Obsessive Compulsive Disorder

Obsessive Compulsive Disorder is considered a form of anxiety disorder. It is characterized by obsessions, which are recurrent, intrusive thoughts which lead to anxiety; and compulsions, which are repetitive behaviors which have developed in an effort to reduce the anxiety. Examples of obsessions include thoughts of having left a door unlocked or the stove on. This then leads to the person having to check these things (the compulsion).

In OCD, there is temporary relief of anxiety, but the individual soon returns to having the obsessions which create the compulsion to check again. This may then happen a number of times, consuming hours of one’s time. Obsessions may take other forms, such as thoughts of having to order/organize; thoughts of having been dirtied or contaminated; and thoughts of having to “ward off” something bad from happening. In addition to checking, the compulsions which follow the obsessions may include organizing, making objects symmetrical, washing, counting, repeating, etc.

In CBT, the individual identifies all of the obsessions and compulsions he/she has and creates a list which can then be ordered in terms of severity (that is, the degree of difficulty to resist). The therapist then helps the individual to experience the obsession without giving in to the compulsion. Properly done, these exercises can be very effective and usually the individual is surprised with his/her success. Medicines which are used involve those that act on the serotonin system in the brain, such as Prozac, Zoloft, Paxil, Anafranil, and others. They can be very effective but tend to take a number of weeks to work. Overall, the combination of treatments is most effective in most cases.