Obsessive Compulsive Disorder

People with obsessive-compulsive disorder (OCD) have unwanted thoughts that come back to them over and over again, making them feel upset or anxious. People deal with these thoughts by doing things over and over again, which can make it hard to go about daily life. Medication and exposure and response prevention treatment are both available and have been shown to work. One in forty adults has OCD, which means that the disorder is quite common. However, less than 10% of people who have signs will go to therapy.

Find out more about OCD’s signs, diagnoses, reasons, and treatments below.

What OCD Is, Its Signs, and How to Diagnose It

What does OCD mean?

OCD is a mental illness that causes people to have unwanted, unwanted thoughts over and over again, which can be scary or uncomfortable. They also feel the need to do repetitive actions, like checking or washing, to calm down when they are feeling worried or uncomfortable. Often, obsessions and compulsions can get in the way so much that the person may not be able to do regular things. If these thoughts or obsessions take up at least an hour a day, the condition can be found.

What are the signs of OCD?

There are two main types of OCD symptoms: obsessions and compulsions. OCD symptoms can range from mild to serious.

People have obsessions when they have thoughts, pictures, or feelings that they don’t want and that bother them. Many people have unwanted or scary thoughts or pictures all the time. But someone who doesn’t have OCD can block out those thoughts without feeling anxious or uncomfortable, while someone who does have OCD can’t. Many times, people are aware that their habits are irrational, but that doesn’t mean they can get rid of the thought. Obsessions can take up a lot of time and make it hard to go about your daily life.

People who have an obsessional thought do things that make them feel better in order to get rid of the worry and/or discomfort that comes with the thought. They might have nothing to do with the thought or picture, but they help temporarily with the upsetting obsession. Over time, someone with OCD starts to connect the routine with feeling better, which makes it harder to stop doing the compulsion. It’s important to remember that not all habits or behaviors that happen over and over again are signs of OCD. It depends on what the behavior is used for. We consider something to be a compulsion if it helps reduce worry or stress. Compulsions are usually not things that people do that don’t help them deal with their problems.

What are the signs of OCD?

As of now, there are no imaging or lab tests used to diagnose OCD. However, the DSM-5 (Diagnostics and Statistics Manual), which mental health workers use to make diagnoses, has criteria for diagnosing OCD. Another tool that can help explain the signs of OCD is the Yale Brown Obsessive Compulsive Scale.

For someone to be diagnosed with OCD, they must have these repeated, irrational thoughts or pictures (obsessions) and do things that help them calm down (compulsions). They have to bother you for at least an hour a day and make it hard to go about your daily life.

The DSM-5 says that these obsessions and compulsions can’t be caused by another disease in order to be diagnosed with OCD. For instance, someone with an eating disorder might have eating routines, someone with schizophrenia or another psychotic disorder might have disturbing thoughts, and someone with Generalized Anxiety Disorder might worry too much. In these situations, the person might not be labeled with OCD. People may have milder symptoms that don’t meet all the standards for an OCD diagnosis. However, treatment for the symptoms they do have can still help them a lot.

As with all psychiatric illnesses, diagnosis can be hard and confusing because symptoms can be shared by more than one disorder. It is important to see a licensed clinician for a good evaluation.

Can you name the different kinds of compulsions?

• Picking at your skin (dermatillomania): picking at your hangnails, hair, scabs, moles, freckles, chest, shoulders, and other places, even when it hurts or bleeds.
• The act of pulling out eyelashes, eyebrows, hair from the head, or hair from other parts of the body is called hair pulling.
• Cleaning: Washing hands, taking showers, or cleaning too much.
• You can do multiple physical checks, like making sure the stove is off, or thought checks, like making sure you haven’t hurt anyone.
• Mental routines include things like going over what happened to make sure nothing bad happened or telling yourself over and over that you’re okay.
• Think, say, or do something over and over again. For example, to protect your best friend, say the word “green” five times out loud every time you walk by their house.
• Saying “cancel that thought” over and over to get rid of a thought is one way to cancel it.
• When you eat in a certain way or order to keep bad things from happening, this is called ritualized eating.
• For example, needing to have pencils on a table at perfect 90-degree angles is an example of ordering and symmetry.
• The person with hoarding is unable to get rid of things, even if they are broken or what most people would consider trash. Letting go of things causes them a lot of stress, and they may do anything to get them back.
• If someone feels irrationally guilty about something, they feel like they have to admit it. For example, you might feel like you have to tell your boss that you went to the bathroom twice even though you are allowed to.
• Seeking reassurance means questioning one’s choices all the time, like having to ask several people at the store over and over again if they should buy a certain item.
• Touching, tapping, or rubbing oneself or things over and over again. For example, you might feel the need to open and close the kitchen cabinets nine times before making coffee in the morning, or you might feel the need to tap the desk three times every time you read a new line in a book.
• Behaviors that hurt oneself, like hitting oneself over and over again; this is different from behaviors that aren’t meant to kill oneself or behaviors that are.
• People think of these actions as compulsions because they help lessen the intense worry that comes with having these upsetting thoughts or pictures. They might not be the same (worrying about germs might not have a cleaning routine; it could be counting, looking for reassurance, checking the lock, or something else).

You don’t have to count sheep to fall asleep at night unless you have to do it every night at the same time and in the same way, and if you “mess up,” you have to start over or an unwanted thought or picture may keep coming back to you. You don’t have to check the stove before you leave for work, but you do have to check it so many times that you can’t leave for hours.

Does childhood OCD happen?

Yes, obsessive-compulsive disorder can show up in kids in different ways than it does in adults. For kids with OCD, it can look like they aren’t paying attention, not talking in public or in class, acting out, or acting sad or unhappy while shutting out the world. Because OCD can look so different in kids who might not be able to explain it, it is important to get a proper evaluation from a trained professional.

Just how common is OCD?

OCD is thought to affect about 1 in 40 people, or 2.3% of adults. It’s thought to happen to about 1 in 100 children, or 1% of children. This is an estimate of the number of people who fully meet the disorder’s criteria. The number of people who have OCD symptoms but don’t meet the full criteria is much higher.

People usually first show signs of OCD between the ages of 9 and 11 or 20 and 22. Even though these are common times for OCD to happen, it can happen at any point in a person’s life. People of all races, countries, and genders can have OCD.

Find out more about how common OCD is here.

Different Ways to Treat OCD

What’s the best way to treat OCD?

Cognitive behavioral therapy (CBT) called Exposure and Response Prevention (ERP) has been shown to be the best way to help OCD.

In Exposure and Response Prevention, the therapist first teaches the client about the best way to treat their OCD and helps them figure out what is bugging them. People with OCD learn that the best way to deal with their fears is to face them slowly but steadily over time. This helps their brain learn that everything is okay.

The client and their provider work together to make decisions about exposure and reaction prevention therapy. This helps the client quickly understand how much control they have over their brain patterns. The brain learns that it is possible to deal with worries without having to act or do certain things, and the nervousness goes down over time.

You can also get help with medications, which, when used with the above therapy methods, can help clients remain in treatment and get better faster. People often look into this if therapy has been tried and isn’t working quickly or if the symptoms are so bad that they make it impossible to start treatment.

Behavioral treatments like Acceptance and Commitment Therapy (ACT) and mindfulness can also help get rid of obsessions, especially thoughts that keep coming back to you. Therapy and support groups can also help a lot because they let the client know they’re not the only one going through hard times and can help them feel less anxious and ashamed.

What does exposure and reaction prevention look like in real life?

You may have stopped going to the grocery store because you feel like you have to wash your hands 23 times afterward, each time with 10 pumps of soap and boiling hot water and a clean towel. Some people think that if they don’t do this, the germs won’t come off and they’ll then get them on their partner or kids. People usually wash their hands or use hand sanitizer after going to the store. But for someone with OCD, washing their hands is a direct response to an obsessional thought, helps reduce the anxiety that comes with the obsessional thought, and is very rigid about how it needs to be done in order to become relieved.

In this case, the goal of exposure and response prevention treatment would be to get to the point where you don’t need to wash your hands before going to the store (exposure).

Yet, it’s likely very hard for you to go to the store without washing your hands from the first day of treatment. Instead, your therapist might begin by exposing you slowly. First, think about what it would be like to not wash your hands before going to the store. After that, you could wash your hands 22 times while you’re in the store, maybe with your therapist. After 21 times. Over time, you would wash your hands less often until you didn’t need to wash them at all.

Is it possible to get rid of OCD?

Most people with OCD are not “cured” in the sense that they never have any more bothersome thoughts or compulsions. OCD is like a long-term illness that gets a lot better and easier to deal with when it is managed.

A person is not “cured” if they never have another intrusive thought. Instead, they feel better over time because they know how to deal with their intrusive thoughts using the skills they learned in ERP.

It is normal to have unwanted or bothersome thoughts, so there is no way to get rid of them. In treatment, clients learn how to deal with their OCD if and when it comes back. Clients with OCD are in charge of how to lessen its power over their lives once they know the tools.

Which medicine works best for OCD?

SSRIs (selective serotonin reuptake inhibitors) are the first medicines that are used to treat moderate to serious OCD. Most of the time, people with OCD need to take bigger doses of these drugs than people with depression or generalized anxiety.

The next time you see your provider, you can talk about whether drug management is right for you and the pros and cons of each choice.

How can you help someone who has OCD?

To help someone with OCD the most, show them you understand and care, and be there for them as they go through treatment. Try not to judge what they do or how they think. Find out how you can help them. A lot of the time, therapists will teach family and friends how to help a client who gives permission.

To help, it’s helpful to know as much as you can about OCD and how to treat it. It is very important for parents to be involved in their child’s care so that everyone knows about exposure and response prevention (ERP) and can help the child use the skills learned in ERP when they need to.

There is a difference between obsessive-compulsive disorder (OCD) and OCD.

It can be hard to tell the difference between these two illnesses. The main difference between OCD and OCPD is that someone with OCD has clear and recognizable obsessions and compulsions, while someone with OCPD is obsessed with order and perfectionism and tries very hard to pay close attention to every detail, even if it hurts their daily life and relationships. A person with OCPD usually doesn’t know about these problems or how they affect other people.

Get help for your OCD.

What should I look for in a doctor for OCD?
Make sure that any doctor you talk to about your OCD has training in Cognitive Behavioral Therapy (CBT) and more specifically Exposure Response Prevention (ERP). Also, find out if the therapist specializes in anxiety disorders and how many of their cases are linked to OCD or those disorders.

Clients can talk to potential therapists before the first session to see if they are a good fit for their needs. Most therapists will be happy to talk to potential clients on the phone before the first session.

Not used to therapy? Find out how to get in touch with a doctor here.