I have a few questions about Obsessive Compulsive Disorder. I was telling one of my close friends about an experience that I've had recently and just couldn't seem to shake the thought. Sometimes I get wrapped up on a certain thought that’s really not that big of a deal but I still obsess over it over and over until I finally tell or confess to my husband or whoever else is there to listen. She stopped me one day and told me that she had a similar experience and she got really depressed about it so they hospitalized her for a few days. She was told she had OCD. My symptoms include: Rapid thoughts, one becoming stuck on then playing it around in my head for awhile and then feeling major anxiety to "tell" or to "get it out" especially if its something that I think my husband would think is wrong. I have triggers such as men (sounds dumb), death-funeral homes and different things. When is OCD a problem? Should it only be helped if there is a harm to myself or others? Otherwise is it just something to handle? I do okay most of the time but I noticed it really bad last week. Sometimes I have a hard time being able to tell which is an OCD thought and which is just a thought (sound dumb?) I've called my PA to talk to him for the past few business days and he's never returned my call. I'm becoming disgusted with that fact because in a sense I'm not sure whether to discuss that with him now or not. I would greatly appreciate it if you could give me a few words of advice. Thanks a bunch!

Obsessive-Compulsive Disorder (OCD) is a type of anxiety disorder, and it occurs in about 2% of the general population in the US. It tends to run in families, and usually shows up by the time people reach adulthood, though there are many exceptions to these rules. No one really knows what causes it.

People with OCD have persistent thoughts, ideas, or images that interfere with normal mental and emotional functioning. Examples of these obsessions could be an obsession with cleanliness that requires an individual to wash their hands repeatedly, or an obsession with safety that requires an individual to check the locks on their doors several times before leaving the house. People may have compuslions that require them to dress or eat in a very specific order or way. Some normal people may exhibit mild forms of this behavior from time to time, but in people with OCD, these behaviors are persistent and interfere with normal social functioning. The symptoms of OCD often overlap or coexist with symptoms of depression or anxiety. Fortunately, there is help for people with OCD in the form of both psychotherapy and medication. The most commonly prescribed medications for OCD are probably fluoxetine (prozac) and venlafaxine (luvox). However, there are many different medications that can work, and it may take trial and error with a few of them to figure out what works best for any given person with OCD.

In your case, it's difficult to tell for sure whether you have OCD or not -- but I think the fact that you are concerned about it is more than enough to seek out an opinion from a medical professional who has time to spend with you. Probably a mental health professional is the best person to do this assessment.

I think if you are not comfortable discussing this problem with your primary care clinician, then it may be time to find someone new. On the other hand, you may just want to ask your PA to refer you to a mental health professional that has experience treating symptoms of anxiety. Though I think it usually leads to better care to share this typ of information with your primary care clinician, there is certainly no requirement that you share all of your intrusive thoughts with your PA in order to go to the next step.

The important thing is that you find a medical professional you can talk openly with, and who can help you determine if you have a medical condition that would benefit from treatment.

Please let us know if there is more information that you need. I hope this general description of OCD and its treatment is helpful to you.

Dr. Mike Potter

-- Michael Potter, MD, is an associate professor at the University of California at San Francisco Medical Center.

First published March 30, 2005
Copyright © 2005 Consumer Health Interactive