The strange or quirky behaviors people with obsessive compulsive disorder exhibit may seem like an exaggeration of normal processes, but these behaviors are part of a life-debilitating condition and recognized as an anxiety disorder. Obsessive compulsive disorder, or OCD, affects millions of Americans and carries a heavy toll for sufferers in terms of work, self-esteem and relationships. It is believed to go undiagnosed for many adults, but treatment strategies are improving. For people with obsessive compulsive disorders, the need to do something repeatedly, however senseless, can’t be resisted. A compulsion to wash hands, count objects, place items in order or mutter the same words over and over are some of the types of obsessive compulsive disorder. The disease is also costly to society, bearing a price well into the billions for direct and indirect expenses associated with it. As a disease, the condition can seem vague and a diagnosis easily missed until the consequences become more severe. It is believed that around 2.2. million people in the U.S. have OCD, and many will go long periods of time without intervention or treatment. Other common characteristics are an obsession with body parts, repetitive cleaning or hoarding impractical items. People with OCD may also be obsessed with doing tasks perfectly or always finishing them in the same way. The repetitive actions that hamper the lives of people with OCD are also called compulsions. The compulsions turn into rituals, and are usually labeled bizarre by the outside world. The person uses the rituals as tools to counteract fears that a recurring thought or image, also known as an obsession, will become reality. Some use the rituals to try to make the compulsion stop. For example, repetitive hand washing may be used to lessen the person’s fear or anxiety of contracting a serious illness. A strong sense of doubt accompanies most obsessions, such as wondering whether a door is locked or not. However, the rituals and repeated behaviors generally bring very short-term relief and cause more stress than they alleviate, especially if the person is unable to complete the ritual. In addition, the rituals can claim so much time for the sufferer that they jeopardize work and relationships. People living with OCD may experience a sense of isolation and frustration at being unable to ignore their compulsions. In fact, some experts say the amount of time spent carrying out the rituals is what distinguishes OCD from behaviors that fall into a normal realm. OCD can affect a person’s success in school, job abilities and financial situation, but medications have been shown to reduce the symptoms. Prescribed as either antidepressants or selective serotonin reuptake inhibitors, the medications work by correcting improper levels of serotonin in the brain, a chemical which regulates mood and behavior. A combination of medicine with counseling or psychotherapy has also been shown effective. During behavior modification treatments, the therapist allows the person to encounter anxiety-causing elements slowly over time, without permitting the patient to use their rituals as a coping tool. People with friends or family members exhibiting OCD characteristics can help by encouraging the person to seek treatment. Research is investigating the role of improper brain chemistry in OCD and medications, and behavior therapies continue to improve.