Definition:

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by recurrent, unwanted and disturbing thoughts (called obsessions) and/or repetitive, ritualized behaviors that the person feels driven to perform (called compulsions).

A person with obsessive-compulsive disorder may realize that his obsessions aren't reasonable, and may try to ignore them or sto  p them. But that only increases his distress and anxiety. Ultimately, he feels driven to perform compulsive acts in an effort to ease his stressful feelings.

Signs and Symptoms:

People with OCD generally:

• Have repeated thoughts or images about many different things, such as fear of germs, dirt, or intruders; acts of violence; hurting loved ones; sexual acts; conflicts with religious beliefs; or being overly tidy. 

• Do the same rituals over and over such as washing hands, locking and unlocking doors, counting, keeping unneeded items, or repeating the same steps again and again.

• Can't control the unwanted thoughts and behaviors.

• Don't get pleasure when performing the behaviors or rituals, but get brief relief from the anxiety the thoughts cause. 

• Spend at least 1 hour a day on the thoughts and rituals, which cause distress and get in the way of daily life.

Treatment:

The First-Line Treatments for OCD should include one or more of the following: 

• A properly trained therapist. Finding a therapist who can diagnose and effectively treat OCD is a challenge to many patients and families. 

• Cognitive behavior therapy is especially useful for treating OCD. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious or fearful without having obsessive thoughts or acting compulsively. One type of therapy called exposure and response prevention is especially helpful in reducing compulsive behaviors in OCD. 

• Medication. Doctors also may prescribe medication to help treat OCD. The most commonly prescribed medications for OCD are anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods. 

• Antidepressants are used to treat depression, but they are also particularly helpful for OCD, probably more so than anti-anxiety medications. They may take several weeks—10 to 12 weeks for some—to start working. Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping.  

• Some people with OCD do better with cognitive behavior therapy, especially exposure and response prevention. Others do better with medication. Still others do best with a combination of the two.

Other options:  

• Brain Surgery Anterior cingulotomy: This is a brain surgery that involves drilling through the skull and using a heated probe to burn an area within a part of the brain called the anterior cingulate cortex. Anterior capsulotomy This procedure is very similar to Anterior cingulotomy.  However, in this surgery, doctors operate on a different part of the brain, called the anterior limb of the internal capsule. About 50% of those who did not respond to behavior therapy or medicines for OCD got some benefit from brain surgery. 

• Gamma Knife  Gamma knife: is a treatment for OCD that does not require opening the skull.  In gamma knife procedures, multiple gamma rays pass through the skull (see image to the right).  On its own, a single gamma ray poses no danger to brain tissue.  However, when gamma rays intersect, the energy level is high enough to destroy the targeted brain tissue.  The most recent version of this procedure is called gamma ventral capsulotomy.  This is because the procedure is limited to the ventral (bottom) half of a brain area called the anterior capsule. About 60% of those who did not respond to behavior therapy or medicines for OCD got some benefit from the procedure. 

• Deep Brain Stimulation (DBS):DBS involves placing electrodes in  targeted areas of the brain. Once the electrodes are in place, they are connected by wires under the skin to pulse generators under the skin (usually just below the collarbone). These pulse generators are similar to pacemakers. The biggest difference is that in DBS the electrodes are in the brain instead of in the heart.

Coping Methods:

Here are some ways to help cope with OCD:

• Learn about obsessive-compulsive disorder. Education about your condition can empower you and motivate you to stick to your treatment plan. 

• Join a support group. Support groups for people with OCD can help you reach out to others facing similar challenges.  

• Stay focused on your goals. Recovery from OCD is an ongoing process. Stay motivated by keeping your recovery goals in mind. Remind yourself that you're responsible for managing your illness and working toward your goals.

• Find healthy outlets. Explore healthy ways to channel your energy, such as hobbies, exercise and recreational activities. 

• Learn relaxation and stress management. Try such stress management techniques as meditation, muscle relaxation, deep breathing, yoga or tai chi. 

• Structure your time. Plan your day and activities. Try to stay organized. You may find it helpful to make a list of daily tasks.

Hotlines:

• National Suicide Prevention Lifeline, at 1-800-273-TALK (8255),
• The Boys Town National Hotline, at 1-800-448-3000.

National OCD Information Hotline:  800-NEWS-4-OCD

• Canada OCD Network

• OCD Help - Home
  Confronting The Bully of OCD, using techniques taught by a leading NYC OCD specialist, Dr. Steven Brodsky, who wrote the Preface. 

•   OCD (Obsessive Compulsive Disorder) Action- 

Support for people with obsessive compulsive disorder. Includes information on treatment and online resources.
Phone: 0845 390 6232
Website: www.ocdaction.org.uk  

•   OCD UK

A charity run by people with OCD, for people with OCD. Includes facts, news and treatments.
Phone: 0845 120 3778
Website: www.ocduk.org

•  Beyond OCD

       2300 Lincoln Park West, Suite 206B
Chicago, IL 60614 T: 773-661-9530

A list of all support groups is available at http://www.ocfoundation.org/find_a_support_group.aspx