Regain Control From Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is a serious mental health condition that involves the occurrence of obsessive thoughts that lead to repetitive behaviors—that is, compulsions.

The Anxiety & Depression Association of America reports that about 2.2 million adults in the United States suffer from OCD. Individuals can develop the disorder at any age, but the average onset is 19.

In popular culture, the term "OCD" is often casually thrown around to describe perfectionists or people who tend to be more particular than most. However, having a diagnosis of obsessive-compulsive disorder means much more than simply caring about keeping things neat or clean.

Individuals who suffer from OCD find it difficult to get rid of unwanted thoughts and urges, which leads to ritualistic behaviors and compulsions that can create significant anxiety in their lives and often make it harder to carry out daily activities.

"The intrusive and unwanted thoughts and images associated with obsessive-compulsive disorder are often frightening and distressing," said Dean McKay, a psychology professor at Fordham University in New York. McKay is also board-certified by the American Board of Professional Psychology in both cognitive behavioral therapy and clinical psychology, and serves on the Scientific Advisory Board of the International Obsessive Compulsive Disorder Foundation and the Scientific Council of the Anxiety and Depression Association of America.

"These thoughts may be accompanied by specific rituals aimed at eliminating these thoughts," McKay explained. "It is widely recognized that OCD is marked by common symptom types. These include contamination concerns and washing rituals; checking rituals; blasphemous, sexual, or harm-related obsessions; and symmetry and ordering rituals."

For example, a person whose OCD manifests in things like checking rituals may lock their door before going to bed at night, but find themselves having obsessive thoughts about whether the door is still locked, which then leads to them compulsively getting up to check the lock multiple times throughout the night, resulting in a loss of sleep. Additionally, obsessive-compulsive disorder can sometimes present unique challenges to a person's sex life. For some individuals with OCD who find themselves obsessing over an irrational fear of contamination, engaging in any sexual activity at all can be distressing as they fear it may expose them to harmful germs or diseases, even with a trusted partner.

"I should add that obsessions and compulsions are very common in the general population," McKay said. "As a result, we should be clear that the distinction between OCD and everyday obsessional experiences is primarily around the severity of distress, and whether the obsessions and compulsions interfere with ordinary functioning."

Experts don't fully understand what exactly causes obsessive-compulsive disorder but many believe that it may develop as a result of some people's natural chemical makeup and brain functions. Some experts also believe certain genes make some individuals more likely to develop the disorder, though the specific gene hasn't yet been identified.

"The causes of OCD remain unclear, but there is emerging evidence that several brain areas may be involved in it, including areas responsible for gaining satisfaction that tasks have been completed, regions for fear activation and areas associated with decision making," McKay added. "There are also compelling findings to suggest that OCD can be learned based on opportunistic learning of strategies that may alleviate commonly occurring unwanted thoughts."

Researchers have found that having a family history of OCD, experiencing trauma or other stressful life events, and having other mental health disorders, such as anxiety and depression, can lead to a greater risk of developing obsessive-compulsive disorder.

If you've struggled with obsessive-compulsive disorder, at some point you've likely felt frustrated at the amount of time wasted by your obsessions and compulsions.

McKay said if you feel a decline in your daily functioning or an increase in your personal distress, that's a great indicator you may need help.

"Loss of sleep due to anxiety related to obsessions is also a very good indicator," McKay said.

DeAvila Ford, a licensed clinical social worker who owns a private practice where she provides online mental health counseling services, added that if you find that symptoms of OCD are getting in the way of your daily responsibilities or your ability to attend social functions, then that's also a significant sign you could benefit from professional help.

Ford said the most effective way to treat obsessive-compulsive disorder is typically with medication, psychotherapy or a combination of the two.

"Serotonin reuptake inhibitors (SSRIs) are typically used to aid in reducing OCD symptoms," Ford explained. "On average, it may take from 8 to 12 weeks before clients will experience improvement in their OCD symptoms when taking medication. Cognitive behavioral therapy (CBT) is a type of psychotherapy that has yielded great results in people who struggle with OCD. This therapy aids in challenging the negative thoughts that are connected to the negative feelings and behaviors associated with the symptoms of OCD."

