Obsessive-compulsive disorder (OCD) is an often debilitating condition that can harm a person’s quality of life. According to diagnostic interview data from the National Comorbidity Survey Replication, an estimated 1.2 percent of adults in the United States had OCD. In the past year, the prevalence rate for females was higher at 1.8 percent, whereas men were 0.5 percent. The lifetime prevalence of the condition among adults in the United States was 2.3 percent.
Of those adults surveyed in the past year, the degree of impairment ranged from mild to severe. Among those with OCD, about 50.6 percent had a severe impairment, while another 34.8 percent of adults had moderate impairment, and 14.6 reported a mild impairment.
Obsessive-compulsive disorder is a common, chronic, and long-lasting condition where a person has recurring and uncontrollable thoughts (obsessions) or behaviors (compulsions) they feel the urge to repeat over and over. It’s an anxiety disorder that physicians routinely treat with benzodiazepine drugs. However, due to their strength and potential for addiction, many people opt against these medications in fear of their side effects or how they make them feel.
If left untreated, OCD dramatically affects people’s lives by filling them with irrational, relentless, intrusive thoughts and images and time-consuming repetitive or elaborate, compulsive behaviors. Despite how debilitating it can be, OCD responds to non-medical behavioral therapy, such as cognitive-behavioral therapy (CBT). For most people, CBT must be considered as the first-line treatment for the condition. CBT for OCD has been shown to change brain activity the same way as medication, but it is more effective, has no risk like drugs, and has a much lower relapse rate.
The most common signs and symptoms of OCD include the following:
These are repeated urges, thoughts, or mental images that cause anxiety. The common symptoms include:
These are repetitive behaviors that someone with OCD feels the need to do in response to an obsessive thought. The common symptoms include:
Not all habits or rituals are compulsions. Everyone double checks things from time to time. However, someone with OCD does the following:
Chemical relief isn’t always a sought-out option, and those who feel that way will seek alternatives. As was mentioned above, cognitive-behavioral therapy is a solid option as a means to avoid medication. The foundation of CBT for OCD involves exposure and response (or ritual) prevention (ERP).
Despite its simplicity, ERP is not easy. It’s not complicated, per se, but it requires a great deal of psychological effort. This is why motivation for change is the primary predictor of success. ERP requires absolute determination and grit.
At its core, OCD behaviors are counterproductive efforts to maintain or increase a sense of safety when someone feels at risk, threatened, or in danger. However, the safety-seeking actions actually lead to worsening anxiety because of something called negative reinforcement, which isn’t to be confused with punishment. In the simplest terms, the maladaptive safety-seeking behavior of OCD is escape, avoidance, and reassurance seeking.
The safety-seeking behaviors mentioned above associated with OCD actually strengthen anxiety and move people toward feeling more insecure or worried. OCD is referred to as “the doubting disease” because, at its core, are deep feelings of doubting crucial aspects of safety. An OCD sufferer is compelled to increase feelings of things that are safe and reduce doubt. Unfortunately, this worsens the illness by engaging in maladaptive rituals that adversely reinforce it.
Obsessive-compulsive disorder is chronic in nature, meaning it will always be a part of your life in one way or another. Although OCD warrants treatment by a medical professional, you can always try some things for yourself and build upon the treatment. You should never give up and always be working toward getting better.
Although it may feel like things won’t ever get better, with the proper support and effort, you can lead a normal life with this condition.
Harvard Medical (N.D.) OCD Prevalence. from https://www.hcp.med.harvard.edu/ncs/ftpdir/table_ncsr_12monthprevgenderxage.pdf
Mayo Clinic (March 2021) Obsessive-Compulsive Disorder (OCD). from https://www.mayoclinic.org/diseases-conditions/obsessive-compulsive-disorder/diagnosis-treatment/drc-20354438
NCBI (June 201) Cognitive-Behavioral Therapy of OCD. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181959/
NCBI (January 2019) Exposure and Response Prevention for OCD. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6343408/
NIMH (March 2021) Obsessive-Compulsive Disorder. from https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml