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http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-

ocd/index.shtml

What is Obsessive-Compulsive Disorder (OCD)?Everyone double checks things sometimes. or e!ample" you might double check to make

sure the stove or iron is turned o## be#ore leaving the house. $ut people %ith obsessive-

compulsive disorder (OCD) #eel the need to check things repeatedly" or have certain thoughts

or per#orm routines and rituals over and over. &he thoughts and rituals associated %ith OCD

cause distress and get in the %ay o# daily li#e.

&he #re'uent upsetting thoughts are called obsessions. &o try to control them" a person %ill

#eel an over%helming urge to repeat certain rituals or behaviors called compulsions. eople

%ith OCD cant control these obsessions and compulsions. *ost o# the time" the rituals end

up controlling them.

or e!ample" i# people are obsessed %ith germs or dirt" they may develop a compulsion to

%ash their hands over and over again. +# they develop an obsession %ith intruders" they may

lock and relock their doors many times be#ore going to bed. $eing a#raid o# social

embarrassment may prompt people %ith OCD to comb their hair compulsively in #ront o# a

mirror-sometimes they get ,caught in the mirror and cant move a%ay #rom it. er#orming

such rituals is not pleasurable. /t best" it produces temporary relie# #rom the an!iety created

 by obsessive thoughts.

Other common rituals are a need to repeatedly check things" touch things (especially in a

 particular se'uence)" or count things. 0ome common obsessions include having #re'uent

thoughts o# violence and harming loved ones" persistently thinking about per#orming se!ualacts the person dislikes" or having thoughts that are prohibited by religious belie#s. eople

%ith OCD may also be preoccupied %ith order and symmetry" have di##iculty thro%ing things

out (so they accumulate)" or hoard unneeded items.

1ealthy people also have rituals" such as checking to see i# the stove is o## several times

 be#ore leaving the house. &he di##erence is that people %ith OCD per#orm their rituals even

though doing so inter#eres %ith daily li#e and they #ind the repetition distressing. /lthough

most adults %ith OCD recogni2e that %hat they are doing is senseless" some adults and most

children may not reali2e that their behavior is out o# the ordinary.

Causes

OCD sometimes runs in #amilies" but no one kno%s #or sure %hy some people have it %hile

others dont. 3esearchers have #ound that several parts o# the brain are involved in #ear and

an!iety. $y learning more about #ear and an!iety in the brain" scientists may be able to create

 better treatments. 3esearchers are also looking #or %ays in %hich stress and environmental

#actors may play a role.

0igns 4 0ymptoms

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eople %ith OCD generally5

• 1ave repeated thoughts or images about many di##erent things" such as #ear o# germs"

dirt" or intruders6 acts o# violence6 hurting loved ones6 se!ual acts6 con#licts %ith religious

 belie#s6 or being overly tidy

• Do the same rituals over and over such as %ashing hands" locking and unlockingdoors" counting" keeping unneeded items" or repeating the same steps again and again

• Cant control the un%anted thoughts and behaviors

• Dont get pleasure %hen per#orming the behaviors or rituals" but get brie# relie# #rom

the an!iety the thoughts cause

• 0pend at least 7 hour a day on the thoughts and rituals" %hich cause distress and get in

the %ay o# daily li#e.

Who +s /t 3isk?

or many people" OCD starts during childhood or the teen years. *ost people are diagnosed

 by about age 78. 0ymptoms o# OCD may come and go and be better or %orse at di##erent

times.

OCD a##ects about 9.9 million /merican adults. +t strikes men and %omen in roughly e'ual

numbers and usually appears in childhood" adolescence" or early adulthood. One-third o#

adults %ith OCD develop symptoms as children" and research indicates that OCD might run

in #amilies.

Diagnosis

&he course o# the disease is 'uite varied. 0ymptoms may come and go" ease over time" or get

%orse. +# OCD becomes severe" it can keep a person #rom %orking or carrying out normal

responsibilities at home. eople %ith OCD may try to help themselves by avoiding situations

that trigger their obsessions" or they may use alcohol or drugs to calm themselves.

OCD can be accompanied by eating disorders" other an!iety disorders" or depression.

irst" talk to your doctor about your symptoms. :our doctor should do an e!am to make sure

that another physical problem isnt causing the symptoms. &he doctor may re#er you to a

mental health specialist.

