Obsessive Compulsive Disorder (OCD) is an anxiety disorder. The presence of obsessions is one of the essential features of OCD, the other component is the compulsions.

We call obsessions to thoughts, images or impulses, which are intrusive, unwanted and repetitive.

Obsessional thoughts have the following characteristics:

• the thoughts must be recognised by the sufferer as their own,

• they often cant be resisted, even though the subject feels compelled to try and push them out of their mind

• the thoughts are usually unpleasant and often abhorrent

• the thoughts are repetitive .

Common thoughts include:

• Contamination - e.g. My hands or my clothes are dirty

• Pathologic doubt - e.g. Did I close the front door?

• Need for symmetry - e.g.. I must put that ornament in the right place

• Aggressive impulse - e.g.. I feel compelled to hurt my baby

• Sexual impulse - e.g.. I feel like saying something inappropriate to that person

Most sufferers experience a mixture of such thoughts. People can sometimes be preoccupied by images rather than thoughts these are often of a violent or sexual nature.

Compulsions are defined as:

1. repetitive behaviours (e.g., hand washing, ordering, checking, need to ask or confess, symmetry, hoarding, striving for perfection) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.

2. the behaviours or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviours or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.

3. At some point during the course of the disorder, the person has recognized that the obsessions or compulsions are excessive or unreasonable. Note: This does not apply to children.

4. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships.

Rituals such as hand washing, counting, checking, or cleaning are often performed in hope of preventing obsessive thoughts or making them go away. Performing these rituals, however, provides only temporary relief, and not performing them markedly increases anxiety. Left untreated, obsessions and the need to perform rituals can take over a person’s life. OCD is often a chronic, relapsing illness.

Studies suggest lifetime prevalence is 2-3%. Peak age for onset in women is between 24-35 and later in men.

There is growing evidence that OCD has a neurobiological basis but also environmental factors affect the development of the disorder. Therefore, OCD improves with drug therapy. Several medications have been proved effective in helping people with OCD: sertraline, clomipramine, fluoxetine, fluvoxamine and paroxetine. However, a combination of drugs and Cognitive Behavioural Therapy ease the distress and shows the person how to deal with the obsessions and compulsions in order to be less anxious.

A type of behavioural therapy known as “exposure and response prevention” is very useful for treating OCD. In this approach, a person is deliberately and voluntarily exposed to whatever triggers the obsessive thoughts and then, is taught techniques to avoid performing the compulsive rituals and to deal with the anxiety. That is why the treatment of OCD can be a little uncomfortable, therefore before undergoing therapy is advisable that you can prepare yourself mentally to cope with a bit of discomfort at times or exposure cannot be possible even at lower levels of anxiety. For example, a compulsive hand washer may be urged to touch an object believed to be contaminated, and then may be denied the opportunity to wash for several hours. The treatment can also be time consuming because some of the tasks required to do at home can take up to 1 hour a day. Commitment and motivation are necessary components for the therapy to be effective.

OCD is sometimes accompanied by depression, post-traumatic stress disorder, eating disorders, substance abuse, or other anxiety disorders. When a person also has other disorders, OCD is often more difficult to diagnose and treat.