Obsessive-Compulsive Disorder (OCD): Frequently Asked Questions

What is OCD?

Obsessive Compulsive Disorder (OCD) is a brain and behavior disorder that can be identified by uncontrollable, reoccurring thoughts (obsessions) and behaviors (compulsions) that a person feels the urge to repeat over and over. OCD symptoms can interfere with all aspects of life including school, work, and social relationships. People with OCD may have obsessions, compulsions or both.

What are the symptoms of OCD?

OCD causes severe anxiety in those affected by it and can have a major impact on a persons’ daily life. Obsessions are persistent ideas, thoughts, urges or images that are experienced as intrusive and cause intense anxiety or distress. The most common obsessions are repeated thoughts about contamination, repeated doubts, a need to have things in a particular order, aggressive impulses, and sexual imagery. Compulsions are the person’s attempt to suppress or neutralize such thoughts or impulses with some other thought or action. These can include repetitive behaviors, such as hand washing, ordering or checking on things; or mental acts, such as praying, counting, or repeating words silently.

At what age does OCD begin?

OCD can affect children, adolescents, and adults. Most people are diagnosed by the age of 19. The age of onset is typically earlier in boys (between the ages of 6 and 15) than girls (between the ages of 20-29).

What causes OCD?

Although genes do play a role in the development of OCD (it tends to run in families), it is believed that the disorder is caused by a combination of genetic vulnerability and environmental influences. Imaging studies have also shown differences in the frontal cortex and subcortical structures of people with OCD. Researchers suggest that OCD may involve problems in communication between the front part of the brain and the brain’s deeper structures. In terms of environment, people who have experienced trauma (such as physical or sexual abuse) during childhood, are more likely to develop OCD. OCD symptoms have also been linked to a type of streptococcal infection – this is called Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infection (PANDAS).

How is OCD diagnosed?

There are no laboratory or brain imaging tests to diagnose OCD. The diagnosis is made based on the observation and assessment of the person’s symptoms by a psychologist, psychiatrist, or other mental health professional.

How effective are treatments for OCD?

Typically, OCD is treated with medication (Serotonin Reuptake Inhibitors –SSRIs, or “tricyclic” antidepressants including clomipramine), psychotherapy (Cognitive Behavioral Therapy – CBT, or Exposure and Response Prevention – EX/RP), or a combination of both. While some people with OCD continue to experience symptoms, the majority of people respond well to treatment. Research has begun to show both medication and therapy can actually normalize the brain circuits involved in OCD.