Patient Resources

Patient Resources



Obsessive Compulsive Disorder (OCD) is a disorder of the brain and behavior. OCD causes severe anxiety in those affected. OCD involves both obsessions and compulsions that take a lot of time and get in the way of important activities the person values.

As many as 4 million Americans have OCD, including 1 million children and teenagers. Most are not promptly or properly diagnosed. Although OCD is rarely completely cured, many patients find meaningful and long-term symptom relief with cognitive behavior therapy and medication. OCD is a debilitating brain disorder that causes problems in information processing. The brain gets stuck on a particular thought or urge and just can’t let go. OCD involves having both obsessions and compulsions. Common obsessions are: contamination fears of germs, imagining having harmed oneself or others, imagining losing control or having aggressive urges, intrusive sexual thoughts or urges, excessive religious or moral doubt, forbidden thoughts, a need to have things “just so” and a need to tell, ask or confess. Common compulsions are: washing, repeating, checking, touching and counting. OCD symptoms can occur in people of all ages. Statistical analyses indicate that a major genetic component is involved in the occurrence of OCD, though the exact gene has not yet been identified.


    What is OCD?
    • OCD is a disorder of the brain and behavior.
    • Individuals with OCD experience automatic and intrusive thoughts (obsessions) which trigger high levels of anxiety.
    • The individual responds to these obsessions by engaging in repetitive acts (compulsions) in an attempt to decrease the anxiety and escape from the obsessions.
    • Obsessions and compulsions need to be time consuming and result in functional impairment in order to have a diagnosis OCD.
    Common Obsessions in OCD
    • Contamination—body fluids, germs/disease, environmental contaminants, chemicals, dirt
    • Fear of being responsible for something terrible happening because of not being careful enough—dropping something on the ground that someone might slip on and hurt themselves
    • Religious obsessions (also called scrupulosity)—concern with offending God or blasphemy
    • Perfectionism—concern about evenness or exactness
    • Hoarding—unable to decide whether to keep or to discard things
    • Losing control— fear of acting on an impulse to harm others
    • Unwanted sexual thoughts—acting on forbidden or perverse sexual thoughts or images
    • Concern with getting a physical illness or disease
    • Superstitious ideas about lucky/unlucky numbers, certain colors
    Common Compulsions in OCD
    • Excessive hand-washing or bathing
    • Excessive cleaning
    • Counting
    • Mental rituals, such as excessive repeating of thoughts or prayers
    • Excessive repeating of activities or words
    • Touching or checking items repeatedly, such as door locks or appliances
    • Arranging or ordering items or belongings
    • Hoarding unneeded items
    Why do patients perform these compulsions?
    • The compulsions (also referred to as rituals) provide short-term relief from the distress triggered by obsessions.
    • However, this short-term relief comes at the expense of long-term problems as the lives of individuals with OCD become increasingly dominated by the compulsions.
    How is OCD diagnosed?
    • Only a trained professional can properly recognize and diagnose OCD.
    • A questionnaire, called the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) is also a useful tool for assessing OCD symptoms.
    How common is OCD?
    • Our best estimates are that about 1 in 100 adults—or between 2–3 million adults in the United States—currently have OCD. This is roughly the same number of people living in the city of Houston, Texas.
    • Lifetime estimates (the number of individuals that develop OCD over the course of their lifetime) are that about 1 in 50 adults—or 4–6 million adults in the United States—have OCD.
    • There are also at least 1 in 200—or 500,000—kids and teens that have OCD. This is about the same number of kids who have diabetes.
    • This means four or five kids with OCD are likely to be enrolled in any average sized elementary school. In a medium to large high school, there could be 20 studens struggling with the challenges caused by OCD.
    • OCD affects men, women and children of all races and backgrounds equally.
    At what age does OCD begin?
    • OCD can start at any time from preschool to adulthood.
    • Although OCD does occur at earlier ages, there are generally two age ranges when OCD first appears.
    • The first range is between ages 10 and 12, and the second is between the late teens and early adulthood.
    Is OCD inherited?
    • Research shows that OCD does run in families and that genes likely play a role in the development of the disorder.
    • Genes appear to be only partly responsible for causing the disorder.
    • No one really knows what other factors might be involved, perhaps an illness or even ordinary life stresses that may induce the activity of genes associated with the symptoms of OCD.
    Is OCD a brain disorder?
    • Research suggests that OCD involves problems in communication between the front part of the brain and its deeper structures.
    • These brain structures use several chemical messengers, including serotonin.
    • Drugs that increase the amount of serotonin in the brain often reduce OCD symptoms.
    What are common obstacles to effective treatment?

