Obsessive-Compulsive Disorder (OCD)

1. Definition and Overview

OCD is an anxiety-related disorder where obsessions (unwanted, intrusive thoughts) lead to significant distress, and compulsions (repetitive behaviors or mental acts) are performed to temporarily reduce that anxiety.

Unlike everyday worries or habits, OCD thoughts and rituals are persistent, time-consuming (often >1 hour/day), and interfere with normal functioning. It affects children, adolescents, and adults, with symptoms ranging from mild to severe and fluctuating over time.

The OCD Cycle

Obsessions → Anxiety → Compulsions → Temporary Relief → Return of Obsessions

OCD Vicious Cycle

How obsessions and compulsions reinforce each other

2. Common Symptoms

Obsessions (Intrusive Thoughts)

• Fear of contamination or germs
• Fear of causing harm to self or others
• Intrusive sexual, violent, or taboo thoughts
• Excessive need for symmetry, order, or perfection
• Religious or moral scrupulosity

Compulsions (Repetitive Behaviors/Mental Acts)

• Excessive handwashing, cleaning, or bathing
• Repeated checking (locks, appliances, safety)
• Counting, tapping, repeating words/silent prayers
• Arranging objects precisely
• Seeking constant reassurance or confessing

Common Obsessions & Compulsions

Visual breakdown of typical patterns

OCD Symptom Loop

Why the cycle continues without intervention

3. Causes and Risk Factors

OCD results from a combination of:

• Genetic: Family history significantly raises risk.
• Neurobiological: Serotonin imbalance; overactivity in brain circuits (e.g., cortico-striato-thalamo-cortical loop).
• Environmental: Trauma, major stress, or infections (e.g., PANDAS in children) can trigger onset/worsening.
• Other: Onset often childhood, adolescence, or early adulthood.

Brain Circuits in OCD

Key neural pathways implicated in the disorder

5. Treatment Options

Medication

• SSRIs (first-line): fluoxetine, sertraline, fluvoxamine, paroxetine, citalopram
• Clomipramine (tricyclic antidepressant – often very effective)
• Augmentation with antipsychotics in treatment-resistant cases

Psychotherapy

• Exposure and Response Prevention (ERP): Gold-standard CBT technique – facing fears without rituals
• Acceptance and Commitment Therapy (ACT)
• Family therapy to reduce accommodation
• Psychoeducation groups

Lifestyle & Self-Care

• Structured routines
• Mindfulness & stress reduction
• Regular exercise & sleep
• Avoiding caffeine/alcohol/drugs that worsen anxiety

How ERP Works

Breaking the obsession-compulsion cycle

ERP Process Step-by-Step

Gradual exposure without compulsive response

Conclusion

OCD is a highly treatable condition. With proper understanding, early diagnosis, evidence-based treatment (especially ERP + SSRIs), and strong support, most people can dramatically reduce symptoms, break the cycle, and reclaim control over their lives.

Recovery is possible — many individuals with OCD lead successful, meaningful lives with the right help.

Hope & Recovery in OCD

Many people thrive with effective treatment

Living Well with OCD

Stability, purpose, and fulfillment are achievable