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Obsessive Compulsive Disorder (OCD)

It is difficult to estimate the number of people with OCD disorder, because so few of them seek help. A National Institute of Mental Health (NIMH) survey reports that OCD affects about three million Americans. Symptoms usually begin in young adulthood, although one third of people with OCD report experiencing some symptoms during their childhood. OCD can also be accompanied by eating disorders, depression, or other anxiety disorders. There is no single, identifiable cause for OCD. However, the combination of medication and therapy has proven to be an effective treatment for many people with OCD.

Symptoms

OCD is characterized by repeated behaviors sparked by anxious feelings or obsessions that may include contamination by dirt or germs, imagined harm to loved ones, runaway sexual urges, and devastating moral guilt. Compulsions are the repeated behaviors or rituals that the person is driven to complete perfectly to cope with their anxiety. A person with OCD feels obligated against their will to wash, clean, organize, or speak specific phrases in rituals that can consume hours of their days. For example, they may find themselves hoarding collections of objects that they have to count routinely to make sure none have disappeared. Some cannot leave the house without performing precise physical routines.

The chronic compulsions can become so complex that they adversely affect the person’s relationships, work, or schooling. It can be difficult to accurately diagnose OCD because symptoms resemble other anxiety or mood disorders. People with brain disorders like Tourette’s syndrome exhibit many of the same symptoms, and the two are often diagnosed together. According to NIMH, individuals are usually diagnosed with OCD when the compulsions begin to take more than one hour each day and interfere with normal routines. If you or a person in your life is experiencing these symptoms, an evaluation by a mental health professional is recommended.

Causes, Genetic Factors and Cultural Influences

Although no specific genes for OCD have been identified, scientists do believe there is a genetic component. When a parent has OCD, there is a low risk that a child will develop the disorder. Low levels of serotonin in the brain have been linked to OCD, and serotonin levels can often be influenced by genetics.

There are no apparent cultural factors influencing development or treatment of OCD.

Risks

People with OCD may abuse alcohol or drugs in an effort to treat their anxiety and some may become addicted. Addiction may make it difficult to effectively diagnose the true disorder.

People under treatment for OCD may become uncomfortable with the side effects of their medication. These can include loss of sexual desire or performance, dry mouth, nausea, drowsiness, and weight gain. If the effects are severe enough, the person may decide to stop taking their mediation, increasing their risk of returning to active OCD behaviors.

Because OCD may be accompanied by severe depression or anxiety disorders, the person may experience despair or entertain suicidal thoughts. They need to be taken seriously. Do not hesitate to contact 911 emergency services in a crisis.

Treatment

OCD cannot be cured at the present time, but medication and therapy has proven effective for many in reducing severity and occurrence of OCD episodes. Therapy can be used to treat acute, ongoing OCD as well as in maintaining the disorder over time. Many people with OCD respond well to antidepressant medications known as selective serotonin reuptake inhibitors (SSRI). An estimated 75 percent of people with OCD experience relief three weeks after they begin taking medication. Commonly used SSRI drugs include fluvoxamine (Luvox®), fluoxetine (Prozac®), sertraline (Zoloft®), paroxetine (Paxil®), and citalopram (Celexa®). Clomipramine (Anafranil®) is a tricyclic antidepressant that also has been proven effective in treating OCD.

Targeted therapy combined with medication has helped many people with OCD. Exposure therapy shows them that confronting their anxieties — such as touching dirt or grime — won’t harm them. Cognitive therapy can help the person with OCD to identify the thought patterns that create anxiety and learn new behaviors that disrupt the cycle of fear and compulsive behavior. Some people experience long-term, positive effects from talk therapy after 12-20 visits. Others may not respond as well.

How You Can Help

If you think a friend or family member needs help, the National Institute of Mental Health (NIMH) recommends that you encourage the individual to get an evaluation from a mental health professional. Family members and friends can help an individual recognize that they have an illness that can be treated if they are willing. It is important to understand that diagnosing serious mental illness is not simple or straightforward. Your doctor may need to revise the initial diagnosis, treatment and drug therapies one or more times over a period of weeks or months to find the best treatment regimen.

Sometimes, family members and friends need to intervene if a loved one with serious mental illness refuses to obtain treatment. This can be a very difficult situation for both the individual with the illness and the family members and friends. It is important to obtain assistance from a mental health professional to guide you through the medical and legal issues involved in an intervention.

Family members and friends of a person with serious mental illness can help by offering their support and affection to the extent possible. It is important to understand that people with serious mental illness cannot simply “pull themselves together” and get better. The support of family members and friends over the long term can be invaluable to an individual with a serious mental illness. Support groups can also be invaluable. Consumer groups offer individuals with mental illness an opportunity to share their needs, concerns and struggles with others in the same situation. Consumer support groups are available in many communities.

Family members and friends need to become educated about serious mental illness. They also need to take care of their own emotional needs. Support groups can also help family members and friends cope with their loved one’s illness. Family support groups provide a place for family members to share their experiences and obtain current information and education about their loved one’s mental illness.

NAMI California maintains a list of NAMI affiliates in your community that offer resources and support to individuals and families needing help with serious mental illness. The list includes information, contact persons, crisis numbers, telephone listings, and email contacts.

Family physicians, mental health professionals, religious counselors, community mental health centers, social service agencies, state and private hospitals are also available to provide help and support as needed. NAMI California maintains a current list mental health professionals (psychiatrists, psychologists, care homes, etc.) that provide support for serious mental illness in your community.

NAMI California also offers the “Family-to-Family” program to educate and support families who have members afflicted with a serious mental illness.

Finally, and most importantly, do not hesitate to get help from your local 911 emergency service or suicide hotline in a crisis.

For additional information, visit these web sites:

Related Resources

Living with Obsessive-Compulsive Disorder

Welcome to NAMI’s Living with Obsessive-Compulsive Disorder community. Here you will find support, get targeted information and connect with people who understand.

Find Support

Learn more about the full spectrum of programs and services that NAMI provides across the country for people living with mental illnesses, and their families and loved ones.

Online Discussion

Living with OCD

Find support, share knowledge, ask questions and meet people who’ve been there.

Mental Illness Discussion Groups

Dozens of online groups for consumers, parents, spouses, siblings, teens and more. Get connected and find support.

Related Links

Anxiety Disorders Association of America (ADAA)

National, non-profit membership organization dedicated to informing the public, providers, and policy-makers about anxiety disorders.

Clinicaltrials.gov

OCD research studies identified through the U.S. National Library of Medicine’s link to federally and privately funded studies worldwide.

National Institute of Mental Health

Information from the NIH institute on OCD.

Obsessive Compulsive Foundation

International, non-profit organization of individuals with OCD and their family, friends, providers, and concerned citizens working to educate the public and provide support to individuals with the disorder.

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