OCD is a mental health condition. It causes thoughts called obsessions, anxiety, and actions called compulsions (also called rituals). People with OCD feel stuck in a stressful cycle of these thoughts and actions. Show Cognitive behavioral therapy helps people get past the cycle of OCD. They learn to deal with bothersome thoughts, calm anxiety, and face fears safely without doing rituals. Some people also take medicine for OCD. If you think you have OCD, talk to a parent or adult in your life. Ask them to help you see a doctor or mental health provider to find out more. If you do have OCD, work with your doctor or therapist to learn and practice the skills that are proven to help OCD get better. What Are Obsessions?Obsessions are thoughts that cause anxiety. They can be fear thoughts about bad things that could happen. Or thoughts about how things have to be. They can be nagging doubts about whether things are OK. Or images or ideas about things that seem scary, bad, or wrong. OCD causes these stressful thoughts to come to mind over and over. They can be about anything, but for many people with OCD, they are thoughts about:
What Are Compulsions?Compulsions are behaviors people with OCD feel a strong urge to do. They are also called rituals. To someone with OCD, rituals seem like the way to stop the thoughts, fix things, be safe, or make sure bad things won't happen. Rituals can be actions, or they can be things people say in their head. Here are some examples of rituals. Someone with OCD might feel like they have to:
What's It Like for Someone With OCD?Most people with OCD can tell that the thoughts and rituals don't make sense. But OCD leads them to feel unsure. They feel a strong urge to do the ritual. They feel if they don't, something bad could happen. At first, rituals give some relief from the bad thoughts and feelings. But rituals multiply. They take more time and energy. And the worry thoughts keep coming back. This is how OCD becomes a stressful cycle. Instead of stopping OCD, the rituals keep it going. Someone with OCD will spend more than an hour a day bothered by worry thoughts and rituals. They may check, arrange, fix, erase, count, or start over many times, just to feel that things are OK. They don't want to think about these things. But OCD makes the thoughts hard to ignore. They don't want to do rituals. But OCD makes them feel they have to. OCD can show up in many parts of their life. Things like getting dressed, having breakfast, or doing schoolwork seem full of stressful choices. OCD can make it seem like one choice might prevent a bad thing. Or that another choice might make a bad thing happen. Someone with OCD may not know why they think, feel, and do these things. They may try to hide their fears and rituals. They may worry what others will think. They may even think they are going 'crazy' — but they're not. OCD can cause this to happen. Why Do Some People Get OCD but Others Don't?Like in many health conditions, a person's play a role in whether they get OCD. That's why OCD often runs in families. Genes can affect the chemistry, structure, and activity in different parts of the brain. With OCD, these differences lead unwanted thoughts to get 'stuck' instead of move on. OCD gets started because someone has genes that make it more likely. But OCD keeps going because of rituals. The more people do rituals, the stronger OCD gets. This happens because our brains learn to do more of what we practice. Our brains also learn to do more of what gets rewarded. In OCD, rituals 'reward' the brain with a feeling of relief. What Is the Treatment for OCD?The treatment for OCD is a type of cognitive behavioral therapy (CBT). In therapy, people meet with a therapist to talk, learn, and practice skills. Along with therapy, some people may take medicine for OCD. In therapy, people might learn:
But even when someone with OCD knows this, it's not easy to just stop doing rituals. That's why therapy teaches skills like:
In therapy, people practice using these skills. One by one, they face fears without doing rituals. This can feel uncomfortable at first, but it quickly gets easier with practice. The more people with OCD resist rituals, the more worry thoughts can fade. As the person practices their skills, the brain's activity can change for the better. Therapy takes time — how long depends on the person. Most people work with their therapist each week for a few months or more. Some people have therapy more often. The therapist will teach, support, and encourage along the way. Often, the therapist will work with a parent, too. Parents want to know how to best help when OCD fears or rituals happen at home. What Should I Do if I Think I Have OCD?If you think you might have OCD:
If you find out you have OCD:
People who are distressed by recurring, unwanted, and uncontrollable thoughts or who feel driven to repeat specific behaviors may have obsessive-compulsive disorder (OCD). The thoughts and behaviors that characterize OCD can interfere with daily life, but treatment can help people manage their symptoms. OCD is a common, long-lasting disorder characterized by uncontrollable, recurring thoughts (obsessions) that can lead people to engage in repetitive behaviors (compulsions). Although everyone worries or feels the need to double-check things on occasion, the symptoms associated with OCD are severe and persistent. These symptoms can cause distress and lead to behaviors that interfere with day-to-day activities. People with OCD may feel the urge to check things repeatedly or perform routines for more than an hour each day as a way of achieving temporary relief from anxiety. If OCD symptoms are not treated, these behaviors can disrupt work, school, and personal relationships and can cause feelings of distress. OCD symptoms tend to emerge in childhood, around age 10, or in young adulthood, around age 20 to 21, and they often appear earlier in boys than in girls. Most people are diagnosed with OCD by the time they reach young adulthood. People with OCD may have obsessions, compulsions, or both.