&reatments

OCD is generally treated %ith psychotherapy" medication" or both.

Psychotherapy. / type o# psychotherapy called cognitive behavior therapy is especially

use#ul #or treating OCD. +t teaches a person di##erent %ays o# thinking" behaving" andreacting to situations that help him or her #eel less an!ious or #ear#ul %ithout having

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obsessive thoughts or acting compulsively. One type o# therapy called e!posure and response

 prevention is especially help#ul in reducing compulsive behaviors in OCD.

Medication. Doctors also may prescribe medication to help treat OCD. &he most commonly

 prescribed medications #or OCD are anti-an!iety medications and antidepressants. /nti-

an!iety medications are po%er#ul and there are di##erent types. *any types begin %orkingright a%ay" but they generally should not be taken #or long periods.

/ntidepressants are used to treat depression" but they are also particularly help#ul #or OCD"

 probably more so than anti-an!iety medications. &hey may take several %eeks;7< to 79

%eeks #or some;to start %orking. 0ome o# these medications may cause side e##ects such as

headache" nausea" or di##iculty sleeping. &hese side e##ects are usually not a problem #or most

 people" especially i# the dose starts o## lo% and is increased slo%ly over time. Talk to your

doctor about any side effects you may have.

+ts important to kno% that although antidepressants can be sa#e and e##ective #or many

 people" they may be risky #or some" especially children" teens" and young adults. / =black bo!=;the most serious type o# %arning that a prescription drug can have;has been added to

the labels o# antidepressant medications. &hese labels %arn people that antidepressants may

cause some people to have suicidal thoughts or make suicide attempts. /nyone taking

antidepressants should be monitored closely" especially %hen they #irst start treatment %ith

medications.

0ome people %ith OCD do better %ith cognitive behavior therapy" especially e!posure and

response prevention. Others do better %ith medication. 0till others do best %ith a

combination o# the t%o. &alk %ith your doctor about the best treatment #or you.

OCD usually responds %ell to treatment %ith certain medications and>or e!posure-based psychotherapy" in %hich people #ace situations that cause #ear or an!iety and become less

sensitive (desensiti2ed) to them. +*1 is supporting research into ne% treatment approaches

#or people %hose OCD does not respond %ell to the usual therapies. &hese approaches

include combination and augmentation (add-on) treatments" as %ell as modern techni'ues

such as deep brain stimulation.

@iving With

=+ couldnt do anything %ithout rituals. &hey invaded every aspect o# my li#e. Counting really bogged me do%n. + %ould %ash my hair three times as opposed to once because three %as a

good luck number and one %asnt. +t took me longer to read because +d count the lines in a

 paragraph. When + set my alarm at night" + had to set it to a number that %ouldnt add up to a

bad number.=

=Aetting dressed in the morning %as tough" because + had a routine" and i# + didnt #ollo% the

routine" +d get an!ious and %ould have to get dressed again. + al%ays %orried that i# + didnt

do something" my parents %ere going to die. +d have these terrible thoughts o# harming my

 parents. + kne% that %as completely irrational" but the thoughts triggered more an!iety and

more senseless behavior. $ecause o# the time + spent on rituals" + %as unable to do a lot o#

things that %ere important to me.=

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=+ kne% the rituals didnt make sense" and + %as deeply ashamed o# them" but + couldnt seem

to overcome them until + got treatment.= (#rom Obsessive-Compulsive Disorder5 When

Bn%anted &houghts &ake Over5 What is it like having OCD? )

Clinical &rials +*1 supports research studies on mental health and disorders. 0ee also5 A Participant's

Guide to Mental Health Clinical Research.

articipate" re#er a patient or learn about results o# studies inClinicalTrials.ov" the

 +1>ational @ibrary o# *edicines registry o# #ederally and privately #unded clinical trials

#or all disease.

ind +1-#unded studies currently recruiting participants %ith !C".

http://www.helpguide.org/mental/obsessive_compulsive_disorder_ocd.htm

Obsessive-Compulsive Disorder (OCD)Symptoms and Treatment of Compulsive Behavior and Obsessive Thoughts

Share: 

It’s normal, on occasion, to go back and double-check that the iron is unplugged or

your car is locked. But if you suffer from obsessive-compulsive disorder (!"#,obsessive thoughts and compulsive behaviors become so e$cessive they interfere

%ith your daily life. &o matter %hat you do, you can’t seem to shake them. But help

is available. 'ith treatment and self-help strategies, you can break free of the

un%anted thoughts and irrational urges and take back control of your life.

