Introduction
Obsessive Compulsive Disorder (OCD) is a chronic mental health condition characterized by recurrent, unwanted thoughts or obsessions and repetitive behaviors or compulsions performed to reduce the anxiety caused by those obsessions. OCD can be disabling when severe, consuming hours of a person's day and significantly interfering with work, relationships, and everyday functioning. It is more complex than the casual use of the term "OCD" often suggests.
Causes
OCD is thought to result from a combination of genetic, neurobiological, and environmental factors. Abnormalities in serotonin regulation and circuits involving the orbitofrontal cortex, thalamus, and basal ganglia are implicated in the disorder. A family history of OCD increases risk, and onset is often associated with life stressors, trauma, or significant transitions. In some children, OCD-like symptoms may be triggered by streptococcal infections (PANDAS).
Symptoms
Obsessions are intrusive, repetitive thoughts, images, or urges (such as fear of contamination, harm, religious/moral concerns, or symmetry) that cause significant anxiety. Compulsions are repetitive behaviors or mental acts (such as washing, checking, counting, or reassurance-seeking) performed to neutralize the distress caused by obsessions. The individual typically recognizes these thoughts and behaviors as excessive but feels unable to stop them.
Diagnosis
A clinician diagnoses OCD using DSM-5 criteria, which require the presence of obsessions, compulsions, or both that are time-consuming (at least one hour per day) or cause significant distress or impairment. The clinician will distinguish OCD from other conditions with similar features, such as generalized anxiety, body dysmorphic disorder, or eating disorders, and assess for common co-occurring conditions like depression and tic disorders.
Treatment
Exposure and response prevention (ERP), a specialized form of cognitive behavioral therapy, is the gold-standard psychotherapy for OCD, helping patients gradually confront feared situations without performing compulsions. SSRIs are first-line medications and are effective at higher doses than used for depression. For treatment-resistant OCD, augmentation strategies, intensive outpatient therapy, or specialized programs may be recommended. Early treatment leads to better long-term outcomes.
This information is intended for educational and informational purposes only. It should not be used in place of an individual consultation or examination or replace the advice of your health care professional and should not be relied upon to determine diagnosis or course of treatment.