Obsessive Compulsive Disorder: Causes, Risk Factors, Symptoms, Treatment

Obsessive Compulsive Disorder

Obsessive-Compulsive Disorder is a common, chronic, and long-lasting disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and/or behaviours (compulsions) that they feel the urge to repeat over and over. The prevalence of OCD is similar across genders, with a slight female predominance in adulthood, while males are more commonly affected in childhood. The onset of OCD can occur from preschool age to adulthood, with most individuals experiencing symptoms by age 19. Obsessions are intrusive and unwanted thoughts, urges, or images that trigger intensely distressing feelings. Compulsions are behaviours an individual engages in to attempt to get rid of the obsessions and/or decrease their distress. However, these compulsions often end up becoming rigid, time-consuming rituals that significantly interfere with daily activities and social interactions. The exact cause of OCD is unknown, but it is believed to involve a combination of genetic, neurobiological, behavioural, cognitive, and environmental factors. There is also a significant impact on family members and caretakers due to the chronic nature of the disease. Regarding treatment, a combination of medication and cognitive-behavioural therapy (CBT) is effective. Selective serotonin reuptake inhibitors (SSRIs) are typically the first-line medication treatment, while CBT with a technique called exposure and response prevention (ERP) is considered the most effective psychotherapeutic approach. Despite these treatments, some individuals continue to experience symptoms.

Symptoms of Obsessive Compulsive Disorder

If you suspect you or someone else is experiencing Obsessive Compulsive Disorder, it is crucial to seek immediate medical attention by calling emergency services or consult with a Psychologist.


While the precise causes of OCD are not fully understood, research has highlighted several factors that may contribute to its development: 1. Genetic Factors: Twin and family studies have shown that OCD may run in families and that genes play a role in the risk of developing the disorder. The identification of specific genes associated with OCD remains an active area of research. 2. Brain Structure and Functioning: Neuroimaging studies have shown differences in the frontal cortex and subcortical structures of the brain in individuals with OCD. These areas are thought to be involved in controlling behaviour, the processing and filtering of thoughts, and the regulation of fear and anxiety. 3. Neurotransmitters: Serotonin imbalance is one of the neurotransmitter dysfunctions associated with OCD. The success of SSRIs in treating OCD suggests that serotonin plays a role in the disorder, although the exact nature of this role is not yet clear. 4. Environmental Influences: Certain environmental factors such as infections, traumatic brain injuries, and psychosocial stressors are also believed to contribute to the onset of OCD. For example, the Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS) hypothesis posits that in some children, strep throat triggers an autoimmune response that results in a sudden onset of OCD symptoms. 5. Behavioural Theories: Behavioural theories for OCD focus on how the behaviour is learned and then perpetuated. For instance, if a person touches a dirty object and then washes their hands to reduce anxiety, the relief that follows handwashing may reinforce the handwashing behaviour, making it more likely to be repeated. 6. Cognitive Theories: These theories suggest that individuals with OCD have a fundamental belief that they should have complete control over their thoughts and actions, and that not having such control is unacceptable. The obsessions in OCD may represent the exaggerated form of such cognitive distortions.

Risk Factors

Several factors may increase the risk of developing or triggering OCD: 1. Genetic Predisposition: Having a family member with OCD increases the risk of developing the disorder. 2. Brain Structure Abnormalities: As mentioned, changes in brain structure or functioning could make a person more susceptible to developing OCD. 3. Behavioural Conditioning: If a person experiences relief from anxiety through a particular ritual, they may be more likely to repeat that behaviour. 4. Stressful Life Events: Major life transitions or stressful events may trigger OCD in those with a tendency towards the disorder. 5. Other Mental Health Disorders: The presence of other mental health disorders, such as anxiety disorders, depression, tic disorders, or eating disorders, can increase the risk for OCD. 6. Age: OCD tends to develop in adolescence or early adulthood, although it can begin in childhood. Complications that can arise from OCD if it is left untreated or improperly managed can include severe depression, anxiety, and suicidal thoughts or behaviours. These complications further highlight the importance of early detection and intervention for those at risk.


The symptoms of OCD are typically divided into two categories: obsessions and compulsions. These symptoms can range from mild to severe and can interfere with all aspects of life, including work, school, and personal relationships. • Obsessions are repeated, persistent, and unwanted thoughts, urges, or images that are intrusive and cause distress or anxiety. Common obsessions may include: • Fears of germs or contamination • Unwanted forbidden or taboo thoughts involving sex, religion, or harm • Aggressive thoughts towards others or self • Having things symmetrical or in a perfect order • Compulsions are repetitive behaviours that a person with OCD feels the urge to do in response to an obsessive thought. Common compulsions may include: • Excessive cleaning and/or handwashing • Ordering and arranging things in a particular, precise way • Repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off • Compulsive counting People with OCD may also: • Spend at least 1 hour a day on these thoughts or behaviours • Not get pleasure when performing the behaviours or rituals, but may feel brief relief from the anxiety the thoughts cause • Experience significant problems in their daily lives due to these thoughts or behaviours It’s important to note that some individuals with OCD might only experience obsessions without compulsions.


