Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions) that are:
- Distressing.
- Extremely difficult to overcome.
- Irrational.
UPMC experts provide comprehensive care for OCD using the latest evidence-based therapies. We will develop a personalized treatment plan to help you manage symptoms and improve your ability to function.
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What Is OCD?
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions) that are:
- Distressing.
- Extremely difficult to overcome.
- Irrational.
What are the types of OCD?
There are several types of OCD, including:
- Contamination OCD — Obsession with dirt, germs, or contamination that leads to compulsive handwashing, cleaning, or avoiding people who are sick.
- Harm OCD — Intrusive thoughts that involve concerns about harm to yourself or others and lead to compulsive checking behaviors, such as repeatedly making sure the stove is off so it doesn’t start a fire.
- Hoarding OCD — Developing excessive fear of throwing away items that might be needed in the future or a sentimental attachment to belongings that leads to accumulating large amounts of clutter.
- Obsessions without visible compulsions OCD — Intrusive thoughts and obsessions that may be sexual, religious, moral, philosophical, or violent.
- Symmetry and ordering OCD — Ordering and arranging objects in a precise way, such as by color or size.
How common is OCD?
According to the National Institute of Mental Health, OCD affect approximately 1.2% of U.S. adults.
What causes OCD?
Researchers aren’t sure what causes OCD. However, it could be linked to genetics, environmental factors, and brain chemistry, structure, or functioning.
OCD risk factors
Risk factors for OCD include:
- Childhood trauma, such as child abuse or neglect.
- Family history of OCD.
- History of strep infection that causes pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections (PANDAS).
Complications of OCD
If left undiagnosed or untreated, OCD can cause complications, including:
- Financial instability — Due to inability to hold a job, excessive spending, or poor performance in school or work.
- Other mental health disorders — OCD increases your risk of developing depression, anxiety, substance use, or eating disorders.
- Physical problems — People with OCD may experience skin damage due to excessive handwashing, tic disorders, or sleep deprivation due to stress and anxiety.
- Social problems — Social isolation, poor self-esteem, and relationship challenges are common.
How can I reduce my risks of OCD?
There is nothing you can do to prevent OCD. However, taking care of your physical and mental health and understanding your OCD risk factors can help you identify and treat symptoms early, before they affect your quality of life.
What Are the Signs and Symptoms of OCD?
Symptoms of OCD include obsessions, compulsions, or a combination of both. Some people with OCD may have a tic disorder, such as Tourette syndrome, which causes involuntary twitching or movement.
Obsessions may include:
- Fear of germs.
- Fear of harming yourself or others.
- Fear of losing things.
- Needing things to be arranged in a particular order.
- Unwanted thoughts involving sex, violence, or religion.
- Worries that something bad will happen.
Compulsions may include:
- Arranging things in a particular order.
- Compulsive counting.
- Excessive cleaning.
- Excessive handwashing.
- Repeated “checking” behaviors, such as checking to make sure the door is locked or the stove is off.
When should I see a doctor about my OCD symptoms?
If you are having OCD symptoms that affect your ability to function or your quality of life, you should schedule an appointment with your doctor right away. If you have thoughts of harming yourself or someone else, or if your symptoms are severe, dial 911 or go to your nearest hospital Emergency Department.
How Do You Diagnose OCD?
Your doctor will ask about your symptoms and look for patterns that are common in OCD. Your doctor may also perform a physical exam and order tests to rule out any physical health problems.
What to expect during your visit
If your doctor suspects OCD, they will:
- Ask about your symptoms.
- Perform a physical exam.
- Perform an OCD evaluation.
- Review your health history and medications.
Tests to diagnose OCD
There is no test that can diagnose OCD. Your doctor will look for patterns of OCD symptoms during an OCD evaluation.
However, your doctor may also order tests to rule out any physical health problems that could be causing OCD symptoms.
OCD prognosis
For some people, OCD is a condition that requires lifelong treatment and management. If left untreated, OCD can lead to problems that affect self-esteem, mental health, school and work performance, and overall functioning. However, with treatment, people with OCD can live healthy and productive lives.
How Do You Treat OCD?
The goals of OCD treatment are to improve your ability to function at school, work, in social situations, and at home. Specific treatment goals will be tailored to individual symptoms, challenges, and needs.
Medication for OCD
Your doctor may prescribe one or more medications to help manage OCD symptoms. The most common medications are antidepressants, which help to reduce symptoms of anxiety.
Behavioral therapy to treat OCD
Cognitive behavioral therapy (CBT) teaches strategies for managing OCD symptoms. Depending on your needs, your doctor may recommend individual, family, or group therapy.
Exposure and response prevention (ERP) therapy is a type of CBT that gradually exposes you to your fears or obsessions. Over time, ERP teaches you to cope with your fear or obsession, which leads to reduced anxiety and improved symptoms.
Deep brain stimulation (DBS) for OCD
If a patient has a diagnosis of chronic, severe, treatment-resistant obsessive-compulsive disorder that has become disabling, and has at least a five-year history of OCD, that patient may be referred by a psychiatrist to a specially trained neurosurgeon for deep brain stimulation.
What is deep brain stimulation for OCD?
Deep brain stimulation (DBS) is a surgical procedure in which a thin wire (electrode) is implanted in the area of the brain where symptoms start.
The electrode, connected to a pulse generator implanted under the skin below the collarbone, carries mild electrical pulses to the brain to help control abnormal behaviors. The DBS procedure, performed by a specially trained neurosurgeon, is adjustable and reversible.
DBS, which is most often used to treat movement disorders, is approved for OCD treatment under a Humanitarian Device Exemption.
Who is a candidate for deep brain stimulation for OCD?
DBS may be considered for patients who:
- Are 18 years of age or older and are not pregnant.
- Do not have hoarding as a primary subclassification.
- Do not require routine MRIs.
- Have a diagnosis of OCD with a documented duration of at least five years.
- Have completed or tried to complete cognitive behavior therapy.
- Have depression and anxiety.
- Have failed to improve after treatment with at least three selective serotonin reuptake inhibitors (SSRIs).
- Have no other neurological disorders, including dementia.
- Have no serious psychiatric disorders (for example, personality disorder) or substance abuse issues in addition to OCD.
- Have not had a previous surgery to destroy the region of the brain that will be the target of stimulation.
- Have OCD rated as a severe or extreme illness.
Why Choose UPMC for OCD Care?
When you choose UPMC for OCD care, you will receive:
- Access to anxiety disorder expertise — Our anxiety disorder experts treat the full spectrum of conditions using the latest, evidence-based guidelines and strategies.
- A full range of treatment options — We offer cognitive behavioral therapy and medication, often in combination, to effectively treat OCD and improve your level of functioning.
- Multidisciplinary care — We partner with mental health professionals, primary care providers, and other medical experts to provide complete care that optimizes your quality of life.
