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Obsessive-compulsive disorder (OCD) is an often-mischaracterized mental health issue.

You’ve probably seen plenty of examples of someone labeled as “OCD” in movies and TV. But obsessive-compulsive disorder is more than just washing your hands frequently or needing to have things arranged a certain way. It can be a lifelong mental health issue that arises after going through a stressful event.

What is OCD?

OCD, a common anxiety disorder, can be explained through a breakdown of its name. “Obsessive” refers to intrusive thoughts that cause anxiety or stress, and the “compulsive” piece is the accompanying behavior that tries to calm that anxiety.

Most people have obsessions and compulsions at some point in their lives. What makes OCD a mental health concern is when those obsessions and compulsions get in the way of daily living, your relationships and quality of life, according to Jennifer Yarnell, PhD, psychologist at Geisinger. When someone with this condition feels distressed, it interferes with their ability to cope.

“If you’re in a public place and you’re worried about germs, you use hand sanitizer and maybe take a shower when you get home,” says Dr. Yarnell. “Once you perform the behavior, your anxiety decreases, and you go on with your life. In people with OCD, the habits or rituals to decrease the anxiety can be unproductive and are often illogical. The need to complete those acts is often non-negotiable.”

Dr. Yarnell said sometimes the habits or compulsions emerge accidentally or by chance. For example, a person with OCD finds comfort in reciting a certain phrase when they become anxious. Eventually the person believes saying that phrase several times might provide more relief.

“The link between the relief of the act and the act itself can happen unconsciously. Once the person becomes aware of the connection, they feel compelled to engage in the act to alleviate their worry or anxiety,” says Dr. Yarnell.

And OCD compulsions are more than what’s shown in the media — which is typically someone who is considered a “neat freak” or obsessed with germs. These behaviors can manifest in a variety of ways, like:

  • Checking repeatedly that things like locks or valves are shut
  • Hoarding items
  • Arranging things in a certain way
  • Repeating words to oneself
  • Counting
  • Constantly thinking of “good” thoughts to neutralize “bad” ones

If the person doesn’t perform the behavior, their anxiety will get worse. It’s not an activity they want to do, and usually it takes up so much time in their day that it affects other areas of their life. For example, someone who needs to perform rituals in the morning might be late to work because of them.

What causes OCD?

There’s still uncertainty about what causes OCD, says Dr. Yarnell. It can be a mix of genetic and environmental factors.

“Just because someone in your family has OCD doesn’t mean you will have it,” she says. “But it is something to note if you grow up with a parent or family member who engages in this behavior.”

Often OCD symptoms will appear in someone after a particularly stressful event or traumatic incident.

“It depends on the person and how they perceive the event,” says Dr. Yarnell. “We’re complicated beings, and no two people will respond exactly the same.”

OCD can occur in anyone. It may start in childhood but affects adults, too. And the condition spans all genders, races and socio-economic backgrounds.

How is OCD treated?

If you or a loved one have symptoms of OCD, the first step is to reach out for help. A primary care provider can recommend a counselor or therapist who has experience treating patients with OCD.

Antidepressants can also help those with OCD.

“There is no cookie-cutter solution, but usually a combination of antidepressants and cognitive behavioral therapy can help manage the condition,” says Dr. Yarnell.

Strong social support can also make a difference for those with OCD.

“This condition can cause a lot of embarrassment and shame for those living with it,” says Dr. Yarnell. “Being empathetic and supportive and understanding the nature of OCD is key.”

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