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About OCD
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What is OCD and how is it treated? 1:54
Obsessive compulsive disorder is a mental health condition that involves unwanted thoughts (obsessions) and repeated behaviors (compulsions). These patterns cause distress and interrupt daily life. Common subtypes include contamination fears, harming others and/or other intrusive thoughts, such as health worries, relationship doubts, and perfectionism.
OCD symptoms include intrusive thoughts that create intense anxiety and compulsions done to relieve that anxiety. Obsessions may involve fears about contamination, harming someone, making a mistake, or needing things to feel perfect. Compulsions may include repeated washing, checking, counting, reassurance seeking, or collecting items with little value. These behaviors provide short-term relief but keep the cycle going.
OCD develops through a mix of genetic, biological, and environmental factors. A family history of OCD increases risk. Brain differences in areas related to decision-making and threat detection may contribute. Other influences can include PANDAS and childhood trauma.
There is no single test for OCD. A clinician reviews symptoms and medical and mental health history. Diagnosis is based on predetermined criteria, which include obsessions, compulsions, or both and symptoms that take significant time and interfere with daily life.
OCD has a genetic component. People with a first-degree relative who has OCD are more likely to develop it, especially if the relative developed symptoms in childhood. OCD is influenced by many genes rather than a single cause.
OCD is a chronic condition. Symptoms may rise or fall over time, but it usually does not resolve without treatment.
The most effective treatment is cognitive behavioral therapy, specifically exposure response prevention (ERP). ERP helps individuals face feared thoughts or situations and reduce compulsive behaviors. Other helpful therapies include acceptance and commitment therapy and mindfulness-based strategies. Medication such as SSRIs, in combination with therapy, may also support symptom relief.
Stress, trauma, major life changes, and physical illness can increase symptoms. Certain medications, including stimulants, and substance use may also worsen OCD.
OCD can take significant time and energy. This can affect school, work, friendships, and family life. Reassurance seeking, avoidance, or rituals can strain relationships and increase isolation.
Educate yourself about OCD and avoid reinforcing stereotypes. Understanding the OCD cycle helps families reduce reassurance and avoid participating in rituals. Encourage treatment, listen with empathy, and offer support without judgment. These steps help strengthen recovery.
Understanding OCD and the Importance of Early OCD Assessment
The phrase “obsessive-compulsive” has worked its way into the English lexicon and is often used in an offhand manner to describe someone who is meticulous or absorbed in a cause. It is important to distinguish these traits from obsessive-compulsive disorder (OCD).
Although these signs are often present in OCD, a person who shows signs of infatuation or fixation with a subject or object, or displays traits such as perfectionism, does not necessarily have obsessive-compulsive disorder. Obsessive-compulsive disorder is most commonly characterized by a person’s obsessive, distressing, intrusive thoughts and related compulsions (tasks or “rituals”) which attempt to neutralize the obsessions.
The OCD Experience: Obsessions, Compulsions, and Daily Impact
Obsessions are experienced as a fear that something has happened, is happening, or may happen.
This fear elicits anxiety, which is defined as an emotional and physiological dysregulation response to a perceived or actual threat. Compulsions are learned behavioral or mental responses that are used to provide temporary relief from the anxiety associated with the fear. While there is some variability in the presence, theme, or dominance of either the obsessions or the compulsions, the following four steps or stages typify the experience of obsessive-compulsive disorder.
While we all may occasionally obsess about something or do something compulsively, the frequency, intensity, intrusiveness of the obsessions and compulsions, and the strength of the conditioned relationship between the two are some of the key factors in determining a diagnosis of bbsessive-compulsive disorder.
Common obsessions can include a fear of contamination, of having harmed other people, of losing control, or of succumbing to violent urges. Obsessions can also include having intrusive unwanted sexual thoughts, excessive religious or moral doubts, of thoughts related to having things “just so” or “just right.”
Repetitive behaviors (e.g. hand washing, ordering, checking) or mental acts (e.g. praying, counting, repeating worlds silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. However, these behaviors or mental acts are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive. The person attempts to ignore or suppress such thoughts, urges, or images, or to neutralize them with some other thought or action (for instance, by performing a compulsion).
Impact of OCD: School, Family, and Relationships
The Impact of OCD
Individuals may spend hours each day performing behavioral or mental rituals to temporarily calm their anxiety. Most individuals with OCD recognize that their fears are irrational, yet still feel unable to resist the obsessions and compulsions.
The key features of OCD include the presence of obsessions and/or compulsions that:
- Entail at least one hour of a child’s day
- Interfere with or impair a child’s life at home, at school, with peers and, if they are employed, at work.
A child’s OCD can disrupt family life, interfere with schooling and have a negative effect on relationships with peers. If left untreated, OCD can lead to other mental health conditions, social isolation and difficulty holding regular employment.
The Impact of OCD on the Family
If a child has OCD, common effects on the family include:
- Disruption of family activities and routines
- Parent frustration
- Sibling discontent
- Arguments
The Impact of OCD on Schooling
At school, a child or teen with OCD can:
- Be indecisive/distracted (because of their unwelcome thoughts)
- Waste time (because of their prolonged rituals)
- Experience medical problems (for example if they refuse to use school bathrooms all day)
- Be consistently late for school or class or refuse to attend
- Be unable to use school library books or shared materials for fear of contamination
- Experience falling grades, school avoidance/refusal
The Impact of OCD on Relationships with Peers
Obsessive-compulsive disorder in a child can be difficult for other children to understand. Because of the insistence on order and rules, OCD can disrupt a range of activities between a child and their peers. In turn, this can lead to bullying or to a child being excluded or isolated in more subtle ways.
Prevalence of OCD
The lifetime prevalence for OCD in the age 18-29 years old demographic is 2%. About 50% of annual cases are classified as severe. The average age of onset for OCD is 19, with 25% of cases occurring by age 14. Males have a slightly higher incidence of OCD than females.
Effective OCD Treatment
The gold standard for OCD treatment is cognitive behavioral therapy (CBT) for OCD, specifically exposure and response prevention (ERP). This evidence-based approach is widely recognized as the best treatment for OCD and the best therapy for OCD for reducing symptoms and improving daily functioning.
ERP therapy for OCD works by helping individuals gradually face intrusive thoughts, fears, and triggering situations while resisting the urge to perform compulsions. Working with a trained OCD therapist or OCD specialist ensures that treatment is structured, supportive, and effective.
Our OCD treatment center provides intensive, specialized care delivered by experienced OCD therapists who are trained in CBT and ERP. We begin with a comprehensive OCD assessment to determine the most appropriate treatment plan.
For some individuals, OCD treatment may also include medication alongside CBT and ERP to support symptom reduction and long-term outcomes.
We are the leading provider among OCD treatment centers, offering in-person care in Greenwich, CT; Madison, NJ; and McLean, VA. For families searching for OCD treatment, we also offer online treatment options to increase access to specialized care.
Contact us for a complimentary consultation. Our team will help determine the best treatment for OCD for your child.
OCD Questionnaire
Download our OCD questionnaire to help determine if an Anxiety Institute consultation would be beneficial.
Resources
Newsletter:
Read Anxiety Institute’s newsletter about OCD.
Anxiety and Depression Association of America, ADAA;
https://adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd
International OCD Foundation;
https://iocdf.org/about-ocd/related-disorders/
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