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Click here to return to the Medical News Today home page. It is a distinct condition but falls within the category of "obsessive-compulsive and related disorders. OCD is a mental health condition that centers around a debilitating obsession or compulsion, distressing actions, and repetitive thoughts. A World Health Organization WHO mental health report estimated that OCD was among the top 20 causes of illness-related disability worldwide for people aged 15 to 44 years.
The report also suggested that OCD was the fourth most common mental illness after phobias , substance abuse, and major depression. OCD is associated with a wide range of functional impairments and has a significant impact on social and working life. There are several types of OCD that present in different ways. Checking: This is a need to repeatedly check something for harm, leaks, damage, or fire. Checking can include repeatedly monitoring taps, alarms, car doors, house lights, or other appliances. It can also apply to "checking people.
This checking can occur hundreds of times and often for hours, regardless of any commitments the individual may have. Checking can also involve repeatedly confirming the authenticity of memories. A person with OCD might repeatedly validate letters and e-mails for fear of having made mistakes. There may be a fear of having unintentionally offended the recipient.
Contamination or mental contamination: This occurs when a person with OCD feels a constant and overbearing need to wash and obsesses that objects they touch are contaminated. The fear is that the individual or the object may become contaminated or ill unless repeated cleaning takes place. It can lead excessive toothbrushing, overcleaning certain rooms in the house, such as the bathroom or kitchen, and avoiding large crowds for fear of contracting germs.
Mental contamination is the feeling of being 'dirty' after being mistreated or put down. In this type of contamination, it is always another person that is responsible. A person with OCD will try to 'scrub away' this feeling by showering and washing excessively. Rumination: Ruminating involves an extended and unfocused obsessive train of thought that focuses on wide-ranging, broad, and often philosophical topics, such as what happens after death or the beginning of the universe.
The person may seem detached and deep in thought. However, the ruminating never reaches a satisfactory conclusion. Intrusive thoughts: These are often violent, horrific, obsessional thoughts that often involve hurting a loved one violently or sexually. They are not produced out of choice and can cause the person with OCD severe distress. Because of this distress, they are unlikely to follow through on these thoughts. These thoughts can include obsessions about relationships, killing others or suicide, a fear of being a pedophile, or being obsessed with superstitions.
Symmetry and orderliness: A person with OCD may also obsess about objects being lined up to avoid discomfort or harm. They may adjust the books on their shelf repeatedly so that they are all straight and perfectly lined up, for example. While these are not the only types of OCD, obsessions and compulsions will generally fall into these categories. OCD is separated from other mental health conditions by the presence of obsessions, compulsions, or both. The obsessions or compulsions cause marked distress, are time-consuming, and interfere with a person's normal function.
Indications of OCD can occur in children and teenagers, with the disease usually beginning gradually and worsening with age. Symptoms of OCD can be mild or severe. Some people experience obsessive thoughts only, without engaging in compulsive behavior. Some people who experience OCD successfully hide their symptoms for fear of embarrassment or stigma. Friends and family may, however, notice some of the more physical signs. Obsessions are more than the everyday worries experienced by most healthy people when thinking about real-life problems.
Instead, people with OCD experience excessive thoughts and worries that prompt them to engage in particular actions or thoughts in an attempt to relieve or suppress the fear and anxiety. Not all "rituals" or forms of repetitive behavior are compulsions.
Normal repetitive behaviors that feature in everyday life may include bedtime routines, religious practices, and learning a new skill. Behavior also depends on the context.
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For example, a person who works in a video store arranging DVDs for 8 hours a day is probably not acting out of compulsion. OCD is thought to have a neurobiological basis, with neuroimaging studies showing that the brain functions differently in people with the disorder.
An abnormality, or an imbalance in neurotransmitters, is thought to be involved in OCD. OCD that begins in childhood is more common in boys than girls , with the usual time of onset of OCD later for females than males. The condition might be triggered by a combination of genetic, neurological, behavioral, cognitive, and environmental factors. OCD runs in families and can be considered a " familial disorder.
Twin studies of adults suggest that obsessive-compulsive symptoms are moderately able to be inherited, with genetic factors contributing 27 to 47 percent variance in scores that measure obsessive-compulsive symptoms. However, no single gene has been identified as the "cause" of OCD. Some rapid-onset cases of OCD in children might be consequences of Group A streptococcal infections, which cause inflammation and dysfunction in the basal ganglia. These cases are grouped and referred to as pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections PANDAS.
In recent years, however, other pathogens, such as the bacteria responsible for Lyme disease and the H1N1 flu virus, have also been associated with the rapid onset of OCD in children. The behavioral theory suggests that people with OCD associate certain objects or situations with fear. They learn to avoid those things or learn to perform "rituals" to help reduce the fear. This fear and avoidance or ritual cycle may begin during a period of intense stress , such as when starting a new job or just after an important relationship comes to an end.
