If you are having any symptoms or have any questions, please call 811 to speak with a registered nurse 24 hours a day.

Get emergency care if you or a loved one has serious thoughts of suicide or harming others.

OVERVIEW

What is obsessive-compulsive disorder?

Obsessive-compulsive disorder (OCD) is a mental health disorder, such as anxiety disorder or depression. It causes people to have unwanted thoughts (obsessions) and to repeat certain behaviors (compulsions) over and over again. We all have habits and routines in our daily lives, such as brushing our teeth before bed. However, for people with OCD, patterns of behavior get in the way of their daily lives.

Most people with OCD know that their obsessions and compulsions make no sense, but they can’t ignore or stop them.

What are obsessions?

Obsessions are ideas, images and impulses that run through the person’s mind over and over again. A person with OCD doesn’t want to have these thoughts and finds them bothersome. Despite this, they can’t control them. Sometimes these thoughts come just once in a while and are only mildly annoying. Other times, a person who has OCD will have obsessive thoughts all the time.

What are compulsions?

Obsessive thoughts make people who have OCD feel nervous and afraid. They try to get rid of these feelings by performing certain behaviors according to “rules” that they make up for themselves. These behaviors are called compulsions. (Compulsive behaviors are sometimes also called rituals.) For example, a person who has OCD may have obsessive thoughts about germs. Because of these thoughts, the person may wash his or her hands repeatedly.

Performing these behaviors usually makes the nervous feelings go away for a short time. When the fear and nervousness return, the person who has OCD repeats the routine all over again.

SYMPTOMS

For many years, OCD was thought to be rare. Some recent studies show that it is more common than once thought. OCD affects men and women equally.

What are some common obsessions?

The following are some common obsessions:

• Fear of dirt or germs
• Disgust with bodily waste or fluids
• Concern with order, symmetry (balance) and exactness
• Worry that a task has been done poorly, even when the person knows this is not true
• Fear of thinking evil or sinful thoughts
• Thinking about certain sounds, images, words or numbers all the time
• Need for constant reassurance
• Fear of harming a family member or friend

What are some common compulsions?

The following are some common compulsions:

• Cleaning and grooming, such as washing hands, showering or brushing teeth over and over again
• Checking drawers, door locks and appliances to be sure they are shut, locked or turned off
• Repeating actions, such as going in and out of a door, sitting down and getting up from a chair, or touching certain objects several times
• Ordering and arranging items in certain ways
• Counting to a certain number, over and over
• Saving newspapers, mail or containers when they are no longer needed
• Seeking constant reassurance and approval

CAUSES & RISK FACTORS

What causes OCD?

No one has found a single, proven cause for OCD. Some research shows that it may have to do with chemicals in the brain that carry messages from one nerve cell to another. One of these chemicals, called serotonin, helps to keep people from repeating the same behaviors over and over again. A person who has OCD may not have enough serotonin.

Many people who have OCD can function better when they take medicines that increase the amount of serotonin in their brain. OCD tends to run in families. Symptoms often begin in children or teens.

DIAGNOSIS

How is obsessive-compulsive disorder diagnosed?

If you believe that you have OCD, you should see a healthcare provider. They can help diagnose and begin treatment for OCD. Your healthcare provider may also arrange for you to see other mental health professionals such as a counselor or psychiatrist. Sometimes OCD can be confused with other disorders and your healthcare provider, with the other members of your healthcare team, can help make an early and accurate diagnosis.

An OCD diagnosis will be based on your symptoms. This includes your behavior, your obsessions and/or your compulsions. A mental health care professional will also consider how these affect or interfere with your daily life.

PREVENTION

Can obsessive-compulsive disorder be prevented or avoided?

You cannot prevent OCD from starting. And once you have OCD, you will always have it. OCD is a chronic condition. But you can prevent the symptoms of OCD by following your treatment plan. You should also take any OCD medications exactly as they are prescribed. You should do this even if you are feeling better.

TREATMENT

How is OCD treated?

Combining therapy with medication is usually considered the most effective way to treat OCD.

Several medicines are available to treat OCD. These medicines are also often used to treat depression and include:

• Clomipramine
• Fluoxetine
• Sertraline
• Paroxetine
• Fluvoxamine

These drugs can cause side effects such as dry mouth, nausea, and drowsiness. Sometimes they also have sexual side effects. It may be several weeks before you see an improvement in your behavior.

Under the guidance of a trained therapist, cognitive behavioral therapy can also be used to treat OCD. In cognitive behavioral therapy, people face situations that cause or trigger their obsessions and anxiety. Then they are encouraged not to perform the rituals that usually help control their nervous feelings. For example, a person who is obsessed with germs might be encouraged to use a public toilet and wash his or her hands just once. To use this method, a person who has OCD must be able to tolerate the high levels of anxiety that can result from the experience.

Living with obsessive-compulsive disorder

People who have OCD often have other kinds of anxiety, like phobias (such as fear of spiders or fear of flying) or panic attacks.

People who have OCD also may have:

• Depression
• Attention deficit hyperactivity disorder (ADHD)
• Eating disorder
• Learning disorder

Having one or more of these disorders can make diagnosis and treatment more difficult, so it’s important to talk to your health care provider about any symptoms you have, even if you’re embarrassed.

FOR MORE INFORMATION

The Centre for Addiction and Mental Health

https://www.camh.ca/en/health-info/mental-illness-and-addiction-index/obsessive-compulsive-disorder