Obsessive-compulsive disorder is one of the "anxiety disorders." It is marked by repetitive patterns of thoughts and behaviors that are senseless, disturbing and very difficult to overcome. This disorder can persist throughout a person's entire life and is often associated with difficulties in every aspect of life. OCD can range from mild to severe.

According to data obtained from the National Institute on Mental Health (NIMH), OCD affects more than 2 percent of the population. In other words, 50,000 people suffer from this condition. It equally affects men and women and all ethnic groups.

OCD typically begins in teenage years or early adulthood. However, some children do develop OCD as early as preschool. About one-third of all OCD cases begin in childhood. It is important to have your child evaluated by a doctor if you suspect he/she may be suffering from OCD.

Obsessions
Obsessions are those unwanted thoughts or impulses that repeatedly fill the minds of OCD sufferers. An OCD sufferer may "obsessively" think about a variety of things. There tends to be a theme to the obsessions.

The most common themes about which an OCD sufferer tends to obsess include:

                1. dirt and contamination
                2. aggression
                3. religion
                4. sex
                5. having things symmetrical or in perfect order
                6. somatic concerns

Obsessions may come in the following forms:

                    1. thoughts
                    2. impulses
                    3. doubts
                    4. images
                    5. fears

Obsessions tend to cause an excessive amount of anxiety and may lead to "compulsive" behaviors designed to help relieve these feelings.

Compulsions are repetitive behaviors that are performed in order to:

1. ward off harm to oneself or others
2. help relieve anxiety

Compulsions tend to take the following forms:

                1. cleaning
                2. checking
                3. counting
                4. slowing down (behaving is "slow motion")

Twenty five percent of all OCD sufferers do not have "motoric"compulsions. Rather, they have "neutralizing thoughts" which serve the same purpose as compulsions.

No pleasure is derived from these behaviors. Rather, they only provide the sufferer with temporary relief from the discomfort caused by the obsessions. These compulsive behaviors tend to be performed in a ritualistic way. The OCD sufferer often feels an urgency to perform these behaviors.

Most adults with OCD admit that these behaviors are senseless, but they can't stop them. Others, particularly children, however, do not realize this.

Let's look at a few examples of obsessions and compulsions together so that you might get a clearer understanding of this anxiety disorder.

                1. obsessed with germs so you compulsively wash your hands over and over;
                2. filled with doubt that you check things repeatedly;
                3. consumed with violent thoughts that you develop counting patterns to control your fears;
                4. you may be troubled by persistent sexual thoughts so you keep rearranging items.

Most people can relate to having some obsessive thoughts or compulsive behaviors, like getting out of bed to check the stove or checking that your doors and windows are locked when leaving the house. Many people tend to be "compulsive" cleaners or "obsessed" with our weight or a relationship. However, these examples do not necessarily constitute OCD.

                1. consume at least one hour per day
                2. cause personal distress
                3. interfere with your daily life

Men and women tend to be approximately equally affected by OCD.

OCD affects approximately 2% of the U.S. population in a given year.

OCD tends to first occur in the teenage or early adult years, although its onset can occur at any time. Approximately 33% of adults with OCD experienced their first symptoms in childhood.

Evidence suggests that OCD may run in families.

The course of OCD is variable. It may ease over time or it may grow worse. It may also come and go.

OCD sufferers may also suffer from a number of other psychological or emotional conditions, such as:

1. depression: feeling hopeless about their future or feeling damaged or inadequate

2. alcohol/drug abuse: in an effort to manage their anxieties

3. eating disorders

4. problems of avoidance: avoiding situations that may trigger their obsessions

OCD may be more difficult to diagnose and treat if it is accompanied by other psychological or physical conditions. Appropriate diagnosis and treatment of other disorders are important to successful treatment of OCD.

Treatment
A combination of medication and behavior therapy is typically the preferred and most effective treatment for OCD.

Medication Medications that affect the neurotransmitter serotonin have been shown to significantly decrease the symptoms of OCD.

These drugs are called Serotonin Reuptake Inhibitors (SRI's) and include:

                1. fluvoxamine
                2. paroxetine
                3. sertraline
                4. clomipramine
                5. fluoxetine

It is not unusual for patients to try several medications before finding which works best. If one drug is not effective, try another. If your response to the medicine is only partly effective, your doctor might use an additional drug, called an "augmenter," to increase the effectiveness of the medical protocol. Other medications are also being studied and are showing a great deal of promise.

Behavior Therapy
A procedure known as "exposure and response prevention" has been shown to be very effective in OCD treatment. This treatment involves exposing the OCD sufferer to the stimulus or situation which activates their obsessions (and consequential anxiety) while teaching him/her to engage in another behavior other than the usual compulsive ritual. Patients are taught to manage their anxieties in more effective ways.

An common example of this procedure is to have a person touch a dirty object and then not wash his/her hands, but to learn to relax and perhaps challenge their irrational thoughts. Patients gradually experience less anxiety from the obsessive thoughts and are increasingly able to function without the need for their compulsive behaviors.

Etiology (Cause)
Research evidence suggests that OCD has a neurobiological basis. In other words, it is not caused by a dysfunctional family nor is it learned from a neurotic parent. Having a parent who was a "neat freak" or a "worry wart" doesn't predispose you to OCD. That means that you are not likely to "teach" it to your children if you have OCD. Scientists see the cause of OCD as based in the interaction between neurobiological and environmental factors. OCD is sometimes accompanied by depression, eating disorders, substance abuse, attention deficit hyperactivity disorder, or other anxiety disorders.

Call your doctor. Tell him/her that you think you may have OCD. Help is out there.