IN THIS ARTICLE:

What is OCD?

Obsessions and compulsions

OCD signs and symptoms

OCD therapy OCD self-help

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Helping someone ith OCD

 

 What is obsessive-compulsive disorder (OCD)?

bsessive-compulsive disorder (!"# is an an$iety disorder characteried byuncontrollable, un%anted thoughts and repetitive, ritualied behaviors you feel

compelled to perform. If you have !", you probably recognie that your obsessive

thoughts and compulsive behaviors are irrational ) but even so, you feel unable to

resist them and break free.

*ike a needle getting stuck on an old record, obsessive-compulsive disorder (!"#

causes the brain to get stuck on a particular thought or urge. +or e$ample, you may

check the stove t%enty times to make sure it’s really turned off, %ash your hands

until they’re scrubbed ra%, or drive around for hours to make sure that the bump

you heard %hile driving %asn’t a person you ran over.

Understanding OCD obsessions and compulsions

Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses

that occur over and over again in your mind. ou don’t %ant to have these ideas but

you can’t stop them. nfortunately, these obsessive thoughts are often disturbing

and distracting.

Compulsions are behaviors or rituals that you feel driven to act out again and again.

sually, compulsions are performed in an attempt to make obsessions go a%ay. +or

e$ample, if you’re afraid of contamination, you might develop elaborate cleaning

rituals. o%ever, the relief never lasts. In fact, the obsessive thoughts usually come

back stronger. /nd the compulsive behaviors often end up causing an$iety

themselves as they become more demanding and time-consuming.

0ost people %ith obsessive-compulsive disorder (!"# fall into one of the follo%ing

categories:

Washers are afraid of contamination. 1hey usually have cleaning or hand-

%ashing compulsions.

Checkers repeatedly check things (oven turned off, door locked, etc.# that

they associate %ith harm or danger.

Doubters and sinners are afraid that if everything isn’t perfect or done

 2ust right something terrible %ill happen or they %ill be punished.

Counters and arrangers are obsessed %ith order and symmetry. 1hey

may have superstitions about certain numbers, colors, or arrangements.

Hoarders fear that something bad %ill happen if they thro% anything a%ay.

1hey compulsively hoard things that they don’t need or use.

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Just because you hae obsessie thoughts or !er"or# co#!u$sie behaiors

does N%T #ean that you hae obsessie&co#!u$sie disorder' 'ith !",

these thoughts and behaviors cause tremendous distress, take up a lot of time, and

interfere %ith your daily life and relationships.

Signs and symptoms of obsessive-compulsive disorder (OCD)0ost people %ith obsessive-compulsive disorder (!"# have both obsessions and

compulsions, but some people e$perience 2ust one or the other.

%CD signs and sy#!to#s: %bsessie thoughts

!ommon obsessive thoughts in obsessive-compulsive disorder (!"# include:

+ear of being contaminated by germs or dirt or contaminating others.

+ear of causing harm to yourself or others.

Intrusive se$ually e$plicit or violent thoughts and images.

3$cessive focus on religious or moral ideas.

+ear of losing or not having things you might need.

rder and symmetry: the idea that everything must line up 42ust right.5 

Superstitions6 e$cessive attention to something considered lucky or

unlucky.

%CD signs and sy#!to#s: Co#!u$sie behaiors

!ommon compulsive behaviors in obsessive-compulsive disorder (!"# include:

3$cessive double-checking of things, such as locks, appliances, and

s%itches.

7epeatedly checking in on loved ones to make sure they’re safe.

!ounting, tapping, repeating certain %ords, or doing other senseless things

to reduce an$iety.

Spending a lot of time %ashing or cleaning.

rdering or arranging things 42ust so.5 

8raying e$cessively or engaging in rituals triggered by religious fear.

/ccumulating 42unk5 such as old ne%spapers or empty food containers.

