Discussion in a group therapy sessionLiving with a mental health condition can be frustrating. It can leave you feeling isolated and like nothing will help your symptoms.

The mental and behavioral health specialists at The Ohio State University Wexner Medical Center in Columbus, Ohio, want you and your family to know help is available. We can find an accurate diagnosis for you and offer appropriate treatment that is individualized to your needs.

Conditions like obsessive-compulsive disorder (OCD) can be debilitating, and our experts understand what you’re going through. Our goal is to ease your symptoms and get you back to living your daily life.

What is OCD?

OCD is a mental health condition that causes people to have frequent, intrusive thoughts called obsessions. To try to control these thoughts, a person with OCD may feel an overwhelming urge to repeat certain rituals or behaviors called compulsions. Usually, people with OCD have both obsessions and compulsions, but sometimes they might have one or the other.

An example of an obsession is a fear of germs, and the related compulsion could be to wash your hands repeatedly.

We all can experience obsessions and compulsions, such as double-checking to make sure the stove is off, at times, but for people with OCD these thoughts and rituals become time-consuming symptoms. They can cause distress and interfere with normal daily living. OCD is treatable, though, if you work with a mental health professional. The earlier you seek help, the better recovery can be.

What causes OCD

We’re not entirely sure why someone develops OCD, but genetics, brain changes and your environment likely play a role. Possible risk factors include:

  • Family history: Having a close family member with OCD can increase your risk of having the disorder, both because of shared genes and learned behavior.
  • Brain changes: Imaging studies have shown differences in the frontal cortex and subcortical structures of the brain in people with OCD.
  • Trauma: Going through a traumatic or stress-related event, especially as a child, can increase your risk.
  • Other mental health conditions: OCD might be related to anxiety, depression, substance use disorder and others.

Symptoms of OCD

Symptoms of OCD generally fall into two categories: obsessions or compulsions. People usually experience both, but not always. OCD symptoms also vary in type and severity from person to person. Some common signs of OCD include:

Obsessions in OCD

Obsessions are frequent, upsetting thoughts that you can’t control, and even though you may realize that the thoughts are irrational, you can’t help worrying about them. Common obsessions include:

  • Perfectionism – This involves obsessing over symmetry and that every object is always in the right order and right place.
  • Harmful thoughts – This involves obsessing about bad, even violent, things happening to yourself or others.
  • Contamination – This involves obsessing over the spread of germs and compulsions of cleanliness.
  • Checking – This involves obsessing over causing harm from being careless, which can lead to a compulsion to double-check tasks repeatedly.
  • Scrupulosity – This involves obsessing over moral or religious issues, such as concerns you thought about or did something that might be a sin or a violation of your faith.

Compulsions in OCD

Compulsions are repetitive actions you feel you must do because of an obsession. Usually, you’re aware these rituals are out of the norm, and you don’t want to do them, but you perform them anyway. Common compulsions include:

  • Bathing and washing your hands repeatedly or using barriers to avoid touching contaminated objects
  • Arranging items in a very particular way, such as items in a cabinet
  • Asking reassurance or giving yourself assurance
  • Apologizing
  • Repeatedly checking things, such as if the stove is off or doors are locked
  • Counting tasks excessively, avoiding certain numbers or experiencing other compulsions related to numbers
  • Praying over and over again

Symptoms can happen to anyone, but they usually first appear in late childhood or early adulthood. It’s important to note that experiencing repeated thoughts or having rituals doesn’t necessarily mean you have OCD. You might have OCD if:

  • You can’t control your obsessions and compulsions.
  • You spend more than an hour daily on obsessions and compulsions.
  • You experience significant challenges in your daily living because of your thoughts or rituals.

OCD-related disorders

There are several mental health and behavioral disorders that are related to OCD that we treat at the Ohio State Wexner Medical Center. Those conditions include:

  • Hoarding – People with hoarding disorder have the urge to acquire material possessions even when there is no need to do so, and they struggle to discard items even when they hold little meaning or value.
  • Trichotillomania – When someone has the irresistible urge to pull out their hair, it's called trichotillomania.
  • Excoriation disorder – This is the repeated urge to pick one's skin, often leading to physical or psychological harm.
  • Tic disorder – Tic disorder is defined by having one or more motor or vocal related tics

Other disorders involving repetitive behaviors could include cheek biting or other actions repeated over and over.

What causes OCD symptoms to get worse?

During times of high stress or trauma, your OCD symptoms can worsen. Hormonal changes, such as during pregnancy or right before menstruation, can also impact the intensity of OCD. Not getting enough sleep can lead to more pronounced symptoms, too.

Does OCD go away?

There is no cure for OCD, and it can be a chronic disorder that is long-lasting, but symptoms can lessen significantly with proper treatment managed by a mental health expert.

Treatment for obsessive-compulsive disorder

Treatment for OCD is typically psychotherapy, medications or a combination of both. At the Ohio State Wexner Medical Center, our OCD experts will work with you to develop a personalized treatment plan that focuses on your needs and goals. Our treatment might include:

  • Psychotherapy – Therapy can be just as effective as medication for some people with OCD. The most common type of therapy for people with OCD is exposure and response prevention (ERP) therapy.
  • Medications – Antidepressants that target serotonin are usually the first medications prescribed for OCD.
  • Transcranial magnetic stimulation (TMS) – If psychotherapy and medications haven’t eased symptoms, you might be a candidate for TMS, which uses magnetic pulses to stimulate areas of the brain to influence mood.

Exposure and response prevention (ERP) therapy

ERP is the gold standard for OCD treatment. Decades of research on the therapy show it’s highly effective in reducing the severity of OCD symptoms.

When done under the guidance of an experienced and compassionate clinician, ERP helps the person with OCD reduce and eliminate rituals and compulsions while gradually confronting situations that provoke anxiety.

ERP is typically conducted weekly or sometimes twice weekly over 15 to 20 sessions. It can be done in person or virtually, depending on the needs of the person with OCD. Consistent therapy attendance and practice of skills between sessions are important components to success.

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