The main symptoms of OCD are recurrent ideas or behaviours that are unwanted and that may appear to be pointless. People with OCD usually have a good sense of reality and readily admit that their obsessions and compulsions are irrational, absurd or superstitious. They are unable to stop themselves from yielding to these impulses, however, and become so completely absorbed in the obsession or compulsion that they think of nothing else until they have finished. If they are forcibly interrupted from completing their thought or behaviour, they usually experience considerable anxiety.
People with OCD tend to be stiff and formal in demeanor, precise and orderly about tasks, and overly concerned about conforming to social norms. They also tend to be intellectual rather than emotional in expression and are notably deferential to others. When they speak, they often qualify potentially assertive statements so as to make them less offensive. At the same time, people with OCD may be prone to lengthy monologues about subjects of interest, and they will continue to discourse even if the listener tries to interrupt or change the subject.
OCD seems to worsen during pregnancy in some women. In others, pregnancy triggers symptoms of OCD that never before existed. After delivery some women seem to develop OCD as a form of postpartum psychiatric disorder. These women often have unwanted and intrusive thoughts of harming their baby. Perhaps as a result of these impulses, women with OCD tend to have trouble bonding with their infants and try to avoid situations, such as bathing the infant, in which they might try to enact their fantasies. Sometimes obsessive-compulsive symptoms accompany other psychiatric changes such as depression which may appear in the weeks or months after the birth of a baby.
Treatment of OCD
Many people with OCD respond well to antidepressants or other drug therapy, often in combination with cognitive or other forms of behavioural psychotherapy. In women with postpartum OCD or OCD that has been exacerbated by pregnancy, the antidepressants Prozac(fluoxetine), Zoloft(sertraline), or Paxil(paroxetine) seem to be particularly effective, especially if combined with psychotherapy. in women who also have symptoms of depression, tricyclic antidepressants, such as amitriptyline(Elavil) or desipramine(Norpramin) may also help. Since very little is understood about OCD in these women, however, the final word about effective treatment must await results of the various studies.