Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a mental health condition involving recurrent, unwanted thoughts (obsessions) and repetitive behaviours or mental acts (compulsions) performed to reduce the distress these thoughts cause.

• Obsessions: recurrent, intrusive, and unwanted thoughts, images, or urges that cause significant anxiety or distress, such as fears about contamination, harm, or symmetry
• Compulsions: repetitive behaviours or mental acts performed to reduce the distress caused by obsessions, such as excessive handwashing, checking, counting, or repeating actions
• Significant time consumed by obsessions and compulsions, often more than an hour a day, interfering with daily functioning
• Recognition, at least at some point, that the thoughts or behaviours are excessive, though this insight can vary

• Believed to result from a combination of genetic, biological, and environmental factors affecting brain circuits involved in anxiety and repetitive behaviour regulation.
• Family history of OCD or related conditions increases risk.
• Can begin in childhood, adolescence, or adulthood, and symptoms may fluctuate in severity over time or with stress.

• Diagnosed through a detailed clinical history exploring the specific pattern of obsessions and compulsions, their impact on daily life, and the amount of time they consume.
• It is distinguished from general worry or perfectionism by the significant distress, time consumption, and functional impairment involved.

Cognitive behavioural therapy, specifically a form called exposure and response prevention, is an effective, evidence-based first-line treatment, helping people gradually reduce compulsive responses to obsessive thoughts.

For moderate to severe OCD, or when therapy access is limited, an antidepressant medicine (commonly an SSRI, often at a higher dose than used for depression) may be used, sometimes alongside therapy.

Treatment often takes time to show full benefit, and a combination of therapy and medicine is often more effective than either alone for more significant symptoms.

Family education can help loved ones avoid unintentionally reinforcing compulsive behaviours, which is a common and understandable pattern that can maintain the condition.

• Seek assessment early if intrusive thoughts and repetitive behaviours are consuming significant time or causing distress.
• Engage consistently with therapy, as exposure and response prevention often requires sustained practice to see full benefit.
• Avoid reinforcing compulsions for a loved one with OCD, even though this can feel difficult in the moment, since professional guidance can help families support recovery appropriately.
• Attend regular follow-up if medicine is prescribed, to monitor response and adjust treatment as needed.