OCD is typically diagnosed through a comprehensive clinical assessment by a mental health professional. This assessment may include: • Clinical Interviews: These are structured interviews that explore the content of an individual's obsessions and compulsions, their frequency, and the degree of distress and impairment they cause. • Psychological Assessment Tools: Standardized assessment tools, such as the Yale-Brown Obsessive Compulsive Scale (Y-BOCS), are used to assess the severity of OCD symptoms. • Medical Examination: To rule out other causes of symptoms, such as medications or other medical conditions, a physical examination may be conducted. • Psychiatric Evaluation: This evaluation will assess for other mental health disorders that may be present, as OCD is often co-morbid with conditions such as depression, eating disorders, and anxiety disorders. There are no laboratory tests to diagnose OCD; the diagnosis is based on the assessment of symptoms. However, sometimes blood tests may be done to rule out other conditions.


Treatment for OCD typically involves a combination of medication and therapy, with the goal of controlling symptoms to the extent that they do not interfere with daily functioning. Cognitive Behavioural Therapy (CBT): • Specifically, a type of CBT called Exposure and Response Prevention (ERP) is considered the most effective form of psychotherapy for OCD. • ERP involves gradually exposing the patient to feared objects or ideas, either directly or by imagination, and then helping the patient to prevent the usual compulsive response. Medications: • Selective Serotonin Reuptake Inhibitors (SSRIs) are often used to help reduce the obsessions and compulsions of OCD. • Tricyclic antidepressants (TCAs) like clomipramine (Anafranil) may be an option for patients who do not respond to SSRIs. Combination Therapy: • Often, the best results are achieved with a combination of medication and CBT. Deep Brain Stimulation (DBS): • For severe cases of OCD not responding to the above treatments, DBS or other neurosurgical procedures might be considered. Alternative Therapies: • Some individuals may find additional relief through techniques like mindfulness, relaxation techniques, and support groups. It's important to note that treatment is highly individualized, and what works for one person may not work for another. Therefore, close follow-up and collaboration with a healthcare provider are crucial to determine the most effective treatment strategy.

Preventive Measures

There are no guaranteed ways to prevent OCD, but some strategies may help control symptoms and prevent them from worsening: • Early Detection and Intervention: Recognizing and addressing symptoms early on can prevent OCD from becoming severe. • Stress Management: Since stress can worsen OCD symptoms, techniques such as mindfulness, meditation, and yoga can be beneficial. • Maintain a Healthy Lifestyle: Regular exercise, a balanced diet, and sufficient sleep can have a positive impact on overall mental health. • Support Networks: Building strong relationships with family, friends, and support groups can provide a safety net and reduce feelings of isolation that can accompany OCD. • Therapeutic Strategies: Learning and practicing cognitive-behavioural techniques, even if one does not have OCD, can help manage small obsessions or compulsive behaviours before they escalate. • Avoiding Substance Abuse: Substance abuse can trigger or exacerbate mental health issues, including OCD.

Do's & Don’t's

Do's Don't
Seek professional help (therapist, doctor) Avoid seeking help or thinking it will go away on its own
Practice mindfulness and relaxation techniques Ignore symptoms or try to suppress them
Educate yourself about OCD and its treatment Engage in compulsive behaviors without seeking therapy
Follow a structured routine Criticize or belittle someone with OCD
Practice gradual exposure therapy Enable or encourage compulsive behaviors
Build a support network Judge or shame someone with OCD
Be patient with yourself and the process Self-medicate or use substances as a coping mechanism

If you suspect you or someone else is experiencing Obsessive Compulsive Disorder, it is crucial to seek immediate medical attention by calling emergency services or consult with a Psychologist.

Frequently Asked Questions
No, OCD is not rare. It affects about 2.3% of the population at some point in their life.
Yes, children can develop OCD. Symptoms often appear in children aged 8-12 or in the late teen years.
No, OCD is a neurobiological disorder and not the result of personal weakness or upbringing.
While there is no cure for OCD, the symptoms can be effectively managed with treatment.
Having OCD does not mean you are crazy. It is a mental health disorder that is unrelated to an individual’s intelligence or character.
Preferring things to be neat or orderly is common. For a diagnosis of OCD, the behaviour must be driven by obsessive thoughts and be time-consuming or cause significant distress or impairment.
Medication can be an effective part of treatment, but the most effective approach often combines medication with cognitive-behavioural therapy, specifically ERP.
OCD is often co-morbid with other disorders such as anxiety disorders, depression, eating disorders, and tic disorders. It’s important to treat all co-occurring disorders.
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