What Is Compulsive Anxiety Disorder?

Compulsive anxiety disorder is not a recognized diagnosis. Rather, it is a shortened term for obsessive-compulsive disorder (OCD). OCD affects about 2.2 million adults in the United States and causes behaviors that seriously affect daily functioning. Performing repetitive acts, also called compulsive behavior, is one of the primary symptoms of OCD.

Definition

• The term "compulsive anxiety disorder" may leave out the obsessive piece, but it is an accurate reflection of this disease. OCD is, first and foremost, an anxiety disorder. People with OCD have such anxiety that they experience persistent, unreasonable thoughts (obsessions) that result in the use of rituals, or repetitive behaviors (compulsions). No matter what the compulsive behavior looks like, its function is to relieve anxiety. People with OCD are driven to perform compulsive acts. Not completing them results in even more anxiety, creating a spiraling cycle of distress.

Obsessions

• Obsessions are defined in the "Diagnostic and Statistical Manual of Mental Disorders" as "recurrent and persistent thoughts, impulses or images that are intrusive, inappropriate and cause marked anxiety and distress." Obsessions go far beyond typical worries about normal problems; in fact, they can sometimes be as extreme as thoughts of harming others. People with OCD typically do not act on such disturbing thoughts, but the thoughts fuel extreme anxiety. Some common obsessions are a fear of dirt and germs or a need for complete order.

Compulsions

• Compulsions include a wide variety of behaviors and are driven by the themes of the obsessions. For example, an obsession with order may result in hoarding behavior or a need to complete a task a specific number of times. An obsession with germs or dirt may produce a compulsion to wash the hands constantly, even to the point of causing the skin to break down. Rituals may include the need to touch, count or check on things a specific number of times. People with OCD may have compulsions that result in balding from pulling their hair, or they may spend excessive amounts of time ensuring that items are in a precise order or location.

Treatment

• Medication and therapeutic approaches usually can control the symptoms of OCD. The first choice of medication is typically an antidepressant, because the action that helps lift depression---increasing the level of serotonin in the brain---also helps to control OCD symptoms.

  Cognitive-behavioral therapy (CBT) is often successful in treating OCD. This targeted therapy works by teaching patients to identify dysfunctional thoughts and routines, and learn alternative behaviors or methods to replace their obsessions and compulsions. People with OCD also respond well to exposure-based therapy, which gradually exposes them to the object or situation possessing their obsessive thoughts. One step at a time, patients are desensitized and learn to manage the anxiety as they are exposed to its cause.

Research

• Researchers are conducting many clinical trials to explore the role of genetics as well as the effectiveness of alternative treatments and medications. One interesting alternative treatment is deep brain stimulation, in which thin wires are implanted in the brain to carry electric currents to specific areas within it. The National Institute of Mental Health is sponsoring a four-year study to determine if deep brain stimulation reduces symptoms in people whose OCD has not responded to other treatments. The study is being conducted at five prominent research hospitals with a planned completion date of 2013.