Obsessive-compulsive disorder

Obsessive-Compulsive Disorder (OCD) is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviour (compulsions) that he or she feels the urge to repeat over and over.

Many people without OCD have distressing thoughts or repetitive behaviours. However, these thoughts and behaviours do not typically disrupt daily life.

For people with OCD, thoughts are persistent, and behaviours are rigid. Not performing the behaviours commonly causes great distress. 

Obsessive-compulsive disorder Symptoms:

OCD comes in many forms, but most cases fall into at least one of four general categories:

Cleaning and contamination

This type of symptom may involve:

• persistent worry about germs or sickness
• thoughts about feeling dirty or unclean 
• persistent fears about exposure to blood, toxic substances, viruses, or other sources of contamination
• avoidance of possible sources of contamination
• compulsions to get rid of items you consider dirty
• compulsions to wash or clean contaminated items
• specific cleaning or washing rituals, such as washing your hands or scrubbing a surface a certain number of times

Symmetry and ordering

These symptoms may involve:

• a need for items or belongings to be aligned in a certain way
• an extreme need for symmetry or organization in items
• a need for symmetry in actions 
• a compulsion to arrange your belongings or other items until they feel “just right”
• feeling incomplete when items aren’t exact
• counting rituals, such as needing to count to a specific number a certain number of times
• magical thinking, or believing something bad will happen if you don’t arrange or organize things in the right way
• organization rituals or specific ways of aligning objects

Forbidden thoughts

These symptoms may involve:

• frequent intrusive thoughts that are often sexual or violent in nature
• guilt, shame, and other distress about your thoughts
• persistent questioning of your sexual orientation, desires, or sexual interests
• persistent worry that you’ll act on your intrusive thoughts or that having them makes you a bad person
• frequent worry that you’ll harm yourself or someone else without meaning to
• obsessions about religious ideas that feel blasphemous or wrong
• persistent feelings of responsibility for causing bad things to happen
• compulsions to hide things you could use as a weapon
• seeking reassurance that you won’t act on intrusive thoughts
• seeking reassurance that you’re not a bad person
• mental rituals to dispel or cancel out your thoughts
• frequently reviewing your daily activities to make sure you haven’t hurt anyone, whether mentally or physically retracing your steps

Hoarding

These symptoms may involve:

• persistent worry that throwing something away could bring harm to you or someone else
• a need to collect a certain number of items to protect yourself or someone else from harm
• extreme fear of throwing away an important or essential item by accident 
• a compulsion to buy multiples of the same item, even when you don’t need that many
• difficulty throwing away things because touching them could cause contamination
• feeling incomplete if you can’t find a possession or accidentally lost or threw it away
• a compulsion to check or review your possessions

Obsessive-compulsive disorder Treatment:

There’s no cure for OCD. But you may be able to manage how your symptoms affect your life through medicine, therapy, or a combination of treatments.

• Psychotherapy. Cognitive behavioural therapy can help change your thinking patterns. In a form called exposure and response prevention, your doctor will put you in a situation designed to create anxiety or set off compulsions. You’ll learn to lessen and then stop your OCD thoughts or actions.
• Relaxation. Simple things like meditation, yoga, and massage can help with stressful OCD symptoms.
• Medication. Psychiatric drugs called selective serotonin reuptake inhibitors help many people control obsessions and compulsions. They might take 2 to 4 months to start working. 
• Neuromodulation. In rare cases, when therapy and medication aren’t making enough of a difference, your doctor might talk to you about devices that change the electrical activity in a certain area of your brain. 
• TMS (transcranial magnetic stimulation).  The TMS unit is a non-invasive device that is held above the head to induce the magnetic field. It  targets a specific part of the brain that regulates OCD symptoms.

Obsessive-compulsive disorder Cause:

• Biology. OCD may be a result of changes in your body’s own natural chemistry or brain functions.
• Genetics. OCD may have a genetic component, but specific genes have yet to be identified.
• Learning. Obsessive fears and compulsive behaviours can be learned from watching family members or gradually learned over time.
• Environmental factors. It’s also possible that trauma, abuse, or other stressful events can play a part in the development of OCD and other mental health conditions.

Risk factors:

• Family history. Having parents or other family members with the disorder can increase your risk of developing OCD.
• Stressful life events. If you’ve experienced traumatic or stressful events, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of OCD.
• Other mental health disorders. OCD may be related to other mental health disorders, such as anxiety disorders, depression, substance abuse or tic disorders.