Obsessive-compulsive disorder is one of the most seriously misunderstood mental health conditions today.
OCD is often portrayed as extreme cleanliness or annoying perfectionism, but the reality is much more complex. True OCD is characterized by frightening obsessions, time-consuming compulsions, and high levels of anxiety — it is a lifelong disorder that's causes are not fully understood.
OCD affects between 1 and 3 percent of all adults, 80 percent of whom show symptoms before the age of 18. It affects both genders relatively equally, and studies have shown no correlation with race. Symptoms of OCD and ADHD can overlap.
Obsessions and Compulsions
OCD in its most basic form consists of two parts:
Obsessions are recurring unwanted thoughts that are seen by the individual as intrusive and beyond their control.
Compulsions are repetitive behaviors or mental acts that someone with OCD may feel compelled to perform to “undo” the obsessive thought.
Obsessions can be about anything, but common obsessions include fear of contamination or germs, fear of something bad happening, fear that the individual has "sinned" or wronged God in some way, or unwanted sexual or violent thoughts.
When someone with OCD finds himself tortured by an obsession, he’ll resort to his compulsion in an attempt to neutralize or push away the thought. Compulsions can be directly related to the obsession — repeatedly washing hands in response to contamination fears, for example — but they don't have to be. Common compulsions include praying, counting, repeatedly "checking" things like locks and stoves, or calling close family members to make sure they’re all right. Doing these "rituals" provides, at best, temporary relief from the torment of the obsession. Not doing them can lead to unbearable anxiety.
In most cases, people with OCD know that their obsessions and compulsions are wholly irrational. In fact, that knowledge tends to increase the anxiety and shame they feel about their condition, and can make them hesitate to seek treatment — instead convincing themselves that they can overcome the problems with willpower. If left unchecked, OCD tends to get worse over time, often leading to serious depression and — in many cases — social isolation as the affected person tries desperately to avoid situations or people that trigger symptoms.
Learn more about OCD symptoms in this free webinar-on-demand with Dr. Roberto Olivardia.
Causes of OCD
Some studies suggest that OCD is linked to an imbalance of serotonin in the brain, as well as deficiencies in the basal ganglia and prefrontal cortex. Misfirings in this area of the brain can lead to rigid thought patterns and repetitive behaviors.
OCD can be diagnosed in children as young as 6, but symptoms typically manifest during the adolescent years or early adulthood. The average age of diagnosis is 19. Some developmentally appropriate childhood behaviors (obsession with rules, ritualistic eating habits, etc.) can look like OCD, but most children outgrow these habits as they mature.
OCD is biologically based and can be hereditary. Family members of people with OCD are more than twice as likely to have the disorder than are people without affected relatives. Even if family members don’t exhibit symptoms of pure OCD, they’re likely to suffer from other disorders on the "OCD spectrum," including anorexia nervosa, body dysmorphic disorder, or trichotillomania (compulsive hair pulling).
Outwardly, OCD can share symptoms with a number of other neurological disorders, including ADHD. People with OCD may seem distracted or unable to focus, and are often sensitive to touch and sound. If their OCD is uncontrolled, they can show symptoms of depression, including difficulty sleeping, lethargy, and deep feelings of shame and guilt.
OCD is highly treatable, either with medication or a type of therapy known as ERP, or Exposure and Response Prevention Therapy. For many suffering from OCD, the first step into treatment is difficult to make — but once taken, the results are well worth it.