What Is Obsessive-Compulsive Disorder?
From hoarding to handwashing to forever checking the stove, obsessive-compulsive disorder (OCD) takes many forms. It is an anxiety disorder that traps people in repetitive thoughts and behavioral rituals that can be completely disabling.

Surveys conducted by the National Institute of Mental Health show that 2 percent of the population suffers from OCD—that’s more than those who experience other mental illnesses like schizophrenia, bipolar disorder, and panic disorder. OCD might begin in childhood, but it most often manifests during adolescence or early adulthood. Scientists believe that both a neurobiological predisposition and environmental factors jointly cause the unwanted, intrusive thoughts and the compulsive behavior patterns that appease the unwanted thoughts.

Unless treated, the disorder tends to be chronic—lasting for years, even decades—although the severity of the symptoms may wax and wane over the years. Both pharmacological and behavioral approaches have proven effective as treatments; often a combination of both is most helpful. For more on causes, symptoms and treatments, see our Diagnosis Dictionary. 

The Varieties and Symptoms of Obsessions
These uncontrollable thoughts or behaviors can interfere with a person’s work, school, and relationships. Though the behaviors may give the person momentary relief from his overall anxiety, he doesn’t derive pleasure from the obsessiveness. People suffering from obsessive-compulsive habits may also contend with motor tics or repetitive movements, such as grimacing and jerking. Research into OCD is ongoing. For example, defects called micro-structural abnormalities have been found in the brain’s white matter of those who suffer OCD, and frontline treatment for this disorder includes exposure and response prevention, as well as plain old empathy and compassion in delivering therapy.

The first symptoms are the obsessions—the unwanted ideas or impulses that occur over and over again and are meant to drive out fears, often of harm or contamination. “This bowl is not clean enough. I must keep washing it.” “I may have left the door unlocked.” Or “I know I forgot to put a stamp on that letter.” The compulsions appear after that—repetitive behaviors such as handwashing, lock-checking, and hoarding. Such behaviors are intended to mitigate fear and reduce the threat of harm. But the effect does not last and the unwanted thoughts soon intrude all over again.

Sufferers may understand the uselessness of their obsessions and compulsions, but that is no protection against them. OCD can become so severe that it keeps people from leaving their homes. The condition strikes males and females in equal proportions.

What Causes OCD?
Current scientific thinking holds that OCD results from a confluence of factors—a biological predisposition, environmental factors including experiences and attitudes acquired in childhood, and faulty thought patterns.

The fact that many OCD patients respond to SSRI antidepressants suggests the involvement of dysfunction in the serotonin neurotransmitter system. Ongoing research suggests there may be a defect in other chemical messenger systems in the brain.

OCD may coexist with depression, eating disorders, or attention-deficit/hyperactivity disorder, and it may be related to disorders such as Tourette’s syndrome, and hypochondria, though the nature of the overlap is the subject of scientific debate.

Advice and tips
Stick to your prescriptions. It can be tempting to escape OCD with drugs or alcohol, but they’re triggers in disguise. Drinking alcohol might feel like it offsets your anxiety, but it creates more before it leaves your system. Same goes for nicotine, the stimulant in cigarettes.

Sleep on it. Anxiety can make it hard to sleep. But sleep is important for good mental health. Instead of expecting to lie down and drift off to dreamland, create a sleep routine that sets your body up for success. Swap the time you spend looking at screens for 10 minutes of relaxing music or a warm bath. Dim noise and lighting and adjust the temperature in your bedroom so you go to sleep, and stay asleep all night.

Get active and take sometimes some risks. When you feel anxious, your body releases a hormone called cortisol. It’s helpful in small doses but harmful at high levels. Regular exercise keeps your cortisol levels in check and benefits everything from your bones and organs to the numbers on your scale.

Seek support. Don’t hold it all in. Help is as close as your phone or computer. Sometimes the simple act of saying out loud what you’re thinking can lower anxiety and give you some perspective. In addition to your doctor, find a therapist, OCD coach, or support group to connect you with people who understand.

Learn to relax. Your body can’t relax if it doesn’t know how. Relaxation techniques like yoga, meditation, taking a walk in nature, or drawing a picture teach your body how it feels to be calm. Try a few to find what works best for you, and spend 30 minutes a day on it.

Celebrate victories. Learning how to live with OCD takes time. Like any other goal, you’ll have successes and setbacks. Yes, it’s important to work on your OCD, but it’s just as important to step back and cheer the big and small progress you make along the way.