Obsessive-compulsive disorder (OCD) was once thought to be a rare mental disease, but research has revealed it is far more common than previously believed. Statistics indicate that approximately 2.3 percent of the population between ages 18 and 54 suffers from OCD, making it even more prevalent than other common mental disorders, such as schizophrenia, bipolar disorder or panic disorder.
Based on these statistics, approximately 3.3 million people in the United States have OCD; that’s about one out of every 200 adults. The prevalence of this disorder has raised the question for some about whether or not their own tendencies or habits may indicate a form of OCD.
Although only a trained therapist can accurately diagnose OCD, understanding the disorder can help you think properly about its symptoms and effects. It’s important to note that simply being detail-oriented or having perfectionist tendencies does not indicate the presence of a disorder. Obsessive-compulsive disorder is more than just being meticulous or wanting to keep things neat and tidy.
What is OCD?
Obsessive-compulsive disorder is not merely a personality trait; it is a psychological disorder affecting the brain and behavior. It is a chronic and long-lasting condition in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that they feel the urge to repeat over and over.
Symptoms of OCD
There are many different types of OCD symptoms, which are subdivided in two groups: obsessions and compulsions.
Obsessions are thoughts, images or impulses that occur over and over again and feel outside of a person’s control. Obsessions are typically accompanied by intense and uncomfortable feelings such as fear, disgust, doubt or a sense that things have to be done in a certain way.
Compulsions are repetitive behaviors or thoughts used with the intention of making obsessions go away. Compulsions can also include avoiding situations that trigger obsessions.
Obsessions and compulsions that become time-consuming and get in the way of important activities or daily life are important factors for determining whether someone has OCD, rather than an obsessive personality trait.
According to the Anxiety and Depression Association of America (ADAA),the lists below are common examples of obsessions and compulsions experienced by those suffering from OCD.
Obsessions (unwanted, intrusive thoughts):
- Constant, irrational worry about dirt, germs or contamination.
- Excessive concern with order, arrangement or symmetry.
- Fear that negative or aggressive thoughts or impulses will cause personal harm or harm to a loved one.
- Preoccupation with losing or throwing away objects with little or no value.
- Excessive concern about accidentally or purposefully injuring another person.
- Feeling overly responsible for the safety of others.
- Distasteful religious and sexual thoughts or images.
- Doubtfulness that is irrational or excessive.
Compulsions (ritualistic behaviors and routines to ease anxiety or distress):
- Cleaning– Repeatedly washing one’s hands, bathing or cleaning household items, often for hours at a time.
- Checking– Checking and re-checking several to hundreds of times a day that the doors are locked, the stove is turned off, the hairdryer is unplugged, etc.
- Repeating– Inability to stop repeating a name, phrase, or simple activity (such as going through a doorway over and over).
- Mental rituals– Endless reviewing of conversations, counting; repetitively calling up “good” thoughts to neutralize “bad” thoughts or obsessions; or excessive praying and using special words or phrases to neutralize obsessions.
OCD and Substance Abuse
Little is known about the precise relationship between obsessive-compulsive disorder and substance use disorder (SUD). However, research has shown a correlation between the two disorders.
For example, a study published by the National Center for Biotechnology Information found that 27 percent of those involved with OCD met the lifetime criteria for a SUD. Additionally, the study determined that 70 percent of the participants with co-occurring SUDs reported that OCD preceded SUD onset by at least one year, and that SUDs affect more than one-quarter of individuals who seek treatment for OCD.
The most common treatment for OCD involves medication, psychotherapy or a combination of the two. Although most people respond well to treatment, some continue to experience symptoms.
Medications known as serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are used to help reduce OCD symptoms. SRIs often require higher daily doses and may take eight to 12 weeks to start working, but some patients experience more rapid improvement.
Psychotherapy also can be an effective treatment for OCD. Certain types of psychotherapy, including cognitive behavioral therapy (CBT) and other related therapies (e.g., habit reversal training) can be as effective as medication for many individuals. A type of CBT called exposure and response prevention is also effective in reducing compulsive behaviors in OCD, even in people who did not respond well to medication.