Everyone has a routine they follow before leaving their homes, such as checking to see if appliances and lights are turned off. But some people with obsessive compulsive disorder (OCD) go back and perform these checks many times.
Obsessive compulsive disorder (OCD) is an anxiety disorder which causes a person to have frequent unwanted and repeated impulses, feelings, thoughts and sensations (obsessions) that make them feel driven to do something (compulsions), to the degree that the compulsions become unwanted rituals.
People with obsessive compulsive disorder may recognize their compulsive rituals are senseless, and unwanted, and performing them is not comforting. But the compulsive behavior produces temporary relief from the anxiety created by their obsessive thoughts. Then, the ritual itself is recognized as a rut, which causes anxiety and the cycle starts again.
These are examples of some common obsessions in OCD:
- Worrying about dirt or bacteria that to the point that it causes stress or repeated hand-washing, showering or cleaning.
- Repeatedly checking things such as the stove or oven, door and window locks, or flipping light switches
- Excessive worrying about losing something important
- Needing to have things arranged in a particular order and if they are not, feeling agitated until they are made right
- Pulling out hairs
- Inability to throw anything away
- Touching things or eating foods in a certain order
- Combing one’s hair in a mirror and staring at the mirror
- Impulsively doing tasks over and over until they are done perfectly; or doing tasks a certain number of times or in a certain order
- Excessive fear of accidentally hurting someone
- Counting things mentally or aloud, such as tiles on a wall or floor, steps taken between places
- Having repeated intrusive disturbing thoughts about doing things that are upsetting or embarrassing
It is believed that obsessive compulsive disorder can result from a combination of biological and environmental factors. Research links low levels of a neurotransmitter, serotonin, as a factor in the development of OCD. It can start at an early age. Some researchers believe it can result from a strep or other type of infection. Environmental factors that can contribute to OCD include life changes, such as the death of a loved one or relationship change, abuse, an illness, or problems at work or school. Without treatment, OCD can become a debilitating condition.
Cognitive-behavioral therapy for obsessive compulsive disorder includes ritual prevention and exposure therapies. Exposure therapy is a form of behavior modification that helps OCD sufferers recognize situations that cause compulsions, and at increasing intervals, help them resist the urge to engage in ritual behaviors. After the exposure therapy exercise has been repeated a number of times, the anxiety diminishes. Since the response is usually far less harsh than the person fears, these anxieties are lessened with practice.
Selective serotonin re-uptake inhibitors (SSRIs) are the most commonly prescribed medications used for anxiety disorders, such as obsessive compulsive disorder.
How SSRIs Work
Serotonin is a neurotransmitter, which is a chemical substance that carries messages between nerve cells. Serotonin affects mood, sleep, temperature, learning, memory, social behavior and several other functions. When used for treating obsessive compulsive disorder, SSRIs correct serotonin imbalances by reducing the re-uptake (re-absorption) of serotonin into the brain and enabling it to build up. Increasing the level of serotonin in the brain increases brain activity, which in turn boosts mood in people with OCD, depression, and some types of anxiety disorders.
Selective serotonin reuptake inhibitors are available only with a doctor's prescription and are sold in tablet, capsule, and liquid forms. Commonly used selective serotonin reuptake inhibitors are fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), and fluvoxamine (Luvox).