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Who has OCD?

Approximately 2.5% of the population, or 6.6 million people, will develop obsessive-compulsive disorder (OCD) in their lifetime. In other words, OCD is a problem many people deal with. You are not alone! OCD is a disorder that affects everyone from all walks of life.

There is nothing that you “did” to develop OCD. In other words, it’s not your fault. OCD is most likely an inherited behavior. Research shows that people who have OCD also have someone in their family who also suffers.

OCD is a neuropsychiatric disorder, or “a brain thing.” Brain scans have shown that the brains of people with OCD act differently than the brains of non-OCD individuals.

What is OCD?

Some people think about OCD as having a “hiccup” in your brain. We don’t really understand why it’s there, but we can try to make the hiccups go away.

Symptoms may start during childhood, but many people begin developing symptoms around the age of 19.

Slightly more than half of individuals with OCD are women.

OCD tends to be a gradually-developing disorder. On the other hand, some cases develop very quickly without warning. Sometimes people don’t realize they even have OCD until they hear about it or read about it.

Some people may not realize why they are feeling a particular way, or why they are doing things. Even if they know these thoughts/behaviors don’t make sense, they still have a hard time changing their thoughts and behaviors.

Why exactly is OCD?

People with OCD have obsessions (thoughts, images or fears) that they can’t get rid of. Soon, they discover ways to make themselves feel less worried, they do a behavior that makes them feel better- this is called a compulsion or a ritual. Most people have both obsessions and compulsions. Here’s an example of having both. Some people have a germ contamination obsession. They worry constantly about all the germs they come into contact with on a regular basis. The only way they can stop from obsessing about contamination is to wash their hands, which is an example of a compulsion. The obsession/compulsion cycle is very powerful. Even more importantly, it’s the compulsions people do that actually make their obsessions stronger!

Building on the germ contamination example, following the hand washing compulsion/ritual, people tend to feel better because they no longer have the contamination obsession. However, this relief is only temporary, because the obsession is likely to come back and be bothersome. So, what will probably happen? Well, one has learned that, last time, washing hands made that obsession go away, so one will do it again. In other words, learning has taken place: “The last time I felt bothered by germs, I washed my hands, and felt better. So, I’m going to wash my hands again…” And so begins the cycle.

What OCD is not

OCD is not just “focusing” on something, like shopping or football. It involves a very specific cycle of anxiety increase and anxiety reduction.

It is not just a repetitive behavior. There are some repetitive behaviors that are sometimes thoughts to be OCD, but are not, i.e., hair pulling, gambling, shopping and eating.

What is the treatment for OCD?

The most widely recognized effective treatment for OCD is called Exposure and Response Prevention (ERP)

ERP is a treatment method supported with research that has been developed specifically for the treatment of OCD.

This model focuses on a number of components.

First, one is exposed to the things that trigger obsessions.

Second, one learns how to not ritualize or do compulsions. This is probably the most challenging part of treatment.

Third, any resistance behaviors, like telling oneself that it really is OK, are identified and eradicated.

ERP is a gradual treatment. One does not face their most distressing obsessions/compulsions first. Instead, treatment will start off working on more moderately upsetting obsessions and compulsions.

As with anything new that a person learns, practice is key. The more a person with OCD faces their obsessions and DOES NOT ritualize/do a compulsion, the less bothersome these obsessions will be.

Do medications for OCD work?

Medications, specifically serotonin reuptake inhibitors (SRIs) have been the main focus of pharmacological treatment of OCD for adults.

In general, research focusing on treatment of OCD with serotonergic medications has supported the use of these medications vs. a placebo (sugar pill). However, although SRIs decrease OCD symptoms, symptoms tend to come back when discontinuing medication.

Many research studies also compare medication vs. ERP. In general, cognitive-behavioral treatment works well both by itself, as well as when combined with an SRI. However, ERP has been found to be as effective as combined treatments. Therefore, one doesn’t necessarily need to be on medication in order to benefit from ERP. But, for some people, medication can help them to be more successful at doing the treatment.

If you are interested in seeking pharmacological treatment, you should speak with a psychiatrist specialized in the treatment of OCD.