Obsessive-compulsive disorder (OCD) is characterized by excessive, unreasonable cravings to perform behaviors as well as persistent, unwanted, intrusive thoughts (obsessions) (compulsions). Even though OCD sufferers may be aware that their actions and ideas are absurd, they frequently lack the control to change them.

Males frequently experience the onset of symptoms earlier than females, usually in childhood, adolescence, or young adulthood. OCD affects 1.2% of American adults on an annual basis.

Examples of obsessions include:

• Thoughts about harming or having harmed someone
• Doubts about having done something right, like turning off the stove or locking a door
• Unpleasant sexual images
• Fears of saying or shouting inappropriate things in public

Examples of compulsions include:

• Hand washing due to a fear of germs
• Counting and recounting money because a person can’t be sure they added correctly
• Checking to see if a door is locked or the stove is off
• “Mental checking” that goes with intrusive thoughts is also a form of compulsion.

Treatment

Out treatment modality starts with comprehensive assessment, and includes these two important approaches: 

1. Medication, especially a type of antidepressant called a selective serotonin reuptake inhibitor (SSRI), is helpful for many people to reduce the obsessions and compulsions.
2. Psychotherapyis also helpful in relieving obsessions and compulsions. Cognitive behavior therapy (CBT) and exposure and response therapy (ERT) are effective for many people. Exposure response prevention therapy helps a person tolerate the anxiety associated with obsessive thoughts while not acting out a compulsion to reduce that anxiety. Over time, this leads to less anxiety and more self-mastery.