Obsessive-Compulsive Disorder Health Article

Definition

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. Anxiety disorder is the experience of prolonged, excessive worry about circumstances in one's life. OCD is characterized by distressing repetitive thoughts, impulses, or images that are intense, frightening, absurd, or unusual. These thoughts are followed by ritualized actions that are usually bizarre and irrational. These ritual actions, known as compulsions, help reduce anxiety caused by the individual's obsessive thoughts. Often described as the "disease of doubt," the sufferer usually knows the obsessive thoughts and compulsions are irrational but, on another level, fears they may be true.

Description

Most people with obsessive-compulsive disorder have both obsessions and compulsions, but occasionally a person will have just one or the other. The degree to which this condition can interfere with daily living also varies. Some people are barely bothered, while others find the obsessions and compulsions to be profoundly traumatic and spend much time each day in compulsive actions. Because the symptoms are so distressing, sufferers often hide heir fears and rituals but cannot avoid acting on them. OCD sufferers are often unable to decide if their fears are realistic and need to be acted upon.

Obsessions are intrusive, irrational thoughts that keep popping up in a person's mind, such as the urgency to wash one's hands again. Typical obsessions include fears of dirt, germs, contamination, and violent or aggressive impulses. Other obsessions include feeling responsible or others' safety or an irrational fear of hitting a pedestrian with a car. Additional obsessions can involve excessive religious feelings or intrusive sexual thoughts. The patient may need to confess frequently to a religious counselor or may fear acting out the strong sexual thoughts in a hostile way. People with obsessive-compulsive disorder may have an intense preoccupation with order and symmetry or may be unable to throw anything out.

Compulsions usually involve repetitive rituals such as excessive washing (especially hand washing or bathing), cleaning, checking and touching, counting, arranging, and/or hoarding. As the person performs these acts, he may feel temporarily better, but there is no long-lasting sense of satisfaction or completion after the act is performed. Often, a person with obsessive-compulsive disorder believes that if the ritual is not performed, something dreadful will happen. While these compulsions may temporarily ease stress, short-term comfort is purchased at a heavy price—time spent repeating compulsive actions and a long-term interference with life.

The difference between OCD and other compulsive behavior is that while people who have problems with gambling, overeating, or with substance abuse may appear to be compulsive, these activities also provide pleasure to some degree. The compulsions of OCD, on the other hand, are never pleasurable.

OCD may be related to some other conditions, such as the continual urge to pull out body hair (trichotillomania); fear of having a serious disease (hypochondriasis); or preoccupation with imagined defects in personal appearance disorder (body dysmorphia). Some people with OCD also have Tourette syndrome, a condition featuring tics and unwanted vocalizations (such as swearing). OCD is often linked with depression and other anxiety disorders.