Obsessions are unwanted thoughts that keep coming back even though one tries to stop them e.g. the thought that the lights in the house could still be on, when they have been checked several times before leaving the house. Compulsions are repeated acts that everyone feels are unnecessary e.g washing the hands repeatedly because there is the feeling that there are germs on them.

Sometimes it must be difficult to understand why these symptoms simply just can't be controlled. It is important to understand that these problems are not the person's own fault. Something in the biological make up, certain physical factors that are unseen but that a person is born with, can cause the tendency to develop an obsessive compulsive disorder. The environment, life experiences, and of course, stress, also contributes to the problem. People do not cause this disease - not the sufferer himself, nor his family members. However, certain beliefs, certain reactions, can have a contributing effect.

Causes:

• Genetics. OCD may have a genetic component. Having parents or other family members with the disorder can increase your risk of developing OCD.
• Biology. It may be a result of changes in the natural chemistry (such as insufficient serotonin) altering brain functions. Some children develop OCD after throat infection (PANDAS.  Pregnant women and new mothers are at increased risk due to hormonal changes with OCD symptoms centering mainly on thoughts of harming the baby.
• Environment. OCD may stem from behavior-related habits that are learned over time. A tendency to react strongly to stress increases the risk of OCD by triggering the intrusive thoughts, rituals and emotional distress characteristic of obsessive-compulsive disorder.

Associated disorders:

• Suicidal thoughts and behavior
• Alcohol or substance abuse
• Other anxiety disorders
• Depression
• Eating disorders
• Contact dermatitis from frequent hand washing

Treatment:

Treatment of OCD involves a combination of medication and Brief Intensive Gestalt (BIG) therapy.

Medication - When the problem is acute medicines are required to control the thoughts and relieve anxiety. These drugs must however always be taken or continued under the psychiatrist's supervision. Sometimes there is depression along with the other OCD symptoms, and this may have to be treated as well.

Brief Intensive Gestalt (BIG) Therapy - This involves  a programme of challenging the unwanted thoughts and training the person in 'thought stopping' methods. This may be combined with relaxation methods to lessen anxiety while preventing the repeating patterns of behavior that trouble the person.

Family Therapy - The family has to be counseled and taught to support the person with the disorder and how to cope with the problem.

It can help bring symptoms under control so that they don't rule daily life.

Symptoms:

Repeated thoughts/images of

• death of someone who is close
• harm befalling someone close
• God or Devil, or Disease affecting self or people or things that the person cares about.
• Fear of contamination or dirt with or without washing and cleaning or hand washing until  skin becomes raw
• Fear of being contaminated by shaking hands or by touching objects others have touched
• Performing the same action repeatedly
• Repeated counting or checking in certain patterns with or without a magical number
• Repeated doubts e.g whether door has been locked or stove has been turned with our without checking behaviour e.g. checking doors repeatedly to make sure they're locked or checking the stove repeatedly to make sure it's off
• Sexual images or thoughts or replaying pornographic images in the mind
• fear about sexual orientation or sexual identity
• Impulses to shout obscenities in inappropriate situations
• Aggressive or horrific impulses or impulses to hurt someone
• Having things orderly and symmetrical with intense distress when the objects are disturbed
• Picking hair or skin (with skin lesions because of the picking or bald spots because of hair pulling)

In addition, the person may show...

• over concern with cleanliness
• over concern with routine
• lessened interest in social activities
• uncertainty about own judgement
• a tendency to get too upset about minor things
• over concern with detail
• a tendency to be easily tired

What the family needs to do:

It is important for the family members of a person affected with OCD to  cooperate with the person's wishes to keep the peace. When the rituals and patterns carry on day after day, it becomes easier to give in than to resist and try to talk the person out of it. This only makes the symptoms worse. On the other hand, ignoring the problem or pretending it doesn't exist is not going to help either. Families should get help and begin a programme for changing the person's behaviour. The home environment should be supportive and reassuring. The earlier the disorder is treated, more the chances of success.