Compulsions are repetitive behaviors that a person feels the urge to do in response to an obsessive thought. Common compulsions include:
Not all rituals or habits are compulsions. Everyone double-checks things sometimes. In general, people with OCD:
Some individuals with OCD also have a tic disorder. Motor tics are sudden, brief, repetitive movements, such as eye blinking and other eye movements, facial grimacing, shoulder shrugging, and head or shoulder jerking. Common vocal tics include repetitive throat-clearing, sniffing, or grunting sounds. It is common for people with OCD also to have a diagnosed mood disorder or anxiety disorder. Symptoms of OCD may come and go, ease over time, or worsen. People with OCD may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves. Although most adults with OCD recognize that their compulsive behaviors don’t make sense, some adults and most children may not realize that their behavior is out of the ordinary. Parents or teachers typically recognize OCD symptoms in children. If you think you or your child may have OCD, talk to a health care provider about the possible symptoms. If left untreated, OCD can interfere in all aspects of life. The exact causes of OCD aren’t known; however, a variety of factors are associated with an increased chance of developing the disorder. Genetics is one factor associated with OCD. Studies have shown that having a first-degree relative (parent, sibling, or child) with OCD is associated with an increased chance of developing the disorder. Scientists have not identified any one gene or set of genes that definitively lead to OCD, but studies exploring the connection between genetics and OCD are ongoing. In addition to genetics, other biological factors may play a role. Brain imaging studies have shown that people with OCD often have differences in the frontal cortex and subcortical structures of the brain, areas of the brain that underlie the ability to control behavior and emotional responses. Researchers also have found that several brain areas, brain networks, and biological processes play a key role in obsessive thoughts, compulsive behavior, and associated fear and anxiety. Research is underway to better understand the connection between OCD symptoms and parts of the brain. Some studies have reported an association between childhood trauma and obsessive-compulsive symptoms. More research is needed to understand this relationship. Children who develop a sudden onset or worsening of OCD symptoms after a streptococcal infection may be diagnosed with a condition called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS). The first step is to talk with your health care provider about your symptoms. Asking questions and providing information to your health care provider can improve your care. Your health care provider will perform a physical exam and ask you about your health history to make sure that your symptoms are not caused by other illnesses or conditions. Your health care provider may refer you to a mental health professional, such as a psychiatrist, psychologist, social worker, or counselor, for further evaluation or treatment. Treatment for OCD typically includes specific types of psychotherapy (such as cognitive behavioral therapy), medication, or a combination of the two. A mental health professional can talk about the benefits and risks associated with different treatment options and help identify the best treatment for you. Sometimes people with OCD also have other mental illnesses, such as anxiety, depression, and body dysmorphic disorder, a disorder in which someone mistakenly believes that a part of their body is abnormal. It is important to consider these other disorders when making decisions about treatment. It is important to follow your treatment plan because both psychotherapy and medication can take some time to work. Although there is no cure for OCD, current treatments help many people with the disorder manage their symptoms, engage in day-to-day activities, and lead full, active lives. PsychotherapyPsychotherapy can be an effective treatment for adults and children with OCD. Research shows that certain types of psychotherapy, including cognitive behavioral therapy (CBT) and other related therapies (such as habit reversal training), can be as effective as medication for many people. For others, psychotherapy may be most effective when used in combination with medication. Research shows that a specific type of CBT called Exposure and Response Prevention (ERP) is effective for reducing compulsive behaviors, even for people who did not respond well to medication. With ERP, people spend time in a situation that triggers their compulsion (such as touching dirty objects) and they are prevented from engaging in their typical compulsion (such as handwashing). Although this approach may cause feelings of anxiety at first, compulsions decrease for most people as they continue treatment. Children with OCD may need additional help from family members and health care providers when it comes to recognizing and managing their OCD symptoms. Mental health professionals can work with young patients to identify strategies for managing stress and increasing support so that the children are able to manage their OCD symptoms at school and at home. MedicationYour health care provider may prescribe medication to help treat OCD. Serotonin reuptake inhibitors (SRIs) are the most common type of medication prescribed for the treatment of OCD. SRIs, including selective serotonin reuptake inhibitors (SSRIs), are often used to treat depression, and they also are helpful for treating symptoms of OCD. With SRI treatment, it may take up to 8 to 12 weeks before symptoms begin to improve, and treatment for OCD may require higher SRI doses than are typically used in treating depression. For some people, these medications may cause side effects such as headaches, nausea, or difficulty sleeping. People respond to medication in different ways, but most people with OCD find that medication, often in combination with psychotherapy, can help them manage their symptoms. Your health care provider can adjust medication doses over time to minimize any side effects or withdrawal symptoms. Do not stop taking your medication without talking to your health care provider first. Your health care provider will work with you to monitor your health and can adjust the treatment plan in a safe and effective way. The most up-to-date information on medications, side effects, and warnings is available on the U.S. Food and Drug Administration (FDA) website. Other TreatmentsIn 2018, FDA approved the use of transcranial magnetic stimulation (TMS), most commonly used in treating depression, as an add-on treatment for adults with OCD. You can learn more about brain stimulation therapies, including TMS, on the NIMH website.
There are several important things you can do to manage stress and anxiety associated with OCD.
If you’re not sure where to get help, your health care provider is a good place to start. Your health care provider can refer you to a qualified mental health professional, such as a psychiatrist or psychologist, who has experience treating OCD and can evaluate your symptoms. You can learn more about getting help and finding a health care provider on NIMH's Help for Mental Illnesses webpage. The Substance Abuse and Mental Health Services Administration (SAMHSA) has an online tool to help you find mental health services in your area. If you or someone you know is having thoughts about wanting to die or is thinking about hurting themselves or someone else, get help quickly.
Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so that others may be better helped in the future. Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit NIMH’s clinical trials webpage. This publication is in the public domain and may be reproduced or copied without permission from NIMH. Citation of NIMH as a source is appreciated. To learn more about using NIMH publications, please contact the NIMH Information Resource Center at 1-866‑615‑6464, email , or refer to our reprint guidelines. MedlinePlus (National Library of Medicine) (En español) ClinicalTrials.gov (En español) U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICESNational Institutes of Health NIH Publication No. 20-MH-4676 Revised 2020 |
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