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What
Is Obsessive-Compulsive Disorder?
APA
Let's Talk About... Series
Obsessive-Compulsive
Disorder is a type of anxiety disorder in which time-consuming
obsessions and compulsions significantly interfere with a
person's routine, making it difficult to work or to have a
normal social life or relationships. At some point in the
course of the disorder, the person realizes that the obsessions
or compulsions are excessive or unreasonable
Obsessions
are recurrent, persistent, intrusive, unwanted thoughts that
cause distressing emotions such as anxiety and disgust. Many
such thoughts center on fears, such as fear of catching or
spreading germs and fear of suffering bodily harm or of hurting
others.
People who experience these strong obsessions recognize that
the thoughts are a product of their own mind and are excessive
or unreasonable. But they cannot rid themselves of these thoughts
by logic or reasoning. Often, people with obsessive-compulsive
disorder (OCD) find that certain behaviors or rituals reduce
their fear and discomfort, and so they feel compelled to repeat
them.
Compulsions
are urges to do something repeatedly that will lessen a fearful
thought or the discomfort it produces. Rituals are the behaviors
people rigidly employ to reduce the tension of a compulsion.
In the most severe cases, a constant repetition of rituals
may fill the day, making a normal routine impossible. Compulsions
include:
- Cleaning:
Provoked by the fear that real or imagined germs, dirt,
or chemicals will "contaminate" them. Some people
spend hours and hours washing themselves or cleaning their
surroundings.
- Repeating:
To dispel anxiety, some people repeatedly utter a name or
phrase or perform a behavior several times. Although they
understand that the repetitions won't actually guard against
injury, their fear that they will be harmed if they don't
repeat the behavior compels them to act.
- Completing:
People with this compulsion must perform a series of complicated
behaviors in an exact order, repeating them until they are
done perfectly.
- Checking:
The fear of harming oneself or others by forgetting to lock
the door or turn off appliances can develop into the ritual
of checking. Some people repeatedly retrace routes they
drive to be sure they haven't hit anyone or caused any accidents.
- Hoarding:
Hoarding involves the collection of useless items. People
who hoard may collect anything-newspapers, clothing, stones,
garbage-to the point hat rooms are filled, doorways are
blocked, and health hazards occur.
HOW IS OCD TREATED?
Obtaining treatment is critical because OCD rarely resolves
on its own. Many people suffer for years before getting help.
Behavior therapies are intended to help people decrease
and ultimately stop the obsessions and compulsions that plague
their lives. Various studies indicate that behavioral therapy
is successful for 50 to 90 percent of people with OCD.
One of the most effective treatments is a type of behavioral
therapy known as exposure and response prevention. During
treatment sessions, patients are slowly exposed to the situations
that give rise to their anxiety and that provoke compulsive
behavior or rituals. A patient may also follow guidelines,
sometimes in the form of an agreement between the psychiatrist
and the patient. For example, the guidelines may permit the
patient to perform only a part of a ritualistic behavior and
may limit the number of repetitions.
Psychotherapy, group therapy, and family therapy have
been helpful for some patients, especially when combined with
medication and behavioral techniques.
Medication.
For many years clomipramine, was the best-recognized and most
studied pharmacotherapy for OCD for many years. However, the
introduction of selective serotonin reuptake inhibitors (SSRIs),
has added substantially to the effective treatment of this
disorder. For some people who have only a partial response
to an SSRI, combining an SSRI with another medication can
improve symptoms.
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MORE INFORMATION…
©
Copyright 2001 The American Psychiatric Association
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