Once the connection between an object and the feeling of fear becomes established, people with OCD begin to avoid that object and the fear it generates, rather than confronting or tolerating the fear. The behavioral theory outlined above focuses on how people with OCD make an association between an object and fear. The cognitive theory, however, focuses on how people with OCD misinterpret their thoughts. Most people have unwelcome or intrusive thoughts at certain times, but for individuals with OCD, the importance of those thoughts are exaggerated. For example, a person who is caring for an infant and who is under intense pressure may have an intrusive thought of harming the infant either deliberately or accidentally.
Most people can shrug off and disregard the thought, but a person with OCD may exaggerate the importance of the thought and respond as though it signifies a threat. As long as the individual with OCD interprets these intrusive thoughts as cataclysmic and true, they will continue the avoidance and ritual behaviors.
Brain imaging techniques have allowed researchers to study the activity of specific areas of the brain, leading to the discovery that some parts of the brain are different in people with OCD when compared to those without. Despite this finding, it is not known exactly how these differences relate to the development of OCD. Imbalances in the brain chemicals serotonin and glutamate may play a part in OCD. Environmental stressors may be a trigger for OCD in people with a tendency toward developing the condition.
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Traumatic brain injury TBI in adolescents and children has also been associated with an increased risk of onset of obsessive-compulsions. One study found that 30 percent of children aged 6 to 18 years who experienced a TBI developed symptoms of OCD within 12 months of the injury. Overall, studies indicate that people with OCD frequently report stressful and traumatic life events before the illness begins.
A number of other psychiatric and neurological disorders , such as depression and anxiety, have similar features to OCD and can occur alongside the condition. OCD usually develops into a chronic condition if left untreated, with episodes where symptoms seem to improve. Without treatment, remission rates are low, at around 20 percent.
However, around 40 percent of people who develop OCD in childhood or adolescence experience remission by early adulthood.
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Treatment for OCD will depend on how much the condition affects the person's ability to function. First-line treatments for OCD will often include:. CBT is a type of psychotherapy talking therapy that aims to help the individual change the way they think, feel, and behave. It refers to two distinct treatments :. Research has shown that 75 percent of people with OCD are significantly helped by cognitive behavioral therapy. Treatment techniques include exposure and response prevention ERP , this involves the following:. Other techniques focus solely on cognitive therapy.
People who participate in this type of therapy work toward eliminating the compulsive behavior. This is done by identifying and re-evaluating their beliefs about the consequences of engaging, or not engaging, in the compulsive behavior. Once these intrusive thoughts and the meanings the person applies to them are acknowledged, the therapist will then encourage the person to:.
These studies have, however, found CT to be effective. It might take up to 3 months for results to be noticed. Hospitals, surgery and procedures. Mental health services. Planning and coordinating healthcare. Pregnancy and birth services. A-Z A-Z. Conditions and treatments. Healthy living. Services and support.
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Be informed — accept that OCD is a recognised and treatable mental health condition, and that understanding what it is all about is the first step towards recovery. Helping a person with their compulsive behaviours can reinforce their symptoms. However, it is important that the involvement of friends and family in rituals is reduced in a very gradual way as part of an agreed plan with the person or treatment program.
Encourage the person to seek help from a professional experienced in treating OCD. Obsessive compulsive disorder OCD is characterised by recurring unwanted and intrusive thoughts, impulses and images obsessions , as well as repetitive behavioural and mental rituals compulsions. It can be difficult, demanding and exhausting to live with a person who has OCD.
This can cause distress and disruption to all members of the family. People with OCD are usually aware that their obsessions and compulsions are irrational and excessive, yet feel unable to control or resist them. When family members and friends are more informed about OCD, it is easier to be supportive and understanding. Many people with OCD experience intense fears of something terrible happening to themselves or others, have constant doubts about their behaviour, and frequently seek reassurance from others.
Common misconceptions include that OCD is caused by laziness, lack of willpower, bad parenting or trauma. Assumptions like these lead to blame and guilt.
Many OCD behaviours that are irritating and demanding are actually symptoms of the condition. There are many OCD resources available that can help resolve misunderstandings and concerns about this disorder. These include books , podcasts , and websites with information about specific aspects of OCD such as hoarding , obsessional thinking and hyper-responsibility and community resources such as telephone helplines and support groups.
Encourage the person to seek professional help. OCD is generally not a condition that will go away without treatment. You can assist in locating an experienced therapist and offer to be involved in their treatment program. If the OCD has involved you or other family or friends extensively in rituals and avoidance behaviours, you will need to know the best ways to modify your involvement so that the treatment can be as effective as possible.
Encourage discussion about OCD as a common and treatable anxiety condition that is nothing to be embarrassed or ashamed of. Support the person with OCD to share their experiences with family and friends — this will help to break the secrecy about OCD. Acknowledge improvements, however small, and encourage the person to reward themselves for their progress.
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Try to be patient and maintain a non-judgemental attitude — this will support the person to focus their efforts on recovery rather than dealing with anger and resentment. If their motivation wanes and they consider stopping treatment, remind them of the gains they have made. Some suggestions include: Talk openly about behaviours that impact on household routines and time.
