If obsessive-compulsive disorder goes untreated, debilitating symptoms could impact your quality of life, but recovery is possible with severe OCD. Obsessive-compulsive disorder (OCD) is a mental health condition that causes a person to have persistent, recurring, intrusive, and often upsetting thoughts (obsessions), along with repetitive behaviors or mental acts (compulsions). These acts are
Obsessive-compulsive disorder (OCD) is a mental health condition that causes a person to have persistent, recurring, intrusive, and often upsetting thoughts (obsessions), along with repetitive behaviors or mental acts (compulsions). These acts are performed in an attempt to reduce anxiety caused by the obsessions.
OCD has a lifetime prevalence of approximately 2.3% among adults in the United States. Up to half of adults with OCD experience serious impairment, known as severe OCD.
Read on to learn how OCD can cause intrusive symptoms that interfere with daily functioning and how these symptoms can be managed.
OCD affects men and women equally. It can develop anytime from preschool to late in life, but begins most often during two peaks: between the ages of 9 to 11 and between the ages of 20 to 23. Up to 50% of cases have juvenile-onset, while less than 10% start after age 40.
Age of onset may play a role in severity. Early or middle childhood-onset has been associated with a better outcome and higher rate of spontaneous remission. Onset in adolescence or later in life may result in more persistent symptoms and course of the condition.
The exact cause of OCD isn't known, but a number of factors that may play a role have been identified.
While no specific genes for OCD have been identified, it appears to run in families, suggesting it has a genetic component.
Some research shows that if a parent has OCD, their child has a slightly increased risk of developing some forms of OCD (such as childhood-onset OCD).
Brain studies have noted differences in the brains of people with and without OCD.
People with OCD show an overactive neural circuit between the prefrontal cortex (involved in cognitive behavior, executive decision making, and personality), and the nucleus accumbens (part of the reward system).
Imaging techniques, such as positron emission tomography (PET) and magnetic resonance imaging (MRI), are being used to study the brains of people with OCD to better understand how brain differences affect OCD.
Serotonin is neurotransmitter (chemical messenger in the brain) that has been associated with the development and maintenance of OCD. Medications that target serotonin levels can help reduce OCD symptoms.
OCD may be influenced by:
Stress, such as marital problems, school exams, or a new baby, can increase symptoms for people with OCD.
Other conditions like depression or other emotional problems can also cause a worsening of symptoms.
Comorbidities (co-occurring conditions) are common in people with OCD. Studies show rates as high as 90% of people with OCD meeting the criteria for at least one other mental health condition in their lifetime.
Conditions seen alongside OCD include:
Many people with OCD also experience suicidal thoughts and actions.
If you are having suicidal thoughts, contact the National Suicide Prevention Lifeline at 1-800-273-8255 for support and assistance from a trained counselor. If you or a loved one are in immediate danger, call 911.
If you or a loved one is struggling with OCD, contact the Substance Abuse and Mental Health Services Administration (SAMHSA) National Helpline at 1-800-662-4357 for information on support and treatment facilities in your area. For more mental health resources, see our National Helpline Database.
OCD symptoms can be severe enough to greatly impact a person's ability to function in daily life, such as attending school, being employed, sustaining relationships, and performing tasks such as running errands or self-care. In fact, worldwide, OCD is counted among the top 10 causes of disability.
About 20% of people with OCD have severely debilitating symptoms that can result in isolation (including staying in their homes), reduced quality of life, and economic hardship.
About 10% of people with OCD have severe symptoms that are resistant to all therapies, leading to great functional impairment.
Some research has found that prolonged treatment has lower relapse rates than short-term treatment, even after treatment is discontinued. This suggests that early intensive and long-term treatment may result in better outcomes for people with OCD.
There are several types of treatments available for OCD, which most commonly include medication and/or psychotherapy (talk therapy).
Medications that may be prescribed to treat OCD include:
Selective Serotonin Reuptake Inhibitors (SSRIs)
Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs)
These medications all target serotonin, and some also target the neurotransmitter norepinephrine. In some cases, such as if a person does not respond to serotonin-targeting medications, a combination of medications may be tried. For example, an SSRI antidepressant may be combined with a medication such as risperidone (also used to treat psychotic symptoms such as hallucinations and delusions).
Cognitive behavioral therapy (CBT) is the most common psychotherapy used to treat OCD. It helps with:
CBT for OCD has two major components.
Behavior therapy and exposure and ritual prevention (ERP) involves:
Cognitive therapy involves:
A mindfulness-based program known as acceptance and commitment therapy (ACT) is emerging as a newer treatment for OCD. It's less researched than CBT, but it is showing promise as a treatment used alongside CBT or for people who have not responded well to ERP.
Characteristics of ACT include:
If you are experiencing symptoms that are disrupting your life, see a healthcare provider or mental health professional, particularly if they:
If symptoms are severe, a psychiatric consultation is recommended.
Increased intensity care may be needed for people with OCD who:
Levels of therapy, from least to most intensive, include:
Research is being conducted on other ways to treat OCD, including some treatments that are beginning to be implemented. These treatments include:
OCD is a mental health condition characterized by intrusive, recurrent thoughts (obsessions) and patterns of behaviors (compulsions) used to try to relieve anxiety caused by the obsessions. It is typically treated with medications, such as antidepressants, and psychotherapy, such as CBT.
Some people with OCD experience severe symptoms that cause debilitating disruptions to their level of functioning. More intensive treatments, such as programs within a mental health facility, may be needed for people with severe symptoms or who are unresponsive to conventional treatments. Emerging therapies that may be used as a "last resort" treatment for OCD include surgery and electroconvulsive therapy.
OCD can make it difficult to function in everyday life, particularly if symptoms are severe. If you are experiencing severe OCD symptoms, managing them may feel daunting. Fortunately, several effective treatment options exist for severe OCD symptoms, including ones that have shown promise in people who have not responded to typical treatment. Speak to a healthcare provider or mental health professional about what options may be right for you.
Severe OCD is indicated based on the level of impairment the symptoms cause. Symptoms may be considered severe if they are causing significant disruption and distress.
There is no cure for OCD, but symptoms can wax and wane in severity over time, and many people go into remission from OCD. Evidence-based therapies can help manage symptoms and may promote OCD remission.
People with severe OCD that are not responding to other treatments may look for inpatient treatment, but untreated OCD does not mean hospitalization will be necessary. Inpatient care is considered a last resort.