Hoarding and other disorders

1he compulsive behavior of hoarding9collecting and keeping things %ith little or no

use or value9is a common symptom of people %ith !", even if the problem may

not be severe. o%ever, people %ith hoarding symptoms are more likely to also be

suffering from other disorders, such as depression, 81S", a specific phobia, skin

picking, kleptomania, /"", tic disorders, or compulsive buying.

If you or a loved one has !", tell your doctor about any symptoms of hoarding,difficulty discarding 2unk, or obsessing about losing things.

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Source: ournal of 8sychiatric 7esearch

%bsessie&co#!u$sie disorder (%CD) sy#!to#s in chi$dren

'hile the onset of obsessive-compulsive disorder usually occurs during adolescence

or young adulthood, younger children sometimes have symptoms that look like !".o%ever, the symptoms of other disorders, such as /"", autism, and 1ourette’s

syndrome, can also look like obsessive-compulsive disorder, so a thorough medical

and psychological e$am is essential before any diagnosis is made.

herapy as treatment for obsessive-compulsive disorder (OCD)

1he most effective treatment for obsessive-compulsive disorder is often cognitive-

behavioral therapy. /ntidepressants are sometimes used in con2unction %ith therapy,

although medication alone is rarely effective in relieving the symptoms of !".

Cognitie&behaiora$ thera!y "or obsessie&co#!u$sie disorder(%CD)

!ognitive-behavioral therapy for obsessive-compulsive disorder (!"# involves t%o

components:

;. E*!osure and res!onse !reention involves repeated e$posure to the

source of your obsession. 1hen you are asked to refrain from the compulsive

behavior you’d usually perform to reduce your an$iety. +or e$ample, if you

are a compulsive hand %asher, you might be asked to touch the door handle

in a public restroom and then be prevented from %ashing. /s you sit %ith

the an$iety, the urge to %ash your hands %ill gradually begin to go a%ay on

its o%n. In this %ay, you learn that you don’t need the ritual to get rid of

your an$iety9that you have some control over your obsessive thoughts and

compulsive behaviors.

<. Cognitie thera!y focuses on the catastrophic thoughts and e$aggerated

sense of responsibility you feel. / big part of cognitive therapy for !" is

teaching you healthy and effective %ays of responding to obsessive

thoughts, %ithout resorting to compulsive behavior.

Four Steps for Conquering Symptoms of Obsessive-Compulsive Disorder

(OCD)

8sychiatrist effrey Sch%art, author of Brain Lock: Free Yourself from Obsessive-

Compulsive Behavior , offers the follo%ing four steps for dealing %ith !":

RELA+EL ) 7ecognie that the intrusive obsessive thoughts and urges are

the result of !". +or e$ample, train yourself to say, =I don>t think or feel that

my hands are dirty. I>m having an obsession that my hands are dirty.= r, =I

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don>t feel that I have the need to %ash my hands. I>m having a compulsive urge

to perform the compulsion of %ashing my hands.=

REATTRI+,TE ) 7ealie that the intensity and intrusiveness of the thought

or urge is caused by !"6 it is probably related to a biochemical imbalance inthe brain. 1ell yourself, =It>s not me9it’s my !",= to remind you that !"

thoughts and urges are not meaningful, but are false messages from the brain.

RE-%C,S ) 'ork around the !" thoughts by focusing your attention on

something else, at least for a fe% minutes. "o another behavior. Say to yourself,

=I>m e$periencing a symptom of !". I need to do another behavior.=

RE.AL,E ) "o not take the !" thought at face value. It is not significant

in itself. 1ell yourself, =1hat>s 2ust my stupid obsession. It has no meaning.

1hat>s 2ust my brain. 1here>s no need to pay attention to it.= 7emember: ou

can>t make the thought go a%ay, but neither do you need to pay attention to it.

ou can learn to go on to the ne$t behavior.

Source: Westwood Institute for n!iet" #isorders

-a#i$y thera!y "or %CD treat#ent

Because !" often causes problems in family life and social ad2ustment, family

therapy can often be beneficial.

+amily therapy promotes understanding of the disorder and can help reduce

family conflicts.

It can motivate family members and teach them ho% to help their loved

one.

/rou! thera!y "or %CD treat#ent

1hrough interaction %ith fello% !" sufferers, group therapy provides support and

encouragement and decreases feelings of isolation.

