What is it?
Obsessive-compulsive disorder (OCD) is a type of anxiety disorder in which you have unreasonable thoughts and fears (obsessions) that lead you to engage in repetitive behaviors (compulsions). With obsessive-compulsive disorder, you may realize that your obsessions aren't reasonable, and you may try to ignore them or stop them. But that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts in an effort to ease your distress.
Obsessive-compulsive disorder often centers around themes, such as a fear of getting contaminated by germs. To ease your contamination fears, you may compulsively wash your hands until they're sore and chapped. Despite your efforts, the distressing thoughts of obsessive-compulsive disorder keep coming back. This leads to more ritualistic behavior — and a vicious cycle that's characteristic of obsessive-compulsive disorder.
Obsessive-compulsive disorder symptoms include both obsessions and compulsions.
OCD obsession symptoms
OCD obsessions are repeated, persistent and unwanted ideas, thoughts, images or impulses that you have involuntarily and that seem to make no sense. These obsessions typically intrude when you're trying to think of or do other things.
Obsessions often have themes to them, such as:
- Fear of contamination or dirt
- Having things orderly and symmetrical
- Aggressive or horrific impulses
- Sexual images or thoughts
OCD symptoms involving obsessions may include:
- Fear of being contaminated by shaking hands or by touching objects others have touched
- Doubts that you've locked the door or turned off the stove
- Thoughts that you've hurt someone in a traffic accident
- Intense distress when objects aren't orderly or facing the right way
- Images of hurting your child
- Impulses to shout obscenities in inappropriate situations
- Avoidance of situations that can trigger obsessions, such as shaking hands
- Replaying pornographic images in your mind
- Dermatitis because of frequent hand washing
- Skin lesions because of picking at your skin
- Hair loss or bald spots because of hair pulling
OCD compulsion symptoms
OCD compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors are meant to prevent or reduce anxiety or distress related to your obsessions. For instance, if you believe you ran over someone in your car, you may return to the apparent scene over and over because you just can't shake your doubts. You may also make up rules or rituals to follow that help control the anxiety you feel when having obsessive thoughts.
As with OCD obsessions, compulsions typically have themes, such as:
- Washing and cleaning
- Demanding reassurances
- Performing the same action repeatedly
OCD symptoms involving compulsions may include:
- Hand washing until your skin becomes raw
- Checking doors repeatedly to make sure they're locked
- Checking the stove repeatedly to make sure it's off
- Counting in certain patterns
- Making sure all your canned goods face the same way
The cause of obsessive-compulsive disorder isn't fully understood. Main theories include:
- Biology. Some evidence shows that OCD may be a result of changes in your body's own natural chemistry or brain functions. Some evidence also shows that OCD may have a genetic component, but specific genes have yet to be identified.
- Environment. Some researchers believe that OCD stems from behavior-related habits that you learned over time.
- Insufficient serotonin. An insufficient level of serotonin, one of your brain's chemical messengers, may contribute to obsessive-compulsive disorder. Some studies that compare images of the brains of people who have obsessive-compulsive disorder with the brains of those who don't show differences in brain activity patterns. In addition, people with obsessive-compulsive disorder who take medications that enhance the action of serotonin often have fewer OCD symptoms.
- Strep throat. Some studies suggest that some children develop OCD after infection with group A beta-hemolytic streptococcal pharyngitis — strep throat. Ho