What is Obsessive-Compulsive Disorder (OCD)?

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Do you wipe off the doorknobs in your home each time someone touches them? Do you go to great lengths to avoid stepping on cracks in the sidewalk? Or do you feel compelled to wash your hands so often that they've become raw and chapped?

Feeling driven to perform such rituals over and over may indicate that you have obsessive-compulsive disorder (OCD). If you have obsessive-compulsive disorder, ritualistic behaviors may literally take over your life. You also may have distressing, unwanted thoughts or images that don't make sense to you. These thoughts or images keep coming back despite your efforts to ignore them. You may strive to hide OCD from friends and co-workers for fear of being labeled "crazy."

Signs & Symptoms

Obsessive-compulsive disorder symptoms include both obsessions and/or compulsions. OCD symptoms can be severe and time-consuming. For instance, someone who feels that his or her hands have become contaminated by germs - an obsession - may spend hours washing them each day - a compulsion. The focus on hand washing may be so great that he or she can accomplish little else.

Obsessions

Obsessions are repeated, persistent, unwanted ideas, thoughts, images or impulses that you experience involuntarily and that appear to be senseless. These obsessions typically intrude when you're trying to think of or do other things.

Typical OCD obsessions revolve around:

Fear of contamination or dirt
Repeated doubts
Having things orderly and symmetrical
Aggressive or horrific impulses
Sexual images

OCD symptoms involving obsessions may include:

Fear of being contaminated by shaking hands or by touching objects others have touched
Doubts that you've locked the door or turned off the stove
Repeated thoughts that you've hurt someone in a traffic accident
Intense distress when objects aren't orderly, lined up properly or facing the right way
Impulses to shout obscenities in inappropriate situations
Avoidance of situations that can trigger obsessions, such as shaking hands
Replaying pornographic images in your mind
Dermatitis because of frequent hand washing

Compulsions

Compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors are meant to prevent or reduce anxiety or distress related to your obsessions. For instance, if you believe you ran over someone in your car, you may return to the scene over and over because you just can't shake your doubts. You may even make up rules or rituals to follow that help control the anxiety you feel when having obsessive thoughts.

Typical compulsions revolve around:

Washing and cleaning
Counting
Checking
Demanding reassurances
Repeating actions over and over
Arranging and making items appear orderly

OCD symptoms involving compulsions may include:

Washing hands until the skin becomes raw
Checking doors repeatedly to make sure they're locked
Checking the stove repeatedly to make sure it's off
Counting in certain patterns
Skin lesions because of picking at the skin
Hair loss or bald spots because of hair pulling

Recommended Treatment

Psychotherapy

A type of therapy called cognitive behavior therapy, CBT has been shown to be the most effective form of therapy for OCD in both children and adults. CBT involves retraining your thought patterns and routines so that compulsive behaviors are no longer necessary. One approach in particular is called exposure and response prevention. This therapy involves gradually exposing you to a feared object or obsession, such as dirt, and teaching you healthy ways to deal with it. Learning the techniques and new thought patterns takes effort and practice, but it's worth it. Most people with OCD show improvement of signs and symptoms with CBT.

Medications

People with OCD are sometimes prescribed certain psychiatric medications. Consultation with a psychiatrist may be helpful if psychotherapy alone does not alleviate symptoms. Many people benefit from medications such as the anti-depressants Paxil, Luvox and Zoloft.

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