OCD can disrupt your daily life. Obsessions and compulsions take up a lot of time and can make you feel anxious or afraid. They may also cause you to avoid people, places or situations that trigger your OCD symptoms.
Treatment includes psychotherapy and medication. Psychiatric drugs called selective serotonin reuptake inhibitors, such as citalopram (Celexa) and clomipramine (Anafranil), can help control obsessions and compulsions.
Obsessions
Unwanted, intrusive thoughts or mental images that keep coming back and cause anxiety and distress. You realize they're irrational, but you can't control them. They include fear of contamination, such as germs or dirt; fears of causing harm to others; and obsessive thoughts about sexuality or gender.
Compulsive behaviors are repetitive actions or mental acts that you feel compelled to do in order to reduce the distress from obsessions. They may include counting, checking things multiple times, or rituals related to numbers. They can also involve a sense of symmetry or ordering and excessive concerns with morality.
Some studies suggest that a history of childhood trauma, including abuse, may be linked to OCD. Other factors may be personality traits like difficulty handling uncertainty or a heightened sense of responsibility, or medications. The most common treatment plan includes psychotherapy (talk therapy) and medication. If medications don't help, your healthcare provider may recommend a procedure called transcranial magnetic stimulation (TMS). Symptoms of OCD often begin in childhood.
Compulsive behaviors
Obsessions are unwanted, persistent thoughts or urges. Compulsions are repetitive behaviors or mental acts (such as counting, praying or checking) that a person feels driven to perform in response to an obsession. The person knows that the behavior isn’t making the obsession go away, but they feel compelled to do it anyway. They may also believe that doing the compulsive action will prevent or reduce anxiety or distress that would occur if they didn’t do it.
Common compulsions include washing hands repeatedly for fear of contamination, checking things like locks or switches, and repeating the same actions over and over. People with body dysmorphic disorder often develop compulsions around grooming or picking at their skin. These are called BFRBs, or body-focused repetitive behaviors. Some examples include pulling hair out, which is called trichotillomania, or biting nails, which is called onychophagia. Obsessions and compulsions aren’t fun. They cause distress and take up hours of a person’s day. They can interfere with work, school and relationships.
Treatment
Obsessions and compulsions can be very time-consuming, and people who meet DSM-5 diagnostic criteria often report them interfering with their work or social life. Psychotherapy can help, especially cognitive behavioral therapy (CBT), which teaches you to change the patterns of thinking that contribute to anxiety and obsessive compulsive symptoms.
Your doctor will ask you about your symptoms and how they affect your daily functioning. He or she may refer you to a mental health professional for further evaluation and diagnosis, including a physical exam.
Treatment options include CBT, exposure and response prevention (ERP), imaginal exposure, and medication. Psychiatric medications called selective serotonin reuptake inhibitors, such as citalopram (Celexa), fluoxetine (Prozac), fluvoxamine (Lexapro), paroxetine (Paxil), and sertraline (Zoloft) can improve OCD. It may take 2 to 4 months before these drugs start working. You can also try taking anticonvulsants such as gabapentin (Neurontin) and pregabalin (Lyrica), or antipsychotics such as aripiprazole (Abilify) and risperidone (Risperdal). Participating in clinical trials that test new treatments is another way to help find better options for treating OCD.
Prevention
Obsessions are uncontrollable thoughts, images or urges that intrude on your mind and cause great anxiety. Compulsions are repetitive behaviors or rituals that you feel driven to perform in order to reduce the anxiety associated with your obsessions. For example, people who are afraid of contamination might develop elaborate hand-washing compulsions. Performing these rituals gives you only temporary relief and, in the end, they just create more anxiety.
Although there is no way to prevent OCD, early treatment can help. For example, keeping a diary of obsessive thoughts or worries may help you recognize how irrational they are. Identifying and anticipating your compulsive urges can also ease them. For instance, if you are prone to checking that doors are locked or appliances turned off, try to lock them or turn them off with extra attention the first time.
Certain risk factors can increase your chances of developing OCD, including a family history of the condition, depression or other mental health conditions, and stressful life events. Children can experience symptoms that look like OCD, but these usually occur in adolescence or young adulthood and can be treated with cognitive behavioral therapy and medicines.
