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Am Fam Physician. 2009;80(3):online

See related article on obsessive-compulsive disorder.

What is obsessive-compulsive disorder?

Obsessive-compulsive disorder (or OCD) is an illness that causes upsetting thoughts that are hard to control. People with OCD often do things over and over to help them cope with these upsetting thoughts.

Who gets OCD and why?

OCD affects one out of every 50 to 100 people at some point in life. Symptoms usually start in the teenage years. OCD seems to be caused by problems in certain parts of the brain and low levels of a brain chemical called serotonin. It can run in families.

What is an obsession?

An obsession is an upsetting thought that you can't get out of your head. It is not an everyday worry. People with obsessions know that these thoughts are not reasonable, but they have a hard time controlling them. These are some examples of obsessions:

  • Worrying about germs or dirt

  • Worrying about whether you forgot to lock a door or turn off the stove

  • Pornographic thoughts or images

What is a compulsion?

A compulsion is something you do over and over to cope with the anxiety caused by an obsession. These are some examples of compulsions:

  • Handwashing, cleaning, or putting things in order

  • Repeatedly checking locks, alarms, or appliances

  • Praying, counting, or repeating words silently

People with OCD spend a lot of time doing things that help them cope with their obsessions.

How do I know if I have OCD?

Talk with your doctor if you think you might have OCD. He or she will ask you some questions, and might want you to see a psychiatrist to help figure out if you have OCD.

How is OCD treated?

OCD can be treated with psychological therapy, medicine, or a combination of both. The type of therapy that seems to work best for OCD is called cognitive behavior therapy. In this type of therapy, you will confront things that you are afraid of and learn not to perform compulsions. Over time, this helps reduce your obsessions.

The medicines used to treat OCD can take several weeks to start working. Do not stop taking your medicine without talking to your doctor first. Talk to your doctor if you have any side effects, such as nausea, headache, trouble sleeping, or sexual problems.

What can I expect when living with OCD?

There is no “cure” for OCD, but the symptoms can be treated. Symptoms might get better or worse for months at a time. Stress management, healthy eating, and making sure you get enough sleep and exercise are important to control OCD.

Where can I get more information?

Your doctor

American Academy of Family Physicians

Obsessive Compulsive Foundation


  • Baer L. Getting Control: Overcoming Your Obsessions and Compulsions. New York, NY: Plume; 2000.

  • Baer L. The Imp of the Mind: Exploring the Silent Epidemic of Obsessive Bad Thoughts. New York, NY: Plume; 2002.

  • Foa EB, Wilson RR. Stop Obsessing! How to Overcome Your Obsessions and Compulsions. New York, NY: Bantam; 2001.

  • Hyman BM, Pedrick C. The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder. 2nd ed. Oakland, Calif.: New Harbinger; 2005.

  • Osborn I. Tormenting Thoughts and Secret Rituals: The Hidden Epidemic of Obsessive-Compulsive Disorder. New York, NY: Dell; 1999.

  • Schwartz J, Beyette B. Brain Lock: Free Yourself from Obsessive-Compulsive Behavior. A Four-Step Self-Treatment Method to Change Your Brain Chemistry. New York, NY: HarperCollins; 1997.

  • Wagner AP. What to Do When Your Child Has Obsessive-Compulsive Disorder: Strategies and Solutions. Rochester, NY: Lighthouse Press; 2002.

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