Obsessive Compulsive Disorder (OCD)

OCD affects 2.3% of the population, 3.3 million Americans and 1% of children. There is an equal distribution between men and women, and 1/3 of OCD cases begin in childhood.

Our lives have routines and rituals that provide structure to our days, the comfort of normality, and a certain degree of predictability to our lives. These routines allow us to function with ease.

With OCD these routines are rigid, overwhelming, controlling, and time consuming. People with OCD lose their ability to control their lives. Their obsessions rob them of clear logical thinking and their compulsions take more and more time and energy to perform.

Obsessions are defined as recurrent, persistent thoughts, impulses or images that are intrusive, inappropriate, unwanted or illogical. These thoughts cause increased levels of distress. The thoughts are not simply excessive worries about real life problems. Compulsions are repetitive, ritualistic, rigid behaviors or mental acts that the person feels driven to perform to decrease anxiety in response to an obsession. The compulsions are excessive and unreasonable.

Common Obsessions:
  • Nagging, irrational worries about dirt or contamination
  • Fear that negative or blasphemous thought or images will cause harm
  • Preoccupation with throwing away objects
  • Rumination about accidentally injuring another person
  • Excessive need for symmetry or order
  • Frequent doubts about anything
  • Unwanted sexual or aggressive thoughts
  • Scrupulosity-religious obsessions
  • Worries about aggressive thoughts or images
  • Fear of harming self or others
  • Fear of contracting or spreading illness
  • Magical thinking
  • Excessive need to know or tell or remember
  • Intrusive, unwanted sounds, words, music
  • Superstitious fears

Common Compulsions:
  • Cleaning repetitive hand washing, bathing or cleaning household items
  • Excessive or ritualized showering or bathing
  • Checking- multiple checks of locks, electrical items, homework
  • Checking for some terrible consequence or catastrophe
  • Repeating- names, numbers, phrases, tunes, tasks, superstitions
  • Slowness-painstakingly slow and methodical approach to daily activities
  • Hoarding-excessively saving items
  • Sorting through garbage for “useful” items
  • Mental rituals
  • Excessive listmaking, rewriting
  • Need to tough, tab, or rub
  • Need to tell, ask or confess
  • Ritualized eating behaviors
  • Self-damaging or self-mutilating behavior
  • Superstitious behavior

Causal Factors:
Biologic, Genetic, and/or Sociologic factors. Can be accompanied by other Anxiety Disorders, Depression, and/or Eating Disorders.

Treatment Options:
Cognitive Behavioral Therapy, Exposure and Response Prevention, and/or Medication.