Obsessive-Compulsive Disorder

People with OCD have persistent, unwelcome thoughts or images, or feel the urgent need to engage in certain rituals. Their obsession may be with contamination of germs or dirt, and will consequently wash their hands over and over trying to keep them free from the contamination. They may fear that they have missed something or forgot to lock a doorand feel the need to check things repeatedly. People who have OCD often have other kinds of anxiety such as phobias (fear of spiders or fear of flying) or suffer panic attacks.

OD symptoms cause emotional distress, take up time (often more than an hour a day), or significantly interfere with the person's work, social life, or relationships. Most individuals with OCD recognize that their obsessions are coming from  their own minds and are not just excessive worries about real problems. When someone with OCD does not recognize that their beliefs and actions are unreasonable, it is called OCD with poor insight.

OCD symptoms tend to wax and wane over time and may be infrequent or constant. Some may be little more than background noise; others may produce extremely severe distress. Obsessions are accompanied by uncomfortable feelings such as fear, disgust, doubt, or a sensation that things have to be done in a way that is "just so (have to touch this bush six times and step to the left)."

Common obsessions are:

• Contamination fears of germs, dirt, bodily waste, etc.
• Imagining having harmed self or others
• Imagining losing control or aggressive urges
• Intrusive sexual thoughts or urges
• Excessive religious or moral doubt, Forbidden thoughts
• A need to have things "just so" , symmetrical, exact
• A need to tell, ask, confess
• Need for constant reassurance
• Thinking about certain sounds, images, words or numbers all the time
• Compulsions

People with OCD try to make their obsessions go away by performing compulsions. Compulsions are acts the person performs over and over again, often according to certain "rules." People with an obsession about contamination may wash constantly to the point that their hands become raw and inflamed. A person may repeatedly check that she has turned off the stove or iron because of an obsessive fear of burning the house down. She may have to count certain objects over and over because of an obsession about losing them.

Common compulsions:

• Cleaning and grooming, such as washing hands, showering or brushing teeth over and over• Checking over and over that drawers, door locks and appliances are shut, locked or turned off
• Repeating, such as going in and out of a door, sitting down and getting up from a chair, or touching certain objects several times
• Ordering and arranging items in certain ways
• Counting over and over to a certain number
• Saving newspapers, mail or containers when they are no longer needed
• Seeking constant reassurance and approval (constantly checking with supervisor that he or she is doing a good job)
• Unlike compulsive drinking or gambling, OCD compulsions do not give the person pleasure. Rather the rituals are performed to obtain relief from the discomfort caused by the obsession.

Other Mental Health Issues

OCD is easy to distinguish from a condition called posttraumatic stress disorder, because OCD is not caused by a terrible event. Schizophrenia, delusional disorders, and other psychotic conditions are usually easy to distinguish from OCD. Unlike psychotic individuals, people with OCD  have a clear idea of what is real and what is not.

OCD in Children and Adolescents.

OCD may worsen or cause disruptive behaviors  in children and adolescents, exaggerate a pre-existing learning disorder, cause problems with attention and concentration, or interfere with learning at school. In many children with OCD, these disruptive behaviors are related to the OCD and will go away when the OCD is successfully treated.

Pervasive Developmental Disorders

Children and adults with pervasive developmental disorders (autism, Asperger's Disorder) are extremely rigid and compulsive.  They have stereotyped behaviors that often resembles very severe OCD.  Those with pervasive developmental disorders have extremely severe problems relating to and communicating with other people, which do not occur in OCD.

Substance Abuse

Individuals with OCD often have substance-abuse problems,  as a result of attempts to self-medicate. Specific treatment for the substance abuse is usually needed.

Connections To Other Disorders  

People who have OCD also may have depression, attention deficit hyperactivity disorder (ADHD), an eating disorder or a learning disorder such as dyslexia.

Having one or more of these disorders can make diagnosis and treatment more difficult,

For more information visit the OCD Foundation’s web site at:

http://www.ocfoundation.org/what-is-ocd.html

Updated February 26, 2008 by Sheila Johnson, Disability Program Navigator.