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Obsessive compulsive disorder

Visit us (http://www.khanacademy.org/science/healthcare-and-medicine) for health and medicine content or (http://www.khanacademy.org/test-prep/mcat) for MCAT related content. These videos do not provide medical advice and are for informational purposes only. The videos are not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of a qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read or seen in any Khan Academy video. Created by Tanner Marshall.

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  • piceratops sapling style avatar for user KB
    At , it states that you don't need to have both obsessions and compulsions to be diagnosed, but also that the compulsions are done in response to the obsession. So, then, how can you have compulsions without obsessions? What's an example of compulsion-only OCD?
    (5 votes)
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  • starky sapling style avatar for user elizabeth
    why are the causes of mental health issues always unknown?
    (3 votes)
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    • leaf green style avatar for user Darrin Morgan
      Mental health is something that is only recently being looked into. Doctors have existed for hundreds of years, but as a society we never really started believing mental illness until the 20th century, so the research and development on mental health studies are very new. Even the medications that are successfully treating many symptoms and disorders are only a couple of decades old. So eventually the causes will be known, it is just going to take much more research. There is definitely a matrix of the causes, just as in any condition.
      (6 votes)
  • purple pi purple style avatar for user Ty Martin
    What is the difference between SSRIs and SRIs?
    (3 votes)
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    • blobby green style avatar for user iapaul1507
      Actually, there is no real difference. SSRI = Selective Serotonin Reuptake Inhbitor and SRI = Serotonin Reuptake Inhibitor (without the "Selective" adjective). Initially, these drugs were thought to only act on the serotonin transporter, the protein that actually effects reuptake of serotonin. However, over the thirty years that they've been in use, it's become clear that they do in fact, have effects on other sites, most commonly various types of serotonin receptor (the protein that transmits the serotonin signal from the synapse to the receiving neuron). No big surprise to pharmacologists, the scientists (like me) who study how drugs work. Our mantra is always, "There are no magic bullets. All drugs work at more than one site or at the same site in different parts of the body."
      (2 votes)
  • blobby green style avatar for user tanyashabbir21
    how many symptoms are needed to diagnose OCD
    (3 votes)
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  • leaf blue style avatar for user Challenge1student
    So praying constantly would be associated with OCD??
    (2 votes)
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    • leafers ultimate style avatar for user William H
      Not exactly, unless you believe you believe if you don't you'll be sentenced to eternal damnation. Regularly praying, and even praying a bit more is a normal expression of faith and you shouldn't worry about it, be proud.
      (3 votes)
  • starky sapling style avatar for user Sideways
    Can OCD also be something small like having to lock the door overnight or having to realign chairs after they have been moved out of place?
    (2 votes)
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    • primosaur ultimate style avatar for user FrenchHornCat
      Possibly. OCD sufferers will usually perform a compulsion due to feelings of anxiety or guilt related to the act of the compulsion itself. A person with OCD may believe that if they do not lock the door overnight or realign the chairs, something awful will happen, or that they will be a bad person if they do not. Compulsions are often attempts (whether the sufferer realizes it or not) to relieve this anxiety and make the thoughts go away, but compulsions usually offer little or no relief. If the behaviors you mentioned are simply due to a desire for organization and don't happen repeatedly, they are likely not OCD-related. If the behaviors occur despite attempts to stop, or if they happen repeatedly despite the fact that the person acting them out realizes that any worries they have associated to them are likely irrational, then this could be symptomatic of OCD.

      Even so, every case of OCD is different and everyone with OCD experiences it differently. There are also many different types of OCD, some of which revolve around particular types of obsessions (such as obsessions revolving solely around responsibility and guilt, etc.). In Pure OCD, individuals experience no visible compulsions but do experience obsessions. Because OCD varies so greatly, it should be examined on a case-by-case basis and it should not be assumed that all sufferers experience obsessions or compulsions in the same way. Hope this was helpful.
      (2 votes)
  • leaf green style avatar for user Marian Marino
    So, if I REALLY like things to be perfectly in order and I'm not fully happy unless they are sorted and organized just so, could this be a sign that I'm a bit OCD? I think I may have the compulsive part of it...
    (2 votes)
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  • ohnoes default style avatar for user a.m.ahkee
    What does it mean by "has tried to suppress thoughts"?
    (2 votes)
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  • sneak peak purple style avatar for user Kyleigh Curtis
    Would having to hug someone and say "I love you" repeatedly count as ocd?
    (1 vote)
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    • boggle green style avatar for user Aeternum
      It could, especially if the action feels strangely out of place, unnecessary, or inappropriate.

      For example, say that you are bidding farewell to a loved one who is moving to another state. It would be considered appropriate to hug them and tell them that you love them, right?

      But say that the person is doing work. Washing the dishes. Talking with someone. Exercising. Watching Netflix. Whatever the circumstance is. Someone with OCD would have an inexplicable urge to hug them and say "I love you," no matter how strange the action seems, because compulsions are quite literally compulsive. It shouldn't only be a one-time-thing: the feeling will linger and you will feel the compulsion to hug them repeatedly throughout the day to the point that the person you are hugging will start to believe that you are acting strangely.

      So yes, it could count as OCD. However remember that every person is different and you should evaluate this case-by-case.
      (3 votes)
  • duskpin sapling style avatar for user Dovewing
    What are the side effects of taking medications like serotonin
    (1 vote)
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    • leafers seed style avatar for user PCMSIII
      Excess serotonin is actually called serotonin syndrome. This is a common side effect of people taking too much medication, or medications that interact with each other in a negative way. In the case of OCD, people can be on SSRI's and then switch to another medication too soon, increasing the amount of serotonin to much in the synaptic cleft.

      Serotonin syndrome is classified as:
      Muscle clonus (Twitching, especially after doing a reflex test)
      Tachycardia (fast heart beat)

      These are considered part of serotonin syndrome when an overdose or drug interaction is suspected. Otherwise, increased cholinergic overstimulation is suspected from a different source.
      (2 votes)

Video transcript

- [Voiceover] Right before you leave the house, you might double-check that you've turned off the stove, right? So it doesn't burn the house down or something. This is a totally normal thing to do. Someone with Obsessive-Compulsive Disorder might feel the need to triple or even quadruple-check it, or even do other things, or have to perform a specific series of things or a routine before they can leave. Obsessive-Compulsive Disorder, or OCD, is a type of anxiety disorder, where you have these frequent and upsetting thoughts that are basically unwanted and intrusive, so they just sort of force their way into your brain, and so you tend to obsess over them, and we end up calling these thoughts obsessions. And these produce some sort of anxiety, and in this attempt to try and control these intrusive obsessions and anxiety, you feel this overwhelming urge, or you feel compelled to repeat certain rituals or behaviors, which we call compulsions, and so the two components to Obsessive-Compulsive Disorder are obsessions and compulsions, that makes sense. And for someone with OCD, these thoughts and rituals cause serious distress to their daily life and can also interfere with their daily activities and social interactions. So, when looking at people with OCD, there are several more common types of obsessions and compulsions, and it's important to note that the obsessions and compulsions usually come together, but there can also be just obsessions or just compulsions. All right, first there's cleaning, and this compulsion is very commonly associated with OCD and is brought about by this obsession with germs and contamination. To control these germs and apparent contamination, someone might spend hours washing both themselves and their surroundings. Now, another type of compulsion is repeating, and this involves saying a phrase or a name or doing some behavior several times in a row. With this compulsion, there's this obsession that if they don't do these repetitions, then something bad'll happen. As an example, they might have to turn on and off a light switch multiple times before entering a room. Checking is another compulsion, and patients will constantly check and re-check something to make sure that it's safe because they have this obsession or fear of hurting themselves or others. An example might be checking several times that the door is locked, or checking that the gas stove is off. Ordering and arranging is this compulsion to order objects in a certain way or make sure that they're symmetrical in some way, or to always have to have things perfect or just so. An example might be needing to have the books on a bookshelf organized by color. They become obsessed with this order and feel that it reduces discomfort and anxiety. Finally, mental rituals are these prayers or phrases that are performed to try and neutralize or get rid of these intrusive thoughts, or to try to prevent this dreaded future event. So if they have this bad thought, they might try and use this specific phrase or prayer to replace this bad thought. Okay, so now, if someone has one of these obsessions or compulsions, they may meet the criteria for OCD. In order to figure this out, a mental health professional will look at the Diagnostic and Statistical Manual for Mental Disorders, the 5th edition, or more fondly known as the DSM-5. For it to be an obsession, the first criteria is that they have to have this recurrent and persistent unwanted thoughts that cause a lot of anxiety and distress. Secondly, the patient has to have tried to suppress or ignore these thoughts, and then for it to be a compulsion, the first criteria is that either repetitive behaviors like ordering or checking, or mental acts like praying or counting, are done in a response to an obsession. And then secondly, the compulsions are done to reduce anxiety or prevent some sort of distress and are clearly excessive. Again, someone doesn't need to have both obsessions and compulsions for a diagnosis of OCD and may have only one or the other, but why might someone have one of these obsessions or compulsions? What causes someone to develop OCD? Well, what we do know is that OCD tends to run in families, and the cause is now thought to be largely biological, as opposed to completely environmental. Ultimately, though, we still don't really know what the exact cause of OCD is. Usually, though, it starts for many people in their childhood or teen years, most being diagnosed by about age 20, and affects about two million Americans, and it's equally as common with men as with women. Once OCD's been diagnosed, we're going to look to treatment, which is either psychotherapy, specifically cognitive behavior therapy, medications, or both. One particularly effective cognitive behavior therapy that they'll probably try is called exposure and response therapy. With this therapy, the patient is exposed to the situations that might be causing some sort of anxiety or causing them to follow through with their compulsions. Through this exposure, the patient might be able to reduce the resulting compulsive rituals and find that the anxiety that comes from the obsessions actually lessons without the rituals. This treatment, though, is only effective if the patient adheres to the procedures. Some patients don't agree to participate because they don't want to experience the anxiety. On the other hand, some patients are given medications. Serotonin reuptake inhibitors, or SRIs, can be effective in treating about half the patients that take them. Although very helpful, they'll often leave residual symptoms, though, or side effects, that might need to be treated with other medications or psychotherapy. Patients that have gotten treatment, though, via these methods are shown to have an increased quality of life and are usually able to get back to their normal routine, including school, work, and relationships.