Obsessive compulsive disorder – OCD

The following might be some of the things you’ve heard about OCD:

• Someone is ‘a little’ OCD
• OCD is not that big a deal, people just need to relax and not worry so much
• OCD is just being a germaphobe
• OCD is a choice
• OCD is about being obsessively tidy or clean
• People with OCD wash their hands many times a day

However, it’s a lot more complicated than all the above.

• Obsessive compulsive disorder (OCD) is a common mental health condition in which a person has obsessive thoughts and compulsive behaviours.
• It affects men, women and children, and can develop at any age. Some people develop the condition early, often around puberty, but it typically develops during early adulthood
• OCD can be distressing and significantly interfere with your life, but treatment can help you keep it under control.
• OCD is a serious mental health condition that causes individuals to experience a variety of symptoms that typically fall into one of two categories: ‘obsessions’ (thoughts or images)) and/or ‘compulsions’ (behaviours), which do intertwine

Obsessions

• are unwanted, persistent and uncontrollable thoughts, images, or impulses
• they can sometimes be persistent worries, fears or doubts or a combination of all these
• the person doesn’t want to have these ideas; he or she finds them disturbing and usually knows that they don’t make sense
• interfere with the sufferers ability to function day to day as they are incredibly difficult to ignore
• come with uncomfortable feelings, such as shame, fear, disgust, doubt, or a feeling that things have to be done “just so”

The sufferer will go to extreme lengths to block and resist their obsessions – invariably they return within a short period of time, often lasting hours if not days, which can leave the person both mentally and physically exhausted and drained. One way people try to block or neutralize obsessions is with compulsions.

Compulsions

• are repetitive/ritualised behaviors or thoughts that a person engages in to neutralize, counteract, or make their obsessions go away
• can also include avoiding situations that trigger obsessions
• are time consuming and get in the way of the normal activities of daily living

People with OCD realise that acting on the compulsion is only a temporary solution, but without a better way to cope, they rely on that compulsion as a temporary escape.

Compulsions serve to avoid or reduce distress. In some cases, a person may believe they must perform compulsive acts in order to prevent something terrible from happening i.e. a person might touch things only after they’ve all been bleached -they believe they must perform this act in order to prevent disease or a person might feel the need to constantly check that the doors are lock – they believe they must do this to stop someone in their family from being harmed.

Normal or abnormal?

Obsessive and compulsive traits on their own are not a mental illness — we all have normal, everyday obsessions, things that maybe we obsess over. I like my kitchen cupboards to be neat and tidy but my sister takes it to the extreme and goes mad if all the labels aren’t facing the right way. She’ll get angry, then sulk for a minute with whoever the perpetrator was, then carry on as normal. However, this doesn’t mean that she has OCD either.

The main difference between normal and abnormal obsessions is that people with OCD report obsessions which are more intense, frequent and difficult to control. They can’t just “snap out of it.”

The real struggle with a person’s OCD is a manifestation of anxiety that creates an actual disturbance in one’s day to day life. Their thoughts are linked with intense anxiety driving them to engage in compulsive behavior — their only way out. See the wheel.

Signs and symptoms of OCD

Issues that commonly concern people with OCD and result in compulsive behaviour include:

• Cleanliness/order – obsessive hand-washing or household cleaning to reduce an exaggerated fear of contamination; obsession with order, with an overwhelming need to perform tasks or place objects, such as books or cutlery, in a particular place and/or pattern (with intense distress or distractions if this order or arrangement is disturbed)
• Counting/hoarding – repeatedly counting items/objects, such as socks/clothes or pavement blocks when they are walking; hoarding items such as junk mail and old newspapers
• Safety/checking – obsessive fears about harm occurring to either themselves or others which can result in compulsive behaviours such as repeatedly checking whether the stove/kettle/iron has been turned off or that windows and doors are locked
• Religious/moral issues – feeling a compulsion to pray a certain number of times a day or to such an extent that it interferes with their work and/or relationships

Most people with OCD know that their thoughts and compulsions are irrational. They know that just because they think something is going to happen doesn’t mean it will, and they know that acting on their compulsions won’t stop or prevent something, but they can’t risk it. This is what makes OCD so distressing for sufferers.

Treatment normally involves counseling, such as cognitive behavioral therapy (CBT), and sometimes antidepressants. CBT for OCD involves increasing exposure to what causes the problems while not allowing the repetitive behavior to occur.

An important thing to remember is that the occasional intrusive thought, even a disturbing and horrific one, is normal for every individual, even those without OCD. But if you need help, please contact you GP. OCD and mental illness can be successfully treated.

I hope this will answer some of your questions about OCD but please feel free to ask for more details or to make any comment.