Obsessive-Compulsive Disorder

Obsessive-compulsive disorder causes people to feel trapped by distressing and senseless thoughts or to feel as if they have to repeat actions, such as washing their hands or checking locks.

As Good as It Gets

In the 1997 movie As Good As It Gets, actor Jack Nicholson portrays a character who does many things that seem odd. He feels as if he has to eat lunch at the same table each day, and he always brings his own plastic uten-sils. He follows a complicated procedure to lock his front door. Many of the things he does, from the way he walks around cracks to the way he talks and thinks, are making his life more difficult to live. This character has obsessive-compulsive (ob-SES-iv-kom-PUL-siv) disorder, a mental disorder that affects approximately 4 to 7 million people in the United States.

What Is Obsessive-Compulsive Disorder (OCD)?

Many people have little rituals ^* that they follow. They might walk the same way to school every day or always touch a particular tree before going into their house. Other people have superstitions ^* , so they might refuse to walk under a ladder. These rituals and superstitions are generally harmless.

People with obsessive-compulsive disorder go much further. Some have obsessions ^* , which are repeated thoughts, urges, or images that intrude into a person's mind and seem senseless and distressing. Others have compulsions ^* , which are repeated behaviors or mental acts that a person feels driven to perform. Such behaviors are aimed at preventing or reducing distress, not providing pleasure. For example, people might have repeated, unnecessary doubts about whether they have performed an important task, such as locking the door. Or they might think that if they do not walk the same route to school every day, something awful will happen to them or to someone they love.

Obsessive thoughts can push aside more important things that the person needs to do and make the person feel compelled to take action. For example, people may follow the same route to school even if it takes them miles out of their way or makes them late for class. Or they may let their doubts about touching the tree cause them to go out and touch it again, only to doubt again whether they took the action. Such people may follow their compulsions because they hope to ease the anxiety ^* they feel about their obsessions.

The key difference between a harmless ritual or superstition and obsessive-compulsive disorder is that the thoughts and behaviors disrupt the lives of people with the disorder. They cannot resist their obsessions and compulsions, even though they know it makes little sense to think and do the things they do.

Doctors are not sure what causes obsessive-compulsive disorder. However, they suspect that the cause involves neurotransmitters ^* in the brain that are not sending signals correctly.

What Are the Symptoms of Obsessive-Compulsive
Disorder?

The first signs of obsessive-compulsive disorder often appear during the late teenage years. The most common symptom is anxiety over germs. This may lead to washing the hands repeatedly, often with harsh cleansers, or to the fear of catching a disease from shaking hands or eating in restaurants.

Other symptoms include checking rituals, such as returning often to check a door lock, even though each time the person finds it locked. Some people with obsessive-compulsive disorder have violent thoughts. They may fear that they or someone they love will die in a horrible accident or that they will harm someone. One example is drivers who fear that they have run down someone, so they return to the spot to check or give up driving.

How Is Obsessive-Compulsive Disorder Diagnosed
and Treated?

Obsessive-compulsive disorder is considered a type of anxiety disorder ^* . Diagnosis involves looking for symptoms and ruling out other physical and mental conditions, including other anxiety disorders. Many patients respond well to prescription drugs that change how neurotransmitters work in their brain.

Behavior therapy ^* to help patients overcome their anxieties also may be useful. One of the most effective types of behavior therapy is known as exposure and response prevention. During treatment sessions, patients are exposed to situations that give rise to their obsessions and compulsions. Patients then learn how to reduce, and eventually stop, their usual responses.

Although there is no way to prevent the disorder, it is important to seek help. Many people with obsessive-compulsive disorder hide their symptoms and withdraw from social contacts. They wait years to seek help, even though treatment is available and quite often successful.