Understanding Obsessive-Compulsive Disorder -- Diagnosis and Treatment

How Do I Know If I Have Obsessive-Compulsive Disorder?

A person with obsessive-compulsive disorder (or OCD) may experience:

  • Excessive and irrational concern about contamination or serious illness
  • Too much concern with keeping everything arranged in an exact way
  • Intrusive thoughts or horrible mental images
  • Sexual or religious thoughts felt to be unacceptable
  • Excessive fear of your house burning or flooding, of causing a car wreck, of spreading an illness, of losing something, of being responsible for another person getting hurt or killed
  • Fear of harming another person or a member of one's family
  • Doing things over and over again (checking)
  • Avoiding colors or numbers associated with bad thoughts or dreaded events
  • Frequently feeling the need to confess something you did or to ask to be reassured that you did something the right way

If you experience these symptoms, and they cause distress or interfere with your normal activities -- or if you find you have trouble controlling them -- you can seek help from a mental health professional.

There are rating scales, such as the as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), that not only can quantify the initial degree and severity of OCD, but also demonstrate progress of treatment by repeating the scoring after several months of treatment.

What Are the Treatments for OCD?

Not every person with OCD responds to the same treatment. Treatment options include medications as well as behavioral treatments. People with OCD should discuss treatment strategies with their therapists. For most people, a combination of these treatments works best.

Medicine for OCD

Since the 1970s, it has been known that drugs that affect a specific brain chemical -- serotonin -- are particularly helpful in OCD. These include a particular tricyclic antidepressant called clomipramine (Anafranil) and also the class of antidepressant drugs called selective serotonin reuptake inhibitors, or SSRIs. SSRIs approved by the FDA for treatment of OCD include Prozac, Zoloft, Luvox, and Paxil. Other SSRIs may also be used.

While these drugs can offer substantial help for many people with OCD, they aren't a cure. When a person stops taking them, OCD symptoms often come back. Other medications, particularly atypical antipsychotics such as Risperdal, Abilify or Seroquel, may be used to supplement the SSRIs to help control symptoms.

 

Psychotherapy

Traditional psychotherapy aims to help a person develop insight into his or her problems. The specific type of psychotherapy that has been best-studied to treat OCD is called cognitive therapy, which involves restructuring thought patterns about obsessions and compulsions. Behavioral treatments for OCD also include exposure therapy with response prevention, in which patients are gradually exposed in a controlled environment to situations that cause anxiety. Techniques are learned to reduce anxiety and resist urges to act on compulsions.

 

WebMD Medical Reference Reviewed by Joseph Goldberg, MD on February 11, 2017

Sources

SOURCES: 

American Psychiatric Association, Diagnostic and Statistical Manual of Mental Disorders - 5th.

Hollander E. Journal of Clinical Psychiatry, 2002. 

Hollander E. Journal of Clinical Psychiatry, 2004.

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