At one time or another, we’ve all double-checked that we locked the front door, “knocked on wood” to ward off certain disaster, or had a strange or even disturbing thought pop into our head from out of the blue. While most people continue about their daily routine without giving these experiences a second thought, if you have obsessive-compulsive disorder (OCD), these kinds of occurrences can become both distressing and debilitating.
OCD is considered an anxiety disorder, as people affected by this mental illness experience severe anxiety as the result of obsessive thoughts. Often, extensive rituals are undertaken in an attempt to reduce the anxiety caused by obsessions.
Obsessions are thoughts, images, or ideas that won’t go away, are unwanted, and are extremely distressing or worrying (“What if I become infected with a deadly disease?” or “What if I molest a child or murder my partner?”). Compulsions are behaviors that have to be done over and over again to relieve anxiety. Compulsions are often related to obsessions. For example, if you are obsessed with being contaminated, you might feel compelled to wash your hands repeatedly. However, this is not always the case.
Who is Affected by OCD?
OCD is a relatively common disease that affects about 2.5% of people over their lifetime. It is experienced equally by men and woman, and affects all races and cultures. OCD usually begins around late adolescence/oung adulthood, although young children and teenagers can also be affected. Parents and teachers often miss OCD in young children and teenagers, as they go to great lengths to hide their symptoms.
Parents should also be aware of a subtype of OCD in children exacerbated or trigged by strep throat, in which the child's own immune system attacks the brain. This Pediatric Autoimmune Neuropsychiatric Disorder (PANDAS) form of OCD accounts for 25% of the children who have OCD. Unlike normal OCD which develops slowly, PANDAS OCD develops quickly and has a variety of other symptoms not associated with typical cases of OCD.
Symptoms of OCD usually appear gradually and can be long-lasting if not treated. Stress from unemployment, relationship difficulties, problems at school, illness or childbirth can be strong triggers for symptoms of OCD.Although a single “OCD gene” has not been identified, OCD may be related to particular groups of genes. You may also be at greater risk if there is a family history of the disorder.
If you have OCD, you may also be at greater risk for other mental illnesses, such as depression, generalized anxiety disorder and alcoholism. This is especially true if you do not seek help for OCD symptoms.
Where Does OCD Come From?
People who are vulnerable to OCD describe a strong need to control their thoughts, and feel that strange or unusual thoughts mean they are going crazy or will lose control.
So, while many people can have strange or unusual thoughts -– especially when feeling stressed -– if you are vulnerable to OCD it may be difficult to ignore or forget about these thoughts. In fact, because these thoughts seem so dangerous, you end up paying even more attention to them, which sets up a vicious cycle.
OCD can also be understood from a biological perspective. Although there was a time when mental illness was thought to be the result of a character flaw, it is now clear that mental illnesses such as OCD have biological causes.
One theory is that OCD comes from a breakdown in the circuit in the brain that filters or “censors” the many thoughts, ideas, and impulses that we have each day. If you have OCD, your brain may have difficulty deciding which thoughts and impulses to turn off. As a result, you may experience obsessions and/or compulsions.
The breakdown of this system may be related to abnormalities of serotonin. Many of the medications which are effective in treating OCD, such as Prozac (Fluoxetine), Paxil (Paroxetine) and Zoloft (Sertraline), and Anafranil (Clomipramine) affect levels of serotonin.
Sources:
American Psychiatric Association. "Diagnostic and Statistical Manual of Mental Disorders, 4th ed., text revision" 2000 Washington, DC: Author.
Pauls, David. "The genetics of obsessive compulsive disorder: a review of the evidence." American Journal of Medical Genetics April 15 2008 148: 133-139. 01 September 2008.
Rachman, Stanley. "Obsessions, responsibility and guilt." Behaviour Research and Therapy February 1993 31:149-154. 01 September 2008.
Saxena, Sanjaya, and Rauch, Scott. "Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder". Psychiatric Clinics of North America September 1 2000 23: 563-586. 01 September 2008.
