Obsessive Compulsive Disorder (OCD)

a disorder in which people have recurring, unwanted thoughts, ideas, or sensations that make them feel compelled to do repetitive actions

Have you ever been lying in bed at night, exhausted and just about to give in to sleep, when suddenly you can't remember if you locked the front door? You get up, check the door, confirm it is locked, and head back to bed. For many people, that is enough. But with OCD, the second-guessing continues to the point of obsession. In an effort to manage the worry and anxiety that comes with the obsession, people with OCD may develop a ritual. Perhaps they lock the door twice, wiggle the doorknob three times, and tug at the door five times before they head to bed. The ritual become an integral part of everyday functions, to the point that it causes dysfunction.

​OCD is a compounding disorder that will likely get worse if untreated, but it is also, fortunately, highly treatable.

What causes OCD?

Like most psychiatric disorders, the cause of OCD is unclear, but it is likely informed by genetics, biology, and environment. Changes in brain function or chemistry can create changes in thought patterns, which may provoke anxiety and worry. A stressful environment may trigger OCD behaviors, especially if they have been present in the family as a method of coping. People who have anxiety, depression, substance abuse, or tic disorders are at greater risk for developing OCD.

There isn't anybody out there who doesn't have a mental health issue, whether it's depression, anxiety, or how to cope with relationships. Having OCD is not an embarrassment anymore – for me.

Just know that there is help and your life could be better if you go out and seek the help."

- Howie Mandel

What are symptoms of OCD?

Symptoms of OCD generally present in teen years or early adulthood, but in some cases they can start in childhood. For most people with OCD, the symptoms come on gradually and will change in severity over time, usually worsening with stress. Due to the demands of the compulsion, OCD can become so time-consuming that it interferes with daily functioning and interpersonal relationships.

​There are predominately four types of OCD. "Washers" are obsessed with contamination and will be compelled to clean or wash hands beyond what is necessary for hygiene. "Checkers" are obsessed with checking things, leading to a compulsion to make sure that the oven is turned off or the door is locked, whatever will keep them safe. "Doubters and sinners" are obsessed with making things perfect to prevent something terrible from happening or to avoid punishment. "Counters and arrangers" are obsessed with symmetry and keeping things in order, leading to a compulsion to organize numbers, colors, or other elements.

Hoarding can also be a symptom of OCD, as 25% of people with OCD hoard out of fear that something bad will happen if they throw things out. However, there is also a hoarding disorder, which is an entirely different condition.

How is OCD treated?

OCD is considered a lifelong condition, but with treatment symptoms can be controlled and be less of an intrusion on your daily life. Treament for OCD relies on a combination of psychotherapy and medications. Cognitive behavioral therapy (CBT) with exposure and response prevention (ERP) is very useful in reducing symptoms. In ERP, a patient is exposed to the subject of their obsession and learn how to resist the urge to do rituals. Antidepressants such as clomipramine (Anafranil), fluoxetine (Prozac), fluvoxamine, Paroxetine (Paxil, Pexeva), and sertraline (Zoloft) have been approved by the FDA to treat OCD, however medications alone are rarely effective in reducing OCD symptoms. If symptoms are severe or treatment-resistant, more intensive or long-term treatment may be needed. These options include outpatient or residential treatment programs, deep brain stimulation, and transcranial magnetic stimulation.