Obsessive-Compulsive Disorder (OCD)

Symptoms

Symptoms of OCD include:

• Obsessions. These are unwanted thoughts, ideas, and impulses that you have again and again. The thoughts are hard to control and usually cause a lot of distress or anxiety. Examples include:
  • A driving need to do things perfectly or correctly.
  • A fear of getting dirty or infected.
  • Feeling like something bad will happen if things aren’t done a certain way.
• Compulsions. These are behaviors that you repeat to try to reduce the distress caused by these thoughts. Examples include:
  • Checking that doors, appliances, or locks are secure.
  • Counting or repeating words, steps, or actions.
  • Washing or arranging things or mentally repeating phrases.

The obsessions or compulsions usually take up a lot of time—more than 1 hour a day.

What Happens

With OCD, you have disturbing, obsessive thoughts that cause fear or anxiety. To get rid of the anxiety, you perform rituals, such as repeated hand-washing or checking that something has been done. But the relief is only temporary. The thoughts come back, and you repeat the rituals.

The rituals or behaviors take up a lot of time. They have a big impact on your daily life. OCD can lower your quality of life because it affects your ability to work and have relationships.

Treatment, such as counseling and medicines, can reduce the symptoms of OCD.

Exams and Tests

Your doctor can check for OCD by asking about your symptoms and your past health. A physical exam may also be done. And you may also get a mental health assessment. This is a check of your emotions and how you think, reason, and remember. You may be given written or verbal tests. The doctor may also look at your appearance, your mood, your behavior, and how you express yourself.

Treatment Overview

Treatment for OCD includes counseling and medicines. Using both tends to work best.

Counseling includes a type of cognitive behavioral therapy called exposure and response prevention (ERP). ERP slowly increases your contact with the thing that causes worries or anxiety. With the help of a counselor, ERP can reduce your symptoms over time.

Antidepressant medicines called selective serotonin reuptake inhibitors (SSRIs) are most often used. Antidepressants work differently for everyone. Your doctor will help find the medicine and dose that works best for you.

Treatment can make your symptoms less severe. But you may still have some mild symptoms after you start treatment.

Self-Care

It's important to take care of yourself every day when you have OCD. Take your medicines as directed. And do the homework your therapist gives you. The homework may include exercises called ERP. This stands for exposure and response prevention.

Reducing overall stress in your life is not a proven treatment for OCD symptoms. But it may help you cope.

It's a good idea to involve family members and loved ones in your treatment. This is even more important if your doctor suggested that you have therapy together. Keep the lines of communication open. It may help you deal with relationships that have become strained during your condition.

Helping Someone Who Has OCD

In order to help someone with OCD, it is important that family members or loved ones learn as much as possible about the condition.

It may help to attend counseling or support groups with or apart from your loved one who has OCD. You can learn ways to help the person with behavioral therapy. And you can learn ways to help them take medicines regularly.

You may also help by providing the health professional with information on behaviors and the effects of treatment.

How you respond to your loved one's symptoms is important. An angry response can make the symptoms worse. And accommodating the behaviors may also be harmful. It is important that you talk to your loved one's health professional about how you should respond and the best ways for you to help.

Medicines

After you are diagnosed with OCD, your doctor will likely prescribe antidepressants known as selective serotonin reuptake inhibitors (SSRIs).

SSRIs are used to relieve the obsessive thoughts and compulsive behaviors in people who have OCD.

In some cases it takes time to adjust the dosage or find the right medicine that will work for you. You may start to feel better within a few weeks after starting antidepressant medicines. But it can take up to 2 to 3 months.

If you have questions or concerns about your medicines, or if you aren't feeling better as expected, talk to your doctor. Your doctor may increase the dose or change to another medicine.

Medicine choices

Medicines used to treat OCD include:

• Antidepressants (SSRIs). Commonly used SSRIs include fluoxetine (for example, Prozac), fluvoxamine (Luvox), and sertraline (Zoloft). They are taken as tablets or capsules.
• Venlafaxine. This can also help symptoms of OCD.
• The tricyclic antidepressant clomipramine (Anafranil). It has been used for years to treat OCD. But it may have more side effects than SSRIs.
• Other medicines, such as antipsychotics.