"Cognitive behavioral therapy is a structured form of therapy that focuses on symptoms and is currently one of the most effective forms of treatment," McKay said.

"The two primary components include exposure with response prevention, which is a collaborative intervention where the client and therapist identify rituals that the client may delay or stop engaging in, with the understanding that the anxiety resulting from the intrusive thought will diminish over time," McKay continued. "The other component, cognitive therapy, targets thoughts that perpetuate obsessional experiences. For example, many OCD sufferers report 'over-importance of thoughts,' where the sufferer says to themselves that because they had a specific intrusive thought, it means something and thus must be dealt with."

"Through treatment, individuals can find strategies that can help them deal with obsessive thoughts in their daily lives," Ford said. "Creating a coping skills toolbox can be helpful. The individual must find ways to self-soothe when the urges occur. That could be through journaling, grounding exercises, etc. The client should work with a therapist to try multiple interventions to aid in decreasing symptoms."

Another way to combat obsessive thoughts in your day-to-day life is to remind yourself that thoughts don't equate to actions or outcomes.

"Thinking something does not mean it will come true," McKay said. "Someone suffering from OCD might even consider some small experiments to test this out, such as wishing for a small office trash can to topple, and that it would be within a specified time frame, such as 15 minutes. The other, more general way to approach this is to simply grant yourself permission to have distressing thoughts."

There are some overlapping symptoms when it comes to obsessive-compulsive disorder and generalized anxiety, so how do you know which one you're dealing with?

Both generalized anxiety disorder and obsessive-compulsive disorder can cause a persistent and intense sense of anxiety or fear. However, generalized anxiety disorder often involves a looming sense of stress and anxiety without a known cause. However, with OCD, the source of anxiety is typically known, as the distress results from the obsessive thoughts themselves.

"Being anxious could be a result of a wide range of factors," McKay said. "People who are concerned with embarrassing themselves might be anxious but not have OCD. People who are worried about their health or occupational functioning would be anxious, but not likely to have OCD. And, it is essential to remember that anxiety is an adaptive emotional response. We get anxious to protect ourselves and worry to motivate problem-solving. Obsessions and compulsions also generate anxiety, and thus these are connected, but in a highly specific manner."

There's another major difference between obsessive-compulsive disorder and generalized anxiety disorder, and that is the compulsions. Compulsions are the ritualistic behaviors people with OCD feel an intense need to perform in order to temporarily calm the fears and anxieties associated with their obsessive thoughts or urges. These compulsions—which can range from excessive hand-washing to repetitive counting, just to name a couple—are not symptoms caused by generalized anxiety disorder.

As is the case with other mental health conditions, it's probably not useful to think of OCD as something to be "cured." Instead, view it as something you can learn to better manage and cope with in healthy ways.

"Since obsessions and compulsions are very common experiences in the general public, it is probably more effective to think of treatment as driving symptoms down to levels similar to what most people experience," McKay said. "A 'cure' would mean, from my perspective, experiencing obsessions and compulsions in a way that is indistinguishable from any member of the general population."

Ford added that recovery from obsessive-compulsive disorder is more about relief than the total elimination of symptoms.

"There is no 'cure' for OCD. However, you can see a significant decrease in symptoms," Ford said. "The desired outcome for treatment is for the symptoms to cease interfering with all aspects of an individual's life. Individuals should be able to function at work, school and in their relationships without the symptoms impacting them."

For anyone who may feel hesitant to come forward to get help for OCD because of the stigma that often surrounds talking about mental health, Ford said it's important to remember professionals are there to help.

"Mental health is just as important as physical health," she said. "You are not alone, and this is a very common diagnosis. If you think you may have this diagnosis, then just speak with a doctor or clinician about your symptoms."

"Between 1 and 3 percent of the population suffers from OCD—this translates to a large number of people," McKay explained. "Even if the intrusive thoughts are scary, intense and embarrassing, there is a very good chance other people, possibly people you know, have similar intrusive thoughts. Experts in OCD have heard a wide range of symptoms that include terrifying thoughts and images that OCD sufferers found difficult to manage and caused extreme anxiety. And, most importantly, we currently have treatments that provide real and lasting relief."