Obsessive-compulsive disorder (OCD), a type of anxiety disorder, is a potentially disabling illness that traps people in endless cycles of repetitive thoughts and behaviors. People with OCD are plagued by recurring and distressing thoughts, fears, or images (obsessions) they cannot control. The anxiety (nervousness) produced by these thoughts leads to an urgent need to perform certain rituals or routines (compulsions). The compulsive rituals are performed in an attempt to prevent the obsessive thoughts or make them go away.
Although the ritual may temporarily alleviate anxiety, the person must perform the ritual again when the obsessive thoughts return. This OCD cycle can progress to the point of taking up hours of the person's day and significantly interfering with normal activities. People with OCD may be aware that their obsessions and compulsions are senseless or unrealistic, but they cannot stop them.
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The symptoms of OCD, which are the obsessions and compulsions, may vary. Common obsessions include:
Fear of dirt or contamination by germs.
Fear of causing harm to another.
Fear of making a mistake.
Fear of being embarrassed or behaving in a socially unacceptable manner.
Fear of thinking evil or sinful thoughts.
Need for order, symmetry, or exactness.
Excessive doubt and the need for constant reassurance.
Common compulsions include:
Repeatedly bathing, showering, or washing hands.
Refusing to shake hands or touch doorknobs.
Repeatedly checking things, such as locks or stoves.
Constant counting, mentally or aloud, while performing routine tasks.
Constantly arranging things in a certain way.
Eating foods in a specific order.
Being stuck on words, images or thoughts, usually disturbing, that won't go away and can interfere with sleep.
Repeating specific words, phrases, or prayers.
Needing to perform tasks a certain number of times.
Collecting or hoarding items with no apparent value.
What Causes OCD?
Although the exact cause of OCD is not fully understood, studies have shown that a combination of biological and environmental factors may be involved.
Biological Factors: The brain is a very complex structure. It contains billions of nerve cells -- called neurons -- that must communicate and work together for the body to function normally. The neurons communicate via electrical signals. Special chemicals, called neurotransmitters, help move these electrical messages from neuron to neuron. Research has found a link between low levels of one neurotransmitter -- called serotonin -- and the development of OCD. In addition, there is evidence that a serotonin imbalance may be passed on from parents to children. This means the tendency to develop OCD may be inherited.
In addition, certain areas of the brain appear to be affected by the serotonin imbalance that leads to OCD. This problem seems to involve the pathways of the brain that link the area of the brain that deals with judgment and planning, and the area of the brain that filters messages involving body movements.
Studies also have found a link between a certain type of infection caused by the Streptococcus bacteria and OCD. This infection, if recurrent and untreated, may lead to the development of OCD and other disorders in children.
Environmental Factors: There are environmental stressors that can trigger OCD in people with a tendency toward developing the condition. Certain environmental factors may also cause a worsening of symptoms. These factors include: