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Obsessive-compulsive disorder is having thoughts (obsessions) and rituals
(compulsions) over and over, which interfere with your life and which you
cannot control or stop.
The part worth leading with is the boundary, because "a bit OCD" is one of the
most misused phrases there is. **Not everyone who has obsessions or
compulsions has OCD.** The symptoms are usually considered OCD when all of the
following hold:
- You cannot control the thoughts or behaviours, even knowing they are
excessive. - You spend at least one hour a day on them.
- You get no pleasure from performing the behaviours. Doing them may give
brief relief from anxiety — that is a different thing from enjoying them, and
it is the reason the loop keeps running. - They cause significant problems in daily life.
That third condition is the one that separates OCD from a preference. Someone
who likes a tidy shelf enjoys the tidy shelf.
What the two halves look like
Obsessions are repeated thoughts, urges or mental images that cause
anxiety: fear of germs or contamination; fear of losing or misplacing
something; worries about harm to yourself or others; unwanted forbidden
thoughts about sex or religion; aggressive thoughts towards yourself or
others; needing things lined up or arranged in a precise way.
Compulsions are behaviours you feel you must repeat to reduce the anxiety
or stop the thoughts: excessive cleaning or handwashing; repeatedly checking
whether the door is locked or the oven is off; compulsive counting; ordering
and arranging things precisely.
Some people with OCD also have Tourette syndrome or another tic disorder —
sudden twitches, movements or sounds they cannot stop their body doing.
Where it comes from
The cause is unknown. Genetics, brain biology and chemistry, and environment
may all play a part. It usually begins in the teens or young adulthood, and
boys often develop it younger than girls.
| Risk factor | |
|---|---|
| Family history | Higher risk with a first-degree relative who has OCD, especially one who developed it as a child or teen |
| Brain structure and function | Imaging shows differences in certain brain areas; the connection is not yet understood |
| Childhood trauma | Some studies link childhood abuse to OCD; more research is needed |
| PANDAS | In some cases children develop OCD or its symptoms after a streptococcal infection — Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections |
Diagnosis, and why it is hard
Start with your provider. A physical exam and medical history come first, to
check whether a physical problem is producing the symptoms. If not, the
provider may do an OCD test or refer you to a mental health specialist.
OCD can be genuinely hard to diagnose: its symptoms resemble those of other
mental disorders such as anxiety disorders, and it is possible to have OCD
and another disorder at the same time.
Treatment
The main treatments are cognitive behavioural therapy, medicines, or both.
CBT teaches different ways of thinking, behaving and reacting to the
obsessions and compulsions. Within it, Exposure and Response Prevention
is the specific approach for OCD: you are gradually exposed to your fears or
obsessions and learn healthy ways to handle the anxiety they produce — rather
than performing the ritual that briefly relieves it.
Medicines are certain antidepressants; if those do not work, another type
of psychiatric medicine may be suggested.
For severe OCD that does not improve, **repetitive transcranial magnetic
stimulation** uses magnetic waves to target the brain areas associated with
the disorder.
Source: MedlinePlus, U.S. National Library of Medicine.
Licence : CC0 1.0 (domaine public) · Adapté de medlineplus.gov
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