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Obsessive-Compulsive Disorder: Over and Over and Over Again

Obsessive-Compulsive Disorder:
Over and Over and Over Again

How common is OCD?
Is OCD the same thing as being compulsive?
What causes OCD?
What is the treatment for OCD?
Can I take medicine for OCD?
Can talk therapy help OCD?

Like most people, you probably have a daily routine that keeps you feeling organized. You probably have some good habits, too. Like brushing your teeth twice a day. Or washing your hands before you eat. But if you find yourself washing your hands dozens of times every day, then you could have a problem called obsessive-compulsive disorder (OCD).

Just as the name suggests, OCD consists of both obsessions and compulsions. Obsessions are ideas and thoughts that pop into your head all the time. Some common obsessions are:
  • fear of dirt or contamination
  • worry about things being in order and lined up perfectly (like socks or papers)
  • constant thoughts about certain sounds or words or numbers
  • fear of harming a family member or friend
  • fear of thinking bad thoughts
Compulsions are "rituals" or rules that you make up to try to get rid of the obsessions, or things you have to do because you're too uncomfortable if you don't. Some typical compulsions are:
  • washing hands very frequently (until your hands are red and chapped)
  • checking repeatedly to see that doors are locked and lights are turned off
  • arranging things in perfect order all the time
  • counting to a particular number, over and over
  • praying a lot
  • repeating specific words to yourself
  • touching certain objects many times
If you have these obsessions and compulsions—or OCD—some of these things may sound familiar to you. Even if you know that they make no sense at all, you still need to do them because they seem to take away your anxiety. Of course, they do give you some relief—but only temporarily. Then you're right back where you started—and maybe even more anxious than before.

People with OCD often think that their rituals will keep them—and the people they love—from getting hurt. They think, "If I do X, then Y will happen." Everybody makes little bargains like this sometimes. Have you ever prayed for something to go your way? Did you offer to be extra good if you got what you wanted? People with OCD think this way all the time. They are sure that their rituals work like magic. Of course, that's not the case.

Some people have a mild form of OCD. They may be fine during the school day. But they have problems when they wake up in the morning or when they go to sleep at night. Other people have more serious cases. Their rituals take over their entire life—at home, at school, after school, at work. In fact, they sometimes make it impossible for people with OCD to live a normal life. That's because it's hard to get anything done if you're spending hours every day counting and repeating and checking. back to top

How common is OCD?
We used to think that only a few people had OCD. Unfortunately, the people who had the disorder were just too embarrassed to tell anyone about it, even their doctors. And so they tried to hide their disorder—and suffered alone. Now we know that almost 4 million people in the United States have OCD. By talking about the disorder, they are able to get help for it.

An equal number of women and men suffer from OCD. And people from all races, ethnic groups, and social classes get it. OCD often begins during the teen years or early adulthood. Young children can get it, too. In fact, some people who were adults when they were diagnosed with OCD probably had it when they were children. If they'd gotten help earlier, they could have saved themselves a lot of unhappiness. back to top

Is OCD the same thing as being compulsive?
Perhaps someone has called you—or your friend—a "compulsive" person. This is not the same as having OCD. A person who is compulsive tends to do all their homework on time. She cares about doing her best at sports and other extracurricular activities. Her bedroom may be really neat. (Now that's an accomplishment!) A compulsive person has high standards. Doing well makes her feel good about herself. But that's different from OCD, which is about obsessions and compulsions that take over part or most of your day and keep you from leading a happy, healthy life. back to top

What causes OCD?
No one knows for sure what causes OCD. One thing seems clear: if other people in your family have OCD, you could be more likely to get it. Scientists think OCD may be caused by an imbalance in a brain chemical called serotonin. They are also studying how other parts of the brain may be different in people with OCD. Many researchers believe that people may be born with a body and temperament that cause the kind of stress that triggers OCD. And others think OCD comes from certain childhood infections. back to top

What is the treatment for OCD?
The bad news is that there is no magic cure for OCD. At least, not yet. The good news is that excellent treatment is available. If you think you have OCD, don't stay away from your health care provider's office because you are ashamed or embarrassed. All mental health professionals who treat OCD have heard hundreds, maybe thousands, of stories from people who have the disorder. So they won't be surprised by what you tell them, even if your rituals involve the bathroom or things having to do with sex. They will not think you are strange or weird. They will think you need treatment so that you can go back to doing all of the things you enjoy.

Most health professionals recommend a combination of medication and talk therapy for OCD. But every individual is different, so you will need to work with your health professional and your parents to find the treatment that is best for you. It may take some time, but once you find the right treatment, you'll feel so much better. back to top

Can I take medicine for OCD?
Antidepressants may help relieve the symptoms of OCD. But you don't have to be depressed for these drugs to work. More than half of the people with OCD who use antidepressants get relief from their symptoms. These drugs work by making the serotonin in your brain stronger.

All medications, including antidepressants, can cause side effects, like nausea, dry mouth, and constipation. Or they can be dangerous if they are mixed with other medications or with drugs or alcohol. Your health professional should talk with you about these risks. Often if the first medicine you try does not help, your health care provider may recommend trying another one. Remember that it can take a few weeks before you begin to feel the medicine working.

Never, ever take a medication that a friend offers you. And never give—or sell—a medication to someone else. That's dangerous—and it's against the law. back to top

Can talk therapy help OCD?
Behavioral therapy can be very effective. A special type of behavioral therapy called "exposure-and-response prevention" is especially popular. In this approach, you are exposed directly to one of your obsessions. But then you are prevented from doing the ritual that helps you get rid of your anxiety (temporarily, that is). For instance, your mental health professional may encourage you to touch something that you think is dirty. But you will not be allowed to wash your hands. After you've done this work for about 10 weeks, your symptoms will begin to disappear—although maybe not completely. Some mental health professionals suggest follow-up sessions after the first round of treatment to make sure that your symptoms don't come back again.

Cognitive-behavioral therapy is also helpful to some people with OCD. This kind of therapy helps people change their beliefs and thinking patterns.

Traditional psychotherapy, which helps people explore and understand their problems, is usually not that helpful for people with OCD by itself. But it can help you understand yourself and know when your OCD symptoms are likely to be worse. back to top

Last Modified Date: 3/28/2001
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