 26 Oct 2014

Last reviewed: 17 Jan 2022

Category: Information on Obsessive compulsive disorder

Average rating: 4.2 out of 5 (1556 votes)

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