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Obsessive-Compulsive Disorder (OCD)

What is obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by a cycle of intrusive thoughts and repetitive behaviors. The thoughts can create feelings of uneasiness, apprehension, fear, or worry; the repetitive behaviors are intended to reduce those feelings.

OCD can affect people of all ages. The National Institute of Mental Health estimates that more than 2 percent of the U.S. population, or about one out of every 40 people, will be diagnosed with OCD at some point in their lives.

What causes OCD?

No one is sure exactly what causes a person to develop OCD, but there are some risk factors that may make a person prone to developing the disorder:

  • Genetics: Studies show that people whose parent, sibling, or child has OCD are at a higher risk for the disorder
  • Brain Functioning: Researchers have found that individuals with OCD may have structural differences in the frontal cortex and subcortical structures of their brains
  • Environment: A person who has experienced trauma in childhood, including physical or sexual abuse, has an increased risk for developing OCD

Some children have been known to develop OCD symptoms after a streptococcal infection. This phenomenon is known as Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).

What are the signs and symptoms of OCD?

A person with OCD usually demonstrates both obsessions and compulsions, but a person may have only obsession symptoms or only compulsion symptoms. Sometimes these thoughts or behaviors do not seem excessive, but they can interfere with a person’s time and daily functioning.

Obsession symptoms of OCD

The obsession symptoms of OCD involve persistent, unwanted thoughts or urges that cause distress or anxiety. You may try to get rid of them by performing a compulsive action.

Obsessions are often centered on specific ideas or themes, such as:

  • Fear of germs or dirt
  • Keeping things neat and symmetrical
  • Aggressive or disturbing thoughts about harming yourself or others
  • Unwanted, sometimes aggressive thoughts about sexual or religious subjects

Symptoms of obsessive behavior may include:

  • Fear of touching objects others have touched
  • Doubts about locking the door or turning off the stove
  • Feeling stress when objects are not in a particular order
  • Unwanted thoughts about acting inappropriately
  • Avoiding situations related to obsessions, such as shaking hands
  • Repetitive, distressing sexual images coming to mind

Compulsion symptoms of OCD

A person with OCD compulsions feel compelled to perform specific, repetitive behaviors or mental acts to help prevent or reduce anxiety related to their obsessive thoughts. These compulsions may only temporarily relieve the anxiety.

Compulsions also tend to be based on specific themes, including:

  • Washing, cleanliness, or order
  • Checking
  • Counting
  • Strict routines

Symptoms of compulsions include:

  • Repeated hand-washing until the skin is damaged
  • Repeatedly checking doors and locks
  • Checking the stove multiple times to make sure it’s off
  • Counting in certain patterns
  • Repeating a prayer, word, or phrase
  • Arranging items to be symmetrical

The severity of OCD can vary, but is often worse with stress. Symptoms may be so mild that you may not realize you have OCD, while others can interfere with daily life and functioning.

Most people who develop OCD show symptoms by the teen or young adult years. Symptoms may begin gradually and change in severity over the years.

The thoughts and behaviors arising from OCD can lead to a variety of problems that may affect your daily life. These include:

  • Reduced quality of life
  • Health issues, such as dermatitis caused by excessive hand-washing
  • Fear of attending work, school, or social activities
  • Relationship difficulties
  • Suicidal thoughts and behavior

How do I learn if I have OCD?

There is a difference between having OCD and being a perfectionist. The obsessive thoughts from OCD go beyond normal worries, and OCD behaviors are more than just preferences.

If you are concerned about symptoms of OCD, you can make an appointment with your family doctor, a psychiatrist, psychologist, or therapist who has experience with obsessive or compulsive behaviors.

Your doctor may perform an exam or order certain tests, such as blood count or thyroid functioning, to rule out other causes of your symptoms. An exam may also reveal complications related to your condition.

Your doctor may conduct, or refer you to, a psychological evaluation. This may include talking about your thoughts and feelings, as well as your symptoms and patterns of behavior. Your doctor may compare your symptoms to the OCD criteria in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

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