What Is OCD?
Obsessive-Compulsive Disorder (OCD) is a common form of anxiety disorder. With OCD a person has uncontrollable, reoccurring thoughts (obsessions) and behaviours (compulsions) that they feel the urge to repeat over and over.
People who have OCD have uncontrollable thoughts that cause them anxiety. This urges them to check things repeatedly or perform routines and rituals. Performing these routines or rituals may bring about a brief but temporary relief from the anxiety.
Left untreated, these thoughts and rituals can cause the person great distress and get in the way of work, school, and personal relationships. OCD affects men, women and children. It can start in puberty but is more likely to start in early adulthood.
The DSM V (Diagnostical Statistical Manual 5) classifies personality disorders in clusters. OCD is classified under Cluster C, which includes Dependent Personality disorder and Avoidant Personality disorder.
What Are The Symptoms Of OCD?
People with OCD experience frequent obsessive thoughts and compulsive behaviours. An obsession is described as an unwanted and unpleasant thought, image or urge that repeatedly enters your mind. These cause feelings of anxiety, disgust or unease.
While a compulsion is described as a repetitive behaviour or mental act that you feel you need to carry out to try to temporarily relieve the unpleasant feelings brought on by the obsessive thought. OCD affects different people in different ways, it usually causes a particular 4 step pattern of thoughts and behaviours.
- Obsession enters your mind.
- This then provokes a feeling of intense anxiety or distress.
- The person then feels driven to perform repetitive behaviours or mental acts – obsession.
- This, in turn, provides temporary relief but the obsession and anxiety soon returns and the cycle begins again.
It’s possible to just have obsessive thoughts or just have compulsions. But most people with OCD will experience both. It should also be noted that some people with OCD may also develop a tic disorder.
Common obsessions may include:
- Fear of germs or contamination
- The fear of losing or misplacing something
- Worries about harm coming towards oneself or others
- Unwanted and taboo thoughts involving sex, religion, or others
- A need for symmetry or orderliness
As I’ve said the compulsions arise as a way of trying to reduce or prevent anxiety caused by the obsessive thought. Although in reality this behaviour is either excessive or not realistically connected.
Common compulsions may include:
- Excessively cleaning or washing a body part
- Keeping or hoarding objects
- Ordering or arranging items
- Repeatedly counting items
- Constantly seeking reassurance
- Checking things such as checking doors are locked or that the gas is off
- Repeating words in their head
- Thinking “neutralising” thoughts to counter the obsessive thoughts
- Avoiding places and situations that could trigger obsessive thoughts
Not all compulsive behaviours will be obvious to other people.
Other Possible Co-Conditions
Some people with OCD may also develop other mental health problems. These can include, but are not limited to,:
- Depression including suicidal feelings
- Eating disorders – Anorexia; Bulimia; BED (Binge Eating Disorder)
- Generalised anxiety disorder
- A hoarding disorder
What Causes OCD?
No one knows exactly why OCD occurs. It is thought OCD may have a genetic component. OCD may also occur in people who have suffered physical or sexual trauma. It has also developed in children after a Paediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcal Infections (PANDAS).
As I’ve already said OCD usually begins in puberty or young adulthood. Although it can affect males and females, it also tends to appear at a younger age in boys than in girls.
How Is OCD Treated?
If left untreated OCD will not get better. But please note that it is a very treatable condition. When people receive the right treatment they will be able to have the life they want.
The first step is to talk to your GP about your symptoms to make sure nothing physical is causing them. Your GP should then be able to refer you for further evaluation and treatment.
OCD is generally treated with cognitive behaviour therapy (CBT), exposure and response prevention (ERP, a specific form of CBT), and/or medication if required. Treatment should always be tailored to your specific needs. It may take time to see some results, so please be patient with yourself during this time.
CBT will teach you different ways of thinking, behaving, and reacting to the obsessions and compulsions. The ERP involves gradually exposing you to your fears or obsessions and teaching you healthy ways to deal with the anxiety. Group therapy may also be suggested. As this provides support and encouragement while decreasing your feelings of isolation.
Family Therapy
OCD can often cause problems in family life. So family therapy may be offered also. This kind of therapy can help promote understanding among the family members. Plus build better lines of communication, aid other family members in helping you with OCD and reduce family conflicts.
Self-help For Those With OCD
Always note: Only use self-help in conjunction with other treatments, not in lieu of.
Some Basics First.
- Seek help from your GP (main doctor) and get referred to a psychologist for treatment.
- If you have any further mental health issues bring them up so you can receive the correct treatment for these also.
- Reduce your stress levels (see suggestions here). This is vital for your recovery, as stress will only hinder any recovery process. Make self-care your priority now.
- Keep a journal. Pen & paper or online whichever suits you best. Write down all your thoughts, no matter how often you get them the same ones. Keep writing it all down until it subsides. This will also help you to begin to explore patterns of thoughts with your therapist. You can also start to challenge these thoughts in a more logical manner when you see them written in front of you. When we do this we begin to regain our power back from them. Journals will also help reduce your stress and aid you sleep better.
- Try to ensure you are getting a good night’s sleep (see suggestions here)
- Make sure to eat at least 3 meals a day. But if this is too much, break it down into smaller more regular meals.
- Take some form of exercise, even a small daily walk will help to start with.
- Avoid alcohol and nicotine. Both will make your anxiety worse.
- Make sure you are setting healthy boundaries (you, your relationships including work, school or college). If you do not set healthy boundaries it will only cause further anxiety and stress to arise in your life.
Reducing your stress and anxiety as much as possible should be a priority for you now to aid your recovery.
Ideas You Can Try Also.
- If your therapist agrees, create a worry period. Rather than try and suppress obsessions or compulsions try and develop a habit of rescheduling them. So set aside a time and a place (not near bedtime) to let all your worries etc, come up. Don’t challenge them during this period but do set a time limit. You can use an alarm on your phone. Write them all down and then at the end go over what has come up. Make sure to incorporate a meditation at the end of this worry period. Maybe a 2/3 minute breather.
Now the rest of the day should be designated OCD free. You will need to discuss this with your therapist further and it will take time to build up to a one a day slot. At the start, it may be a once per hour slot, but be patient with yourself, you can do this.
There is a similar technique using a recording of your thoughts and then listening to the obsession until it no longer causes you to feel highly distressed. By continuously confronting your worry or obsession you will gradually become less anxious. You can then repeat the exercise for each different obsession or worry.
2. Join a support group. Reach out to family and friends also. OCD can be very isolating so this support is vital. Support groups are also important for family and friends, especially parents if your child has OCD.
Also, find out all you can about OCD and how it affects you. Your therapist should be able to help with this as well as national organizations for OCD. Remember information is empowering and it will aid you in your recovery. (see links to national organisations below)
When children or young people have OCD, it’s important for parents to work with their teachers to be sure that they too understand the problem. So make sure you (the parent) understand your child’s OCD and any recommendations to help from the therapist or other professionals involved in your child’s treatment.
Helping A Friend Or Loved One With OCD
The way you react to your loved one’s OCD symptoms can have a big impact on their outlook and recovery. Negative comments or criticism can make OCD worse. While a calm, supportive environment can help improve the outcome of treatment.
Family or individual therapy is hugely beneficial for you also. So please ask for some help yourself especially if you feel you are struggling too.
So how can you help:
- Avoid making personal criticisms. OCD behaviours are symptoms, not character flