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Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions). To get rid of the thoughts, they feel driven to do something repetitively (compulsions). The repetitive behaviors, such as hand washing/cleaning, checking on things, mental acts (like counting), or other activities, can significantly interfere with a person’s daily activities and social interactions.

Many people without OCD have distressing thoughts or repetitive behaviors. However, these do not typically disrupt daily life. For people with OCD, thoughts are persistent and intrusive, and behaviors are rigid. Not performing the behaviors commonly causes great distress, often attached to a specific fear of dire consequences (to self or loved ones) if the behaviors are not completed. Many people with OCD know or suspect their obsessional thoughts are not realistic; others may think they could be true. Even if they know their obsessional thoughts are not realistic, people with OCD have difficulty disengaging from the obsessive thoughts or stopping the compulsive actions.

A diagnosis of OCD requires the presence of obsessional thoughts and/or compulsions that are time-consuming (more than one hour a day), cause significant distress, and impair work or social functioning. OCD affects 2-3% of people in the United States, and among adults, slightly more women than men are affected. OCD often begins in childhood, adolescence, or early adulthood. Some people may have some symptoms of OCD but not meet full criteria for this disorder.

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Expert Q&A: Obsessive-Compulsive Disorder

The often off-hand or casual way OCD is referred to in the media or in everyday conversion may make it seem that the obsessions or compulsions are just something annoying or amusing that a person could “get over.” But for people with OCD it’s not a simple annoyance, it is all-consuming anxiety associated with the obsessive thoughts.

Many people will at times have concerning thoughts or prefer a clear routine and structure. But for people with OCD, the thoughts become overwhelming and create a great deal of anxiety. Compulsions associated with OCD disrupt normal daily activities. A diagnosis of OCD requires that the obsession or compulsions take more than one hour a day and cause major distress or cause problems at home, work or other function.

Talking about your ODC and deciding who to tell are personal decisions. Family and friends can be an important source of support and understanding. They may have noticed changes in your behavior and talking about it could provide them with a better understanding and the ability to be more supportive.

In addition to the basic information on this help page, suggestions for other sources of information include the National Institute on Mental Health – NIMH-OCD page, the International OCD Foundation and NAMI’s OCD page.

Personal stories of people living with OCD can also be very useful in helping someone understand what it is like. Some examples include:

Some people with mild OCD improve without treatment. More moderate or severe OCD usually requires treatment. However, there are often periods of time when the symptoms get better. There may also be times when symptoms get worse, such as when a person is stressed or depressed.

Try to learn as much as you can about OCD, what it’s like, and what options are available to treat and manage the disorder. Remember to view compulsive behaviors as part of a medical condition and not personality traits or a matter of simple choice. Recognize small accomplishments – what may seem like a small change may actually take significant effort. Be patient – remember progress may be slow and symptoms may increase or decrease at times. Be mindful of changes — any change, including positive change, can be stressful and increase OCD symptoms. Work together with your family member to develop a family plan with agreed upon actions for managing symptoms. For example, set limits on discussions relating to obsessions/compulsions. Assistance from a mental health professional may be useful.

Yes, OCD is more common among people who have a family member who has the disorder. People with an immediate relative (parent or sibling) with OCD are two to five times more likely to experience OCD than someone without a close relative with OCD.

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Author

Tristan Gorrindo, M.D.

Tristan Gorrindo, M.D.

Chief Medical Officer
Optum Behavioral Care

Medical leadership for mind, brain and body.

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