Frequently Asked Questions
What are some of the common features of OCD?
- Obsessions often involve a concern with disastrous consequences. Obsessions often reflect a fear of harm to the person with OCD or others (e.g. “I may have picked up germs that will kill me.” “I may lose control of the car I’m driving and hit a child.”)
- Rituals are designed to reduce anxiety over the possibility of harm and other horrible consequences of mistakes (e.g. “I must check the doors and windows frequently because I don’t want anyone to break in and kill my family.” “I must wash my hands constantly so I won’t get sick or make others sick.”)
- When someone tries to resist or fight their obsessions, that often only makes them worse.
- Doubt and guilt are painful components of OCD. OCD can make a sufferer doubt even the most basic things about themselves, others or the world they live in. Individuals with OCD may doubt their perceptions, their sanity, the likelihood they will become murderers, etc. Guilt is another excruciating part of the disorder. Sufferers often feel responsible for things that no one would ever take upon themselves.
How common is OCD?
Diagnosable OCD is found in 2.5% of the population, though only a fraction of this number actually receive a diagnosis and get treatment. The typical onset of OCD is late teens or early twenties, quite possibly because one’s sense of personal responsibility increases at that age.
What causes OCD?
We don’t know exactly what causes OCD. It appears to run in families and there might be a mild genetic factor. In the histories of people with OCD there appears to be a certain kind of learning that reinforces the notion that having certain thoughts is as bad as doing the action (thought-action fusion) and that thinking about harmful events increases their probability (magical thinking).
What is the prognosis for OCD with treatment?
If the person with OCD is determined and works hard, then the results are good. Up to 80% of OCD sufferers improve significantly with proper treatment of cognitive behavioral therapy and medication.
What is the difference between a worry and an obsession?
- While the degree of apprehension in a worry might be excessive, they typically involve real-life situations (e.g. finances, job or school performance). The specific uncomfortable thoughts involved in worrying usually change from one day to the next. Worries seem reasonable to the person having them.
- Obsessions, on the other hand, are constant, excessive and usually reflect unrealistic fears, such as thoughts of causing personal harm or threats of contamination. Obsessions are experienced as intrusive and unwanted. The individual with OCD can, at times, view their obsessions as irrational.
What is the difference between normal checking and compulsive checking?
A diagnosis of OCD is warranted when the symptoms cause significant stress, are time-consuming (take more than an hour a day), or noticeably interfere with the person’s functioning. A person who has to check the door exactly six times before leaving the house, but is otherwise free of obsessive-compulsive symptoms may have a compulsive symptom, but does not have full-blown OCD.
Are people with OCD who have unwanted thoughts about hurting someone at risk of acting on their fears?
If they have OCD, the answer is no. Some OCD sufferers have unfounded fears about acting on irrational impulses, but they do not act on them. Indeed, the main reason they become preoccupied with such impulses is because they are so abhorrent to OCD sufferers.
What keeps OCD going?
If you have OCD, you are struggling with thoughts or impulses you believe are dangerous and cause anxiety. You then engage in safety-seeking behavior (compulsions and rituals) that you believe are necessary to reduce the danger. However, the thoughts and impulses, while anxiety-provoking, are not dangerous. The rituals get reinforced because the individual mistakenly concludes that the compulsions and rituals are necessary to prevent some terrible event.
