Symptoms

Persistent, unpleasant, and unwelcome mental images, often with a violent theme. Disturbing thoughts or impulses that may conflict with moral or religious beliefs. An uncontrollable urge to count, touch, or reorganize everything in sight. Washing hands until they are raw to placate an excessive fear of germs. Repeatedly checking that the door is locked or the stove is turned off because you are convinced that disaster will strike unless you do so.

These are some of the possible manifestations of obsessive-compulsive disorder, or OCD, an anxiety disorder that afflicts about 1 in 50 Americans. The obsessions are the distressing thoughts or images that sufferers can't seem to shake. The compulsions are the overt or covert rituals they engage in to temporarily relieve the stress associated with those unpleasant thoughts or images. OCD episodes last at least an hour each day, although symptoms may ebb flow, abate over time, or worsen as a person gets older. Anyone can develop OCD at any age; about one third of adult OCD sufferers experienced their first symptoms as children. Children with OCD seldom realize that their obsessive thoughts and ritualistic behaviors are out of the ordinary. Adults with OCD generally recognize that their obsessions or compulsions are unreasonable or extreme.

OCD is sometimes accompanied by depression, an eating disorder, or other anxiety disorders, such as panic attacks. OCD victims may avoid situations that trigger their obsessions, or they may abuse drugs or alcohol in an unsuccessful attempt to relieve their anxiety. In most cases, however, OCD is rarely severe enough to prevent someone from meeting their responsibilities at home or at work.

Treatment

According to the American Psychiatric Association (APA), research suggests that 65% of obsessive-compulsive patients who can cooperate with their therapist and conscientiously follow instructions, will recover with behavior therapy. A form of behavioral therapy known as "exposure and response prevention" exposes the OCD patient to the situation that triggers the compulsion and then helps that patient avoid engaging in the usual ritual. For example, the therapist might have the patient leave a room, lock the door, then refrain from returning to check that the door is indeed locked. This therapy works best in patients who complete a behavioral therapy program, according to the APA, though results have been less promising in some people who have both OCD and clinical depression.

Studies indicate that nearly half of OCD patients respond to medicinal treatment. According to the National Institute of Mental Health, the most effective medications for OCD include fluvoxamine, paroxetine, sertraline, clomipramine, and fluoxetine. More OCD drugs are under development.