Frequent, repetitive handwashing may be a sign of obsessive-compulsive disorder, or OCD.
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Obsessive compulsive disorder, or OCD, is a mental disorder characterized by recurrent, persistent thoughts (obsessions) and ritualistic behaviors (compulsions) that interfere with a person's daily life and relationships, according to the "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" (DSM-5).
People with OCD often realize their compulsive behavior is irrational, but they feel powerless to stop, since that only increases their level of anxiety.
The International OCD Foundation estimates that about 1 in 100 adults in the United States — and 1 in 200 children — has OCD. The condition often appears first during childhood or the teen years, and it tends to occur in men and women in roughly equal numbers. [Hypersex to Hoarding: 7 New Psychological Disorders]
Symptoms of OCD
OCD has many manifestations, but commonly, the obsessions of a person who has OCD are in some way linked to his or her compulsions. A child who obsesses about germs or contamination, for example, might compulsively wash his hands. Other common obsessions and compulsions include the constant need to "check" things, like that the front door is locked or the oven is turned off; an obsession with counting or arranging things in a particular order; or compulsive hoarding.
While OCD symptoms show up differently in each individual, those who have the disorder have at least one thing in common: Their obsessive-compulsive tendencies get in the way of everyday life. This is what separates OCD from the day-to-day anxiety and habits that are deemed "normal."
A small amount of obsessive thinking or compulsive behavior is not necessarily a symptom of OCD; these are normal responses to real stress that serve a valuable purpose. The ability to foresee — and then worry about — possible dangers allowed early humans to take precautionary measures and survive difficult situations. But those with OCD may worry and compulsively perform "precautionary" behaviors even after they have determined that no danger exists.
Causes of OCD
Researchers have many theories about the causes of OCD in humans, ranging from childhood trauma to bacterial infection to genetics — the condition often runs in families. But scientists agree that OCD coincides with abnormalities in certain brain processes.
When exposed to threatening or frustrating situations, most people with OCD experience hyperactivity in the parts of the brain regulating external stimuli, including the amygdala — the part of the brain where danger is evaluated and processed — and the orbital frontal cortex, which performs cognitive processing and decision-making functions.
Serotonin is a neurotransmitter (a chemical that relays messages within the brain) that may play a part in OCD. People with the condition who take medication that modifies serotonin levels have fewer symptoms of OCD (see Treatments, below).
Diagnosis of OCD
While not all perfectionist behaviors are symptomatic of OCD, the disorder can become so severe and time-consuming that it becomes dysfunctional, preventing a person from normal day-to-day activities.
Only a qualified physician or mental-health provider can make an accurate diagnosis of OCD. The condition is often present with other mental-health disorders, such as depression, eating disorders or other anxiety disorders.
Treatment for OCD
There are several methods of treating OCD; most involve some kind of medication, psychotherapy or a combination of both.
Cognitive-behavioral therapy (CBT) has been shown to be effective in treating OCD by teaching the individual with the disorder to try a different approach to those situations that trigger their obsessive-compulsive behavior. One type of CBT, known as exposure and response prevention, can help people with OCD by teaching them healthy ways to respond when exposed to a feared object (dirt or dust, for example).
Selective serotonin reuptake inhibitor (SSRI) antidepressants are the medications most commonly prescribed for treating OCD. Anti-anxiety medication may also be prescribed.
Both types of medications may take several weeks to begin to work, according to the National Institutes of Health. In addition to side effects such as headache, nausea and insomnia, antidepressants have been shown to cause suicidal thoughts and behaviors in some people. People taking antidepressants need to be monitored closely, especially when starting their treatment.