HealthFacts

OBSESSIVE-COMPULSIVE DISORDER (OCD)

DEFINITION

Traits such as punctuality, diligence, cleanliness and careful organization are found and valued in many individuals. Such traits never become excessive in most people, but in some they may become so excessive that they cause severe distress and an inability to live a normal life. When these characteristics are present to such a degree, the individual is said to suffer from obsessive-compulsive disorder (O.C.D.) Studies have found that 1.5 percent of the American population (over 3 million people) probably have O.C.D. and 2.5 - 3 percent will have at some time in their lifetime. O.C.D. is equally common in men and women.

SYMPTOMS

O.C.D. is characterized by obsessions or compulsions. Obsessions are intrusive and unwanted ideas, thoughts, images or impulses that occur repeatedly. Individuals who have obsessions describe them as senseless, undesirable, repugnant as well as intrusive and involuntary. Common obsessional themes are:

• Aggression- harming others, acting on an illegal impulse, causing a disaster;
• Contamination- fear of things that lead to irrational fears of illness in themselves or others. Common things are germs or dirt, environmental contaminants such as toxic waste, or household cleaners or solvents;
• Sex- perverse sexual thoughts or impulses;
• Loss- fear of losing important people or possessions;
• Religion- blasphemous thoughts;
• Orderliness and symmetry;
• Doubt- unsure whether one has done something, ie: locking doors and windows.

These obsessions create anxiety, which in turn creates behavior to try and control the anxiety. These behaviors are called compulsions. Compulsions are behaviors that may seem purposeful but are performed in a ritualistic manner.

Common compulsions include:

• cleaning and washing
• checking
• hoarding
• counting
• touching
• repeating
• avoiding
• ordering / arranging
• reassurance seeking

90 percent of patients with O.C.D. exhibit both obsessions and rituals. Both obsessions and compulsions consume time (more than an hour a day), interfere with functioning, cause distress and are resisted yet are difficult to control.

Most people with O.C.D. recognize that their obsessions and ritualistic behaviors are excessive but feel powerless to respond rationally. They often fear they will be judged "goofy, stupid, insane, crazy, or bizarre" by others.

At its worst, O.C.D. can occupy virtually every waking moment of the persons life. The disorder can acutely affect other family members as the person may insist they comply with avoidance and rituals, such as not bringing "contaminated" friends into the house, changing clothes, or washing hands before meals.

TREATMENT

The ultimate goal of treatment is to reduce the symptoms. A combination of several therapies has been found to be most effective.

• Behavior Therapy - Behavior therapy consists of confronting the feared situations until the anxiety lessens and delaying the compulsive behavior for longer and longer periods of time. This technique often helps reduce the symptoms and establish more normal behavior. In some cases, people with O.C.D. forget how to do certain things normally. Having someone demonstrate normal behavior is often helpful in changing behavior.



• Medication - Medication is often used to decrease the acute anxiety O.C.D. creates. Antidepressants are occasionally used, particularly when there seems to be depressive symptoms also. Another medication that has been used recently with O.C.D. is Clomipramine.



• Support Groups - There are self-help groups available for people with O.C.D. The support groups provide specific support for coping and learning that others have very similar obsessions and rituals, reduces the fear of being "the only one." In the Twin Cities area call Obsessive Compulsive Disorder Support Groups 872-9752 or Obsessive Compulsive Anonymous 474-7184.

Health Facts are publications of ALLINA HEALTH SYSTEM'S BEHAVIORAL HEALTH SERVICES. For CRISIS or IMMEDIATE SERVICES call ASSESSMENT and REFERRAL at (612)863-8633 or 1-800-782-3520. For Additional Information call BEHAVIORAL HEALTH SERVICES at (612)422-4529