By S.W. Kim, M.D.
Obsessive-compulsive disorder (OCD) is a mental health condition characterized by excessive worries, doubts, or superstitious beliefs that disrupt everyday life. For the person with this disorder, it may feel like the brain gets stuck on a particular thought or urge and just can’t let go. Obsessive-compulsive disorder currently affects about 1 in 50 adults and at least 1 in 25 may have had the disorder at some point in their lives. Most people with obsessive-compulsive disorder experience a gradual onset of OCD behaviors and are diagnosed before age 30.
Some people with obsessive-compulsive disorder may be particularly concerned with cleanliness and feel they must clean or wash excessively. Others may have symptoms related to doubting and worrying about their environment. In these cases, the person with the disorder might repeat tasks such as shutting the garage door or turning off the faucet 10 times before they are able to leave home. Others may feel the need to maintain extreme order and perform tasks in a very specific way—persistently organizing things around them according to color or size. The severity and type of compulsive behavior varies from person to person and may change over time. When repetitive behavior persistently disrupts daily life, the results can be disabling. Consequently, obsessive-compulsive disorder is also associated with other mental health conditions such as depression or social phobia.
Like many psychiatric disorders, the specific cause of obsessive-compulsive disorder is not known. Research has shown that compulsive behavior results from a problem in the brain’s ability to process information. We also know that changes in brain function such as traumatic injury or stress can affect OCD symptoms. Genetics or strep infection may also play a role. It’s important to understand that obsessive-compulsive disorder is a biological disease and not the result of personal weakness or flaws.
The University of Minnesota is currently involved in several research studies examining whether genetics and/or the immune system affect obsessive-compulsive disorder. At this time most people achieve long-term symptom relief with comprehensive treatment that combines cognitive behavioral therapy and antidepressants that affect the level of serotonin in the brain (examples of medications include the brand name and generic versions of Prozac, Zoloft, Lexapro, Celexa, and Luvox).
Although obsessive-compulsive disorder occurs equally in men and women, pregnancy may play a special role in bringing about or worsening symptoms for some women. Pregnancy presents special challenges when treating OCD since the effects of antidepressants during pregnancy is not yet well understood. When a patient with obsessive-compulsive disorder becomes pregnant, she should consult immediately with her health care provider. Health care providers may choose to discontinue medication and increase therapy until after the child is born. The best choice of treatment, however, will vary from person to person. Because of the complexity of treating OCD, the Obsessive Compulsive Foundation has developed an online referral program to locate health professionals in your area who have special experience in treating obsessive-compulsive disorder at https://www.ocfoundation.org/ocf1000c.htm.
Suck W. Kim, M.D., is professor of psychiatry at the University of Minnesota. He sees patients through University of Minnesota Physicians. For more information on obsessive-compulsive disorder, visit the Obsessive Compulsive Foundation Web site at http://www.ocfoundation.org. This column is an educational service of the University of Minnesota. Advice presented should not take the place of an examination by a health-care professional. For more health-related information, go to