Encourage the person with OCD to be a part of decision making about how this is achieved. Set realistic goals together and talk about ways to ensure that everyone will abide by the plan. If the person with OCD is in treatment, offer to attend a session with them so that you can seek advice about how you can best support their treatment program. Try to maintain normal household routines whenever possible. Focus on strengthening family and social connections, and reinforce a sense of stability by maintaining positive traditions and occasions — celebrate birthdays and anniversaries, or have regular family dinners.
Reinforce positive communication and behaviours such as sharing, hugs and helping each other and keep up family activities such as going to the footy, or taking the dog to the park. Reach out for support and help for yourself If you live with someone with OCD, it is likely you will need some support and help for yourself. Attend a support group for families and friends in similar situations.
Attend education and skills groups for carers of people with OCD. Seek out information or workshops on stress management, relaxation and mindfulness meditation, and healthy living. If your physical or emotional health is suffering, seek professional help for yourself — short-term counselling and support can be found through your GP, local community health centre, or a private psychologist. Take time out for yourself whenever possible and try to maintain hobbies and outside interests.
Assist them to be fully informed about effective treatments, including medication and psychological therapy. Information about available options can help alleviate many of the fears that people with OCD have about treatment, such as: how the treatments work, what is expected of the person, how long it should take, what self-management strategies can improve recovery, and how these treatments have helped others with OCD. Encourage them to seek treatment from a professional who is experienced in treating OCD. Fears and worries about treatment may be exacerbated if the person with OCD is exposed to an incompetent or inappropriate treatment service.
Emphasise that knowing when to seek help is actually a sign of strength, not weakness. Seek advice from professionals and support groups on your own, if necessary. If you think the person is in danger of harming themselves or someone else, call your doctor, local mental health service crisis assessment team or the police dial More information here. Send us your feedback. Rate this website Your comments Questions Your details. Excellent Good Average Fair Poor. Next Submit Now Cancel.
Please note that we cannot answer personal medical queries. Enter your comments below optional. Did you find what you were looking for? Yes No. Email Address. Submit Now Cancel. Thank you. Your feedback has been successfully sent. Anxiety explained Phobias Obsessive compulsive disorder Panic disorder Trauma Anxiety explained Anxiety and fear in children You can help your child overcome anxiety by taking their fears seriously and encouraging them to talk about their feelings Anxiety disorders Anxiety disorders are common mental health problems that affect many people Anxiety Disorders - Diagnosis video Anxiety disorders are common, affecting about one in ten with persistent, excessive worrying that can hinder their ability to function.
Anxiety Disorders - treatment and support video In this video clip, participants discuss the various forms of treatment and support they have received from medical professionals as well as from other sources. Depression explained The most important thing is to recognise the signs and symptoms and seek support Fighting your fears Fear is a natural human emotion, and it is something that everyone experiences in their lifetime. Generalised anxiety disorder GAD Worrying can be constructive if it helps you to work out possible solutions to a problem, but some people are troubled by excessive anxiety Let's talk about depression in men Depression affects men of all ages, however men continue to seek help for mental health issues at significantly lower rates than women.
Managing and treating anxiety Learning all about anxiety is central to recovery Self-harm and self-injury Self-harm and self-injury is when people hurt themselves on purpose, usually in response to intense emotional pain or negative feelings, thoughts or memories Phobias Agoraphobia A person with agoraphobia is afraid to leave familiar environments, because they are afraid of having a panic attack Claustrophobia With appropriate treatment, it is possible to overcome claustrophobia or any other phobia Fear of flying About one in six people have a significant fear that prevents them from flying, so fear of flying is common Social phobia A person with social phobia experiences anxiety in situations where they are likely to be scrutinised and observed by others Obsessive compulsive disorder Anxiety Disorders - Diagnosis video Anxiety disorders are common, affecting about one in ten with persistent, excessive worrying that can hinder their ability to function.
Obsessive compulsive disorder Obsessive compulsive disorder can have a profound effect on a person's life Obsessive compulsive disorder - family and friends Living with a person with OCD can have a major impact on family and friends Panic disorder Anxiety Disorders - Diagnosis video Anxiety disorders are common, affecting about one in ten with persistent, excessive worrying that can hinder their ability to function.
Panic attack Without treatment, frequent and prolonged panic attacks can be severely disabling Panic disorder and agoraphobia Panic disorder is not the same as anxiety or a single panic attack. Trauma Anxiety Disorders - Diagnosis video Anxiety disorders are common, affecting about one in ten with persistent, excessive worrying that can hinder their ability to function.
Near-miss experiences and traumatic events Traumatic events usually happen quickly and chaotically. Post-traumatic stress disorder PTSD People with post-traumatic stress disorder often experience feelings of panic or extreme fear, which may resemble what was felt during the traumatic event Survivor reactions to traumatic events If you have survived a traumatic event, whether you were injured or not, it's important to recognise that trauma also causes emotional harm.
Torture and trauma Some survivors of torture and trauma live with their memories for years, or even for the rest of their lives Trauma and children - newborns to two years Babies and toddlers can be as affected by trauma as any other family member Trauma and children — tips for parents Tell your child the facts about a distressing or frightening experience using language they can understand Trauma and children - two to five years Preschoolers may not have the words but will show their distress at traumatic events through changes in behaviour and functioning