although the label gets tossed around pretty casually these days (as in, "OMG he's so OCD I can't even put my glass down without a coaster!").
There's nothing "casual" about OCD, however. The essential features of true Obsessive-Compulsive Disorder are the intrusive presence of obsessions (recurrent, usually disturbing thoughts) and/or compulsions (feeling driven to repeat certain behaviors or rituals) that are severe enough to be time consuming (for example, more than an hour a day) or cause the person experiencing them severe distress or impairment in normal routine, occupational or social functioning.
Although Obsessive-Compulsive Disorder may begin in childhood, it usually first appears gradually in adolescence or early adulthood, and is pretty evenly distributed between males and females in adulthood (it affects somewhat more boys than girls at younger ages). Although most people with the disorder experience both obsessions and compulsions, a relatively small percentage may experience only one or the other. The majority of individuals experience their symptoms as waxing and waning, and symptoms may get worse with stress, hormonal or other physical fluctuations.
perhaps so much so that they may be embarrassed or fearful of being thought "crazy" to ask for help or reveal their symptoms to someone else. News stories and features (20/20, Oprah), TV shows like Monk, and outspoken personalities like comedian Howie Mandel, have gone a long way in letting people with OCD symptoms know they're not alone, not crazy, and that there's effective help available.
Obsessions commonly take the form of repetitive thoughts or fears about germs or contamination, doubts (wondering whether one has done or neglected to do something), intense distress when something is moved or out of order, or worries about disturbing impulses (such as to shout an obscenity in church). Compulsions may take the form of repetitive behaviors like hand washing or door knob turning, feeling driven to check and recheck something, or intricately created rituals that the person feels must be adhered to specifically to avoid something bad from happening.
Remember, in order to be considered a disorder, OCD-like symptoms have to create severe distress and disruption in a person's life.
To warrant a diagnosis of Obsessive-Compulsive Disorder, the following criteria must be met, according to the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5):
A. Either obsessions, compulsions, or both must be present
Obsessions are defined as follows:
Compulsions are defined as follows:
B. The obsessions or compulsions are time-consuming (e.g. take more than 1 hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning
C. The obsessive-compulsive symptoms are not attributable to the phsysiological effects of a substance or other medical condition
D. The symptoms are not better explained by the symptoms of another mental disorder
and most likely to benefit from a medical component to treatment. SSRI (selective serotonin reuptake inhibitor) medications have been particularly successful in relieving symptoms, and have even greater success when combined with behavior therapy. Unfortunately, there is not yet a reliable diagnostic test for OCD; it is only properly diagnosed by a comprehensive face-to-face interview with a licensed mental health professional.
OCD can be successfully treated. Hooray!
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