Obsessive Compulsive Disorder

What is Obsessive Compulsive Disorder (OCD)?
Obsessive Compulsive Disorder is an anxiety disorder where a person uses ruminative thoughts or rituals to control anxiety. Obsessions are thoughts that insistently intrude into a person's mind against his or her will and continue to recur despite all efforts to stop them. Compulsive rituals - repetitive actions a person feels compelled to carry out despite his or her better judgment - are often associated with the obsessive behavior.

What causes OCD?
Most people engage in some types of rituals or unacceptable thoughts at some point in their lives. Such behavior becomes a problem when it becomes so extensive and time-consuming that it interferes with a person's daily life. Research indicates OCD involves abnormal metabolism of serotonin in the brain. There is evidence that OCD may run in families and across generations. However OCD has been diagnosed in individuals with no family history of OCD.

Signs and Symptoms
There are five forms of ritualizing: cleaning, checking, hoarding, orderliness, and repeating. Cleaners and checkers are the most common.

Cleaners attempt to avoid "contaminates" and will engage in prolonged and ritualistic washing or cleaning (i.e., excessive hand-washing, avoidance of touching door knobs or using a public restroom).

Checkers worry to the point of obsession about future harm or danger. They check to avoid these dangers. For example, a checker who fears fires may return home repeatedly during the day to check the stove or to be sure no one left a candle lit somewhere.

Orderliness is a form of checking. Such a person will insist on doing a task in a particular order without interruption. If an interruption occurs, the person will feel compelled to re-start the task from the beginning. For example, a person may feel compelled to arrange his or her clothes on hangers, by color, with exactly one inch between each hanger.

Hoarders fear throwing things away. They may check the empty cereal box a dozen times before throwing it away. They may also have collections of old newspapers or strings.

Repeating ritualizers will do tasks by numbers - a certain number of times or in multiples of a certain number. For example, a woman may feel compelled each time she brushes her hair, to use 30 strokes.

Treatment Options
Probably the best treatment for OCD is a combination of medication and behavior therapy. (Traditional talk therapy alone has generally been found ineffective in reducing symptoms of OCD.) Because OCD is believed to involve an imbalance in serotonin in the brain, an antidepressant will likely be prescribed. Behavior therapy can work to reduce the anxiety that drives the obsessive compulsive behaviors by gradually exposing the person to what he or she is afraid of, getting him or her to label the fear as a thought, not a realty, then preventing the rituals used to reduce anxiety.

Information source: Pine Rest TODAY Magazine, "Anxiety Disorders: Riding the Storm Out." Copyright © Fall 1994.