Psychological disorders / Category / Emile Du Toit / May 9th 2014
People with obsessive-compulsive disorder (OCD) have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to attempt to control the anxiety these thoughts produce.
However, most of the time the rituals end up controlling them. For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Being afraid of social embarrassment may prompt people with OCD to comb their hair compulsively in front of a mirror –sometimes they get ‘caught’ in the mirror and can’t move away from it.
Performing such rituals is not pleasurable. At best, it produces only temporary relief from the anxiety created by obsessive thoughts. Other common rituals are a need to check things repeatedly, touch things (especially in a particular sequence), or count things. People with OCD may also be preoccupied with order and symmetry, have difficulty throwing things out (so they accumulate), or hoard unneeded items.
Some common obsessions include the following:
Healthy people also have rituals, such as checking to see whether the stove is off several times before leaving the house. The difference is that people with OCD perform their rituals even though doing so interferes with daily life and they find the repetition distressing. Although most adults with OCD recognise that what they are doing is senseless, some adults and most children may not realise that their behaviour is out of the ordinary.
OCD can be accompanied by eating disorders, other anxiety disorders, or depression. It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence or early adulthood.
One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families. The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. If OCD becomes severe, it can keep a person from working or carrying out normal responsibilities at home. People with OCD may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves.
OCD usually responds well to treatment with certain medications and/or exposure-based psychotherapy (using CBT), in which people face situations that cause fear or anxiety and become less sensitive (desensitised) to them.
Some people with OCD do not respond well to current treatments, and there is ongoing research, plus combination and augmentation (add-on) treatments, as well as modern techniques such as deep brain stimulation.
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