Dear Not sure,

Obsessive-compulsive disorder, or OCD, is a relatively common mental condition affecting about 3.3 million Americans or about 2.3 percent of the adult population. People with OCD are plagued by persistent, unwanted thoughts, called obsessions, and the need to perform complex rituals, known as compulsions. Some of these rituals include checking to see if the door is locked, counting things repeatedly, or washing one's hands over and over. The need to perform rituals interrupts and interferes with daily activities. Performing these rituals offers temporary relief from intrusive obsessions, such as worrying that the door has been left open, or feeling that one's hands are filthy or contaminated. Being unable to perform these rituals creates intense feelings of anxiety and discomfort.

No one is sure why people have OCD. New research suggests that OCD may be related to atypical functioning of the circuitry in a part of the brain called the striatum. Treatment for OCD, a combination of behavioral therapy aimed at reducing the need to perform rituals, along with anti-depressant medication, seems to make a difference.

What is it that makes you think you might have OCD? What behaviors are you noticing in yourself? You say that you are too afraid to go seek help, but don't say specifically what you are afraid of. Often people with OCD have vivid, unwanted thoughts about hurting others, or doing some other dangerous or inappropriate thing. Sometimes people who have these thoughts are so ashamed or embarrassed that they are afraid to speak of them, even to their health care providers or close friends. They feel as if they are the only ones to ever experience these sorts of compulsions, and that no one else would be able to understand. It's important to remember that these sorts of thoughts are common among people with OCD, and that thinking about hurtful things does not mean that they will actually do these things.

Although it can be hard to talk about this, your fear is preventing you from getting the diagnosis you need (whether or not it's OCD), and then the right treatment plan. You can start with your own doctor, someone you have known, if you have one. S/he may not be able to diagnose you, but s/he can help create trust and provide a competent referral to a mental health professional. Working with a mental health professional who has experience with diagnosing and treating OCD, and possibly medication, can help you feel more comfortable and more effective in your life.

For more information, support, or help in finding a mental health provider in your area familiar with OCD, check out the Obsessive-Compulsive Foundation, an international not-for-profit group of people with OCD and related disorders, their friends and families, and professionals and other concerned individuals.

Alice

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