Obsessive-compulsive disorder

Obsessive-compulsive disorder

It is characterized by either obsessions or compulsions:

Obsessions as defined by:

1. Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress

2. The thoughts, impulses, or images are not simply excessive worries about real-life problems

3. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action

4. The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)

Compulsions as defined by:

1. Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly

2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive

Diagnosing OCD

OCD is an illness, and having it is not a person's fault, just like having asthma or diabetes is not someone's fault. And like asthma, diabetes, or any other illness, OCD can be treated so people can get relief from its symptoms.

But unlike diabetes or other illnesses, you can't have a lab test or blood test to tell you if you have OCD. Instead, a doctor such as a psychologist or psychiatrist has to ask you questions about obsessions and compulsions. They will ask and discuss questions like:

* Do you have worries, thoughts, images, feelings, or ideas that bother or upset or scare you?
* Do you feel you have to check, repeat, ask, or do things over and over again?
* Do you feel you have to do things a certain number of times, or in a certain pattern?

Once a doctor has diagnosed a person with OCD, he or she can begin treating the condition. The good news is that there are treatments that really work. Lots of mental health specialists, psychiatrists, psychologists, and counselors are trained in treating OCD.
Getting Therapy for OCD

For many teens, the thought of going to therapy can be a little scary and overwhelming. A lot of people are so embarrassed by their obsessions and compulsions that they don't even tell their parents and friends about them, never mind a stranger.

But most people find they feel comfortable — even relieved — after they meet with a therapist once or twice and know what to expect. The therapist will often begin by teaching about OCD and how the therapy works.

A type of talk therapy called cognitive-behavioral therapy (CBT) offers specific methods, called exposure and ritual (or response) prevention that work for people with OCD.

CBT helps people to learn to use the power of their own behavior to change their thoughts and feelings for the better. First, a person learns how OCD works — how giving in to compulsions makes OCD stronger and how resisting compulsions makes OCD weaker. Exposure therapy and ritual prevention allow someone to face their fears in a safe way, little by little, without doing compulsions. Therapists who treat OCD teach people new ways to react to worries and fear without doing rituals.

This type of therapy actually helps "reset" the brain's mechanisms that trigger obsessions and compulsions. At first, it can seem hard to stop doing rituals, but eventually people feel safe and stronger about dealing with their obsessions and compulsions.

Overcoming OCD is not a fast or easy process. It takes patience, practice, and hard work. People with OCD usually go to therapy about once or twice a week for a while, then less often as they begin to get better. Sometimes the doctor may also prescribe medications to help with symptoms.

Feeling better can take anywhere from a few months to a few years. For many teens with OCD, the symptoms may get better for a time and then might get worse during stressful events in their lives. But learning how to deal with OCD makes it easier to take care of it if there is a flare-up. Lots of people with OCD find that support groups can help them feel less alone and let them make friends with others who understand and are living with the same challenges.

Having OCD doesn't mean a person is crazy — or that he or she should just be able stop the obsessions and compulsions alone. Going to the doctor when you have flu isn't embarrassing, and neither is seeking treatment if you think you have OCD. With help, people can get relief from OCD and have more time and energy to spend doing things they enjoy.


The following are some common obsessions:

* Fear of dirt or germs
* Disgust with bodily waste or fluids
* Concern with order, symmetry (balance) and exactness
* Worry that a task has been done poorly, even when the person knows this is not true
* Fear of thinking evil or sinful thoughts
* Thinking about certain sounds, images, words or numbers all the time
* Need for constant reassurance
* Fear of harming a family member or friend

The following are some common compulsions:

* Cleaning and grooming, such as washing hands, showering or brushing teeth over and over again
* Checking drawers, door locks and appliances to be sure they are shut, locked or turned off
* Repeating, such as going in and out of a door, sitting down and getting up from a chair, or touching certain objects several times
* Ordering and arranging items in certain ways
* Counting over and over to a certain number
* Saving newspapers, mail or containers when they are no longer needed
* Seeking constant reassurance and approval