Self-help for OCD tip !" Challenge obsessive thoughts andcompulsive behaviors

If you have obsessive-compulsive disorder (!"#, there are many %ays you can

help yourself in addition to seeking therapy.

Re"ocus your attention

Learn to recognize and reduce stress

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'atch ?-min. video:@uick Stress 7elief 

 

'hen you’re e$periencing !" thoughts and urges, try shifting your attention to

something else.

ou could e$ercise, 2og, %alk, listen to music, read, surf the %eb, play a

video game, make a phone call, or knit. 1he important thing is to do

something you en2oy for at least ;A minutes, in order to delay your response

to the obsessive thought or compulsion.

/t the end of the delaying period, reassess the urge. In many cases, the

urge %ill no longer be uite as intense. 1ry delaying for a longer period. 1he

longer you can delay the urge, the more it %ill likely change.

Write do0n your obsessie thoughts or 0orries

Ceep a pad and pencil on you, or type on a laptop, smartphone, or tablet. 'hen you

begin to obsess, %rite do%n all your thoughts or compulsions.

Ceep %riting as the !" urges continue, aiming to record e$actly %hat

you>re thinking, even if you’re repeating the same phrases or the same urges

over and over.

'riting it all do%n %ill help you see 2ust ho% repetitive your obsessions are.

'riting do%n the same phrase or urge hundreds of times %ill help it lose its

po%er.

'riting thoughts do%n is much harder %ork than simply thinking them, so

your obsessive thoughts are likely to disappear sooner.

Antici!ate %CD urges

By anticipating your compulsive urges before they arise, you can help to ease them.

+or e$ample, if your compulsive behavior involves checking that doors are locked,

%indo%s closed, or appliances turned off, try to lock the door or turn off the

appliance %ith e$tra attention the first time.

!reate a solid mental picture and then make a mental note. 1ell yourself,

 41he %indo% is no% closed,5 or 4I can see that the oven is turned off.5 

'hen the urge to check arises later, you %ill find it easier to relabel it as

 42ust an obsessive thought.5 

Create an %CD 0orry !eriod

7ather than trying to suppress obsessions or compulsions, develop the habit of

rescheduling them.

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!hoose one or t%o ;D minute 4%orry periods5 each day, time you can

devote to obsessing. !hoose a set time and place (e.g. in the living room from

E:DD to E:;D a.m. and A:DD to A:;D p.m.# that’s early enough it %on’t make

you an$ious before bedtime. "uring your %orry period, focus only on negative thoughts or urges. "on’t

try to correct them. /t the end of the %orry period, take a fe% calming

breaths, let the obsessive thoughts or urges go, and return to your normal

activities. 1he rest of the day, ho%ever, is to be designated free of obsessions

and compulsions.

'hen thoughts or urges come into your head during the day, %rite them

do%n and 4postpone5 them to your %orry period. Save it for later and continue

to go about your day.

Fo over your 4%orry list5 during the %orry period. 7eflect on the thoughts

or urges you %rote do%n during the day. If the thoughts are still bothering

you, allo% yourself to obsess about them, but only for the amount of time

you’ve allotted for your %orry period.

Create a ta!e o" your %CD obsessions

+ocus on one specific %orry or obsession and record it to a tape recorder, laptop, or

smartphone.

7ecount the obsessive phrase, sentence, or story e$actly as it comes into

your mind.

8lay the tape back to yourself, over and over for a ?A-minute period each

day, until listening to the obsession no longer causes you to feel highly

distressed.

By continuously confronting your %orry or obsession you %ill gradually

become less an$ious. ou can then repeat the e$ercise for a different

obsession.

Self-help for OCD tip #" a$e care of yourself 

/ healthy, balanced lifestyle plays a big role in keeping !" behavior, fears, and

%orry at bay.

1ractice re$a*ation techni2ues

'hile stress doesn’t cause !", a stressful event can trigger the onset of obsessive

and compulsive behavior, and stress can often make obsessive-compulsive behavior

%orse.

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0indful meditation, yoga, deep breathing, and other stress-relief

techniues may help reduce the symptoms of an$iety brought on by !".

1ry to practice a rela$ation techniue for at least GD minutes a day.

