Obsessive Compulsive Disorder

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Obsessive Compulsive Disorder (OCD) affects 1 in 50 people, (1 in 100 children) and affects men and women equally.  It may appear at any time in a person's life, but for 50% of sufferers, it begins in childhood or adolescence.    Symptoms may come and go, improve or worsen over time.  OCD appears to run in families.  It can occur together with other disorders such as  Depression,    Anxiety Disorders,   Eating Disorders,   Trichotillomania (hair pulling),  or    Tourette Syndrome  

It is characterised by anxious thoughts (obsessions) and/or rituals (compulsions) you feel you cannot control.  It is sometimes dubbed 'the doubting disease'.

Recurrent, unwanted and distressing thoughts which you cannot control.  For example, the thought that your hands may be contaminated or that something terrible will happen.   It is common to frequently doubt things, then worry - leading to the compulsion to check.

You might experience 'Intrusive Thoughts' where perhaps a sudden thought comes into your mind that distresses you.  An example may be of violence, and you may therefore fear that you will hurt someone close to you.   You may think  about sexual acts which repulse you, or have thoughts which go against your religious beliefs.  Because these thoughts distress and repulse you - they are not acted upon.

Rituals/behaviours which you feel you must do.  They may include handwashing, counting, checking (electricity or gas eg), cleaning etc.   They are usually performed in response to the obsessional thought, in an effort to make that thought go away. 
Eg.  In the above example of thinking your hands are contaminated, the compulsion is to repeatedly wash them.
You may spend long periods of time counting things or touching them, or you may become pre-occupied with symmetry or order.

Performing these behaviours though will only provide temporary relief.  Not performing them increases the anxiety.

Childhood compulsions may include not stepping on cracks in paving stones - and believing some awful event will occur if they do.  Others may switch a light on and off a certain amount of times, or until "it feels right", or repeating a phrase (or asking the parent to repeat) until it "sounds right".   Symmetry, order,  routine, touching, counting etc may also be features.   Childhood OCD Links

Most people can identify with some of the symptoms, but it only becomes a disorder when the thoughts or behaviours take up at least an hour a day, are very distressing and interfere with your daily life.

Some people may medicate themselves with alcohol or drugs  but that tends to complicate matters rather than help.

Recent research provides growing evidence that OCD has a neurobiological cause.   Neuro Imaging shows different brain activity patterns to a person without OCD.   PET scans have shown that Behavioural Therapy and medication produces changes in the brain - proof that the treatment works!

Normally includes behaviour therapy and/or medication.  A combination of the 2 is most effective. 
Medication is usually the SSRI type of anti-depressants including paroxetine, sertraline, fluoxetine and clomipramine.
Behaviour Therapy often consists of dealing with the particular fear eg. Someone who compulsively cleans the house will be asked (to either do this or  imagine) to allow the family to use the house as normal, and then the person is discouraged from cleaning for several hours.
The person should gradually experience less anxiety from the thoughts and become better able to cope without performing the behaviour for longer periods of time.  Behaviour therapy is shown to be of greater  long term benefit than other treatment.

(Obsessive Compulsive Disorder is very different to Obsessive Compulsive Personality Disorder (see links) - and they should not be confused)

See Keeping Well page for Self-Help Info

Links        Childhood OCD      Trichotillomania

Obsessive Action

First Steps to Freedom

National Phobics Society 

The Infinite Mind - OCD  (medscape article) with links to radio interview

My Obsessively Clean Den

OCD Notes - Exeter  University

OCD -  Royal College of Psychiatrists

OC & Spectrum Disorders Association

OC Foundation

OCD Hope  Florida Resource Centre

OCD at Medscape


OCD Centre of Los Angeles

Hope for OCD - Cognitive Behaviour Therapy

OCD at NIMH article

OCD Resource Centre inc. Club OCD for young people

A Guide for Patients and Families

OCD - Diagnosis & Treatment in Primary Care   Medscape article

Coping Strategies

Awareness Foundation for OCD

OCD Online

OCD at Suite 101

OCD Screening Quiz

Online Screening Test for OCD

OCD Screening Checklist

Body Dysmorphic Disorder

Understanding & Treating OCD

Stuck in a Doorway  - OCD Discussion Board

alt.support.ocd   Forum

Childhood OCD

Children with OCD   BMJ Article

OCD & Young People  - Maudsley Hospital

CD-Rom for OCD  "Why Me?"

Article - Does your child have OCD?

OCD at TS+

Teen OCD

Treatment of OCD in Children

OCD in Young People  RCPsych




Trichotillomania Learning Centre

Helen's Trichotillomania Pages (UK)

Trichotillomania FAQ

Tina's Trichotillomania Site

Discussion/Support Forum


Obsessive Compulsive Disorder - The Facts
Freeing your child from OCD
Understanding Obsessions and Compulsions
Obsessive Compulsive Disorders - a Complete Guide to Getting Well & Staying Well
See Books page for others

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17 November 2002