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  • Writer's pictureAlan Frischer, MD, MPH


Do you go to great lengths to avoid stepping on cracks in the sidewalk? Do you wipe then doorknobs in your home each time they’re touched? Do you feel compelled to wash your hands so often that they become raw and chapped?

If you perform rituals like these over and over, you may have obsessive-compulsive disorder. OCD is characterized by unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions), and can take over your life.

OCD is a type of anxiety disorder that is surprisingly common. It affects both adults and children, and is almost 50% more common in women (2.9%) then in men (2.0%). The onset is typically between the late teens and mid-twenties. Interestingly, it appears to be positively correlated with education: higher levels of education indicate a higher likelihood of having OCD! Other factors that can increase the risk of developing OCD include family history, stressful life events, and pregnancy.

The obsessions of OCD show themselves in recurrent and persistent thoughts, impulses or images that are intrusive and cause distress. These thoughts are more than just excessive worries about real problems in your life. You may attempt to ignore or suppress these thoughts, images or impulses but cannot, even though you recognize that they are a product of your own mind.

The compulsions of OCD may show themselves as the drive to perform repetitive behavior such as hand washing, or repetitive mental acts such as counting silently. These mental or physical acts are intended to prevent or reduce distress about unrealistic obsessions, but performing the ritualistic behavior gives only temporary relief until the next obsessive thought occurs.

Currently, medications used to treat OCD target serotonin and dopamine receptors in the brain. New research indicates that abnormal levels of the neurotransmitter glutamate may contribute to OCD. Fortunately, there are already medications in use that affect glutamate levels. This area of treatment may play a major role in the future.

Although the specific causes of OCD are unknown, getting treatment may help to keep it from worsening. It is a chronic condition, which means that learning to live with it may be necessary. Psychotherapy as well as medication sometimes helps to control the symptoms.

These suggestions may be useful for managing OCD:

  • Join a support group in order to share experiences with others in similar situations.

  • Enlist the support of loved ones (unless they are among the causes!) who can offer encouragement in tough times.

  • Remember that if your loved one has OCD, you cannot simply wish or nag away their repetitive behaviors.

  • Avoid using alcohol or recreational drugs as coping mechanisms.

  • Get involved with social activities and community service, rather than becoming isolated.

  • Learn about the disorder. Educate the people around you, so that they can help.

  • Stick to your treatment plan, even if it is difficult or uncomfortable.

  • Consult your health care professional. If medications are prescribed, take them as directed.

There is a wide spectrum of OCD symptoms, from very mild to severe and debilitating. Many successful and famous people with OCD traits not only survive but also thrive. The condition may even be a contributing factor to some of their accomplishments.

I wish success to those of you afflicted by OCD. I wish success to those of you afflicted by OCD. I wish success to those of you afflicted by OCD.

May 11, 2018

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