Ado!t hea$thy eating habits

Start the day right %ith breakfast, and continue %ith freuent small meals

throughout the day. Foing too long %ithout eating leads to lo% blood sugar, %hich

can make you feel more an$ious.

3at plenty of comple$ carbohydrates such as %hole grains, fruits, and

vegetables. &ot only do comple$ carbs stabilie blood sugar, they also boost

serotonin, a neurotransmitter %ith calming effects.

E*ercise regu$ar$y

3$ercise is a natural and effective anti-an$iety treatment that helps to control !"

symptoms by refocusing your mind %hen obsessive thoughts and compulsions arise.

+or ma$imum benefit, try to get GD minutes or more of aerobic activity on

most days. /erobic e$ercise relieves tension and stress, boosts physical and

mental energy, and enhances %ell-being through the release of endorphins,

the brain’s feel-good chemicals.

Aoid a$coho$ and nicotine

/lcohol temporarily reduces an$iety and %orry, but it actually causes an$iety

symptoms as it %ears off. Similarly, %hile it may seem that cigarettes are calming,

nicotine is actually a po%erful stimulant. Smoking leads to higher, not lo%er, levels of 

an$iety and !" symptoms.

/et enough s$ee!

&ot only can an$iety and %orry cause insomnia, but a lack of sleep can also

e$acerbate an$ious thoughts and feelings. 'hen you’re %ell rested, it’s much easier

to keep your emotional balance, a key factor in coping %ith an$iety disorders suchas !".

Self-help for OCD tip %" &each out for support

bsessive-compulsive behavior (!"# can get %orse %hen you feel po%erless and

alone, so it’s important to build a strong support system. 1he more connected you

are to other people, the less vulnerable you’ll feel. ust talking about your %orries

and urges can make them seem less threatening.

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Stay connected to "a#i$y and "riends

bsessions and compulsions can consume your life to the point of social isolation. In

turn, social isolation can aggravate your !" symptoms. It’s important to have a

net%ork of family and friends you can turn to for help and support. Involving others

in your treatment can help guard against setbacks and keep you motivated.

Join an %CD su!!ort grou!

ou’re not alone in your struggle %ith !", and participating in a support group can

be an effective reminder of that. !" support groups enable you to both share your

o%n e$periences and learn from others %ho are facing the same problems. +or a

searchable database of !" support groups, see the 7esources and 7eferences

section belo%.

'elping a loved one ith obsessive-compulsive disorder (OCD)

If a friend or family member has !", your most important 2ob is to educate

yourself about the disorder. Share %hat you’ve learned %ith your loved one and let

them kno% that there is help available. Simply kno%ing that !" is treatable can

sometimes provide enough motivation for your loved one to seek help.

Ti!s "or he$!ing a "riend or "a#i$y #e#ber 0ith %CD

1he %ay you react to a loved one’s !" symptoms can have a big impact.

Negatie co##ents or criticis# can #ake %CD 0orse3 %hile a calm,

supportive environment can help improve the outcome of treatment. +ocus on

the sufferer’s positive ualities and avoid making personal criticisms.

Don4t sco$d so#eone 0ith %CD or tell the person to stop performing

rituals. 1hey can’t comply, and the pressure to stop %ill only make the

behaviors %orse. 7emember, your loved one’s !" behaviors are symptoms,

not character fla%s.

+e as kind and !atient as !ossib$e' 3ach sufferer needs to overcome

problems at their o%n pace. 8raise any successful attempt to resist !", and

focus attention on positive elements in the person’s life.

Do not !$ay a$ong 0ith your $oed one4s %CD ritua$s' elping the

sufferer %ith rituals %ill only reinforce the behavior. Support the person, not

their rituals.

Create a !act to not a$$o0 %CD to take oer "a#i$y $i"e' Sit do%n as a

family and decide ho% you %ill %ork together to tackle your loved one’s !"

symptoms. 1ry to keep family life as normal as possible and the home a lo%-

stress environment.

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Co##unicate !ositie$y3 direct$y and c$ear$y' !ommunication is

important so you can find a balance bet%een standing up to the !" and not

further distressing your loved one.

-ind the hu#or' Seeing the humor and absurdity in some !" symptoms

can help the sufferer become more detached from the disorder. f course, a

situation is only humorous if the sufferer finds it funny, too.