    Studies find that it takes an average of 14–17 years from the time OCD begins for people to obtain appropriate treatment.

    • Some people choose to hide their symptoms, often in fear of embarrassment or stigma. Therefore, many people with OCD do not seek the help of a mental health professional until many years after the onset of symptoms.
    • Until recently, there was less public awareness of OCD, so many people were unaware that their symptoms represented an illness that could be treated.
    • Lack of proper training by some health professionals often leads to the wrong diagnosis. Some patients with OCD symptoms will see several doctors and spend several years in treatment before receiving a correct diagnosis.
    • Difficulty finding local therapists who can effectively treat OCD
    • Not being able to afford proper treatment

The above information was taken from “What You need to Know about OCD” published by the International OCD Foundation.

Compulsive Hair Pulling

Compulsive Hair Pulling

Trichotillomania (trick-o-til-o-MAY-nee-ah) is a disorder that causes people to pull out the hair from their scalp, eyelashes, eyebrows, pubic area, underarms, beard, chest, legs or other parts of the body, resulting in noticeable bald patches. Hair pulling varies greatly in its severity, location on the body and response to treatment. For some people, at some times, trichotillomania is mild and can be quelled with a bit of extra awareness and concentration. For others, at times the urge may be so strong that it makes thinking of anything else nearly impossible.

Trichotillomania (also referred to as TTM or “trich”) is currently defined as an impulse control disorder, but there are still questions about how it should be classified. It may seem to resemble a habit, an addiction, a tic disorder or obsessive-compulsive disorder. Most recently, it is being conceptualized as part of a family of “body-focused repetitive behaviors” (BFRBs) along with skin picking and nail biting.

Chronic Skin Picking

Chronic Skin Picking

Chronic skin picking (CSP) is a serious and poorly understood problem. People who suffer from CSP repetitively touch, rub, scratch, pick at, or dig into their skin, often in an attempt to remove small irregularities or perceived imperfections. This behavior may result in skin discoloration or scarring. In more serious cases, severe tissue damage and visible disfigurement can result.

CSP is now thought of as one of many Body-Focused Repetitive Behaviors (BFRBs) in which a person can cause harm or damage to themselves or their appearance. Other BFRBs include chronic hair pulling (trichotillomania), biting the insides of the cheeks and severe nail biting.

Skin picking or other BFRBs can occur when a person experiences feelings such as anxiety, fear, excitement or boredom. Some people report that the act of repetitively picking at their skin is pleasurable. Many hours can be spent picking the skin, and this repetitive behavior can negatively impact a person’s social, work and family relationships.

Though skin picking often occurs on its own—unconnected to other physical or mental disorders—it is important to identify whether or not skin picking is a symptom of another problem that needs treatment. For example, skin picking could be a symptom of illnesses such as dermatological disorders, autoimmune problems, body dysmorphic disorder, obsessive-compulsive disorder, substance abuse disorders (such as opiate withdrawal), developmental disorders (like autism) and psychosis. Establishing whether skin picking is an independent problem or a symptom of another disorder is an important first step in creating an appropriate treatment plan.

Helpful Websites

International OCD Foundation (IOCDF)
Trichotillomania Learning Center (TLC)
Anxiety Disorders Association of America (ADAA)
Tourette Syndrome Association (TSA)
DFW OCD and Anxiety Support Group