Obsessive Compulsive Disorder (OCD)

Who is affected?

It's estimated around 12 in every 1,000 people in the UK are affected by the condition. This equates to almost 750,000 people. OCD affects men, women and children. The condition typically first starts to significantly interfere with a person's life during early adulthood, although problems can develop at any age.


Introduction 

Obsessive compulsive disorder (OCD) is a mental health condition where a person has obsessive thoughts and compulsive activity. 


An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters a person's mind, causing feelings of anxiety, disgust or unease. A compulsion is a repetitive behaviour or mental act that someone feels they need to carry out to try to temporarily relieve the unpleasant feelings brought on by the obsessive thought. For example, someone with a fear of their house being burgled may feel they need to check all the windows and doors are locked several times before they can leave the house.


OCD symptoms can range from mild to severe. Some people with OCD may spend an hour or so a day engaged in obsessive-compulsive thinking and behaviour, but for others the condition can completely take over their life.

Symptoms of OCD

Obsessive compulsive disorder (OCD) affects people differently, but usually causes a particular pattern of thought and behaviour.


This pattern has four main steps:


  • obsession – where an unwanted, intrusive and often distressing thought, image or urge repeatedly enters your mind
  • anxiety – the obsession provokes a feeling of intense anxiety or distress
  • compulsion – repetitive behaviours or mental acts that you feel driven to perform as a result of the anxiety and distress caused by the obsession
  • temporary relief – the compulsive behaviour brings temporary relief from anxiety, but the obsession and anxiety soon return, causing the cycle to begin again


Obsessive thoughts


Almost everyone has unpleasant or unwanted thoughts at some point in their life, such as a concern that they may have forgotten to lock the door of the house or that they may contract a disease from touching other people, or even sudden unwelcome violent or offensive mental images.


Most people are able to put these types of thoughts and concerns into context, and they can carry on with their day-to-day life. They do not repeatedly think about worries they know have little substance.


However, if you have a persistent, unwanted and unpleasant thought that dominates your thinking to the extent it interrupts other thoughts, you may have developed an obsession.
Some common obsessions that affect people with OCD include:


  • fear of deliberately harming yourself or others – for example, fear you may attack someone else, even though this type of behaviour disgusts you
  • fear of harming yourself or others by mistake or accident – for example, fear you may set the house on fire by accidentally leaving the cooker on
  • fear of contamination by disease, infection or an unpleasant substance
  • a need for symmetry or orderliness – for example, you may feel the need to ensure all the labels on the tins in your cupboard face the same way


Compulsive behaviour


Compulsions arise as a way of trying to reduce or prevent the harm of the obsessive thought. However, this behaviour is either excessive or not realistically connected at all.


For example, a person who fears becoming contaminated with dirt and germs may wash their hands repeatedly throughout the day, or someone with a fear of causing harm to their family may have the urge to repeat an action multiple times to try to "neutralise" the thought of harm. This latter type of compulsive behaviour is particularly common in children with OCD.


Most people with OCD realise that such compulsive behaviour is irrational and makes no logical sense, but they cannot stop acting on their compulsion.


Some common types of compulsive behaviour that affect people with OCD include:


  • cleaning and hand washing
  • checking – such as checking doors are locked, or that the gas or a tap is off
  • counting
  • ordering and arranging
  • hoarding
  • asking for reassurance
  • repeating words silently
  • extensively "overthinking" to ensure the feared consequence of the obsession does not occur – for example, if you fear you may act violently
  • thinking "neutralising" thoughts to counter the obsessive thoughts
  • avoiding places and situations that could trigger obsessive thoughts


Treatments for OCD


With treatment, the outlook for OCD is good. Many people will eventually be cured of their OCD, or their symptoms will at least be reduced enough that they can enjoy a good quality of life.

OCD is indeed a chronic, but equally a very treatable, medical condition. The treatment found to be the most effective in successfully treating OCD is Cognitive Behavioural Therapy (CBT). In many cases, CBT alone is highly effective in treating OCD, but for some people a combination of CBT and medication is also effective.  Medication may reduce the anxiety enough for a person to start, and eventually succeed in therapy.

However what we know is that left unchecked and untreated OCD will mushroom and feed upon itself and can have the power to consume if left unchallenged. 

Just as a person with some types of diabetes can learn to manage the disease by changing their diet and exercise habits, a person with OCD can learn to manage symptoms so they don’t interfere with daily functioning and allow them to regain a much improved quality of life.  For some people it is even possible to achieve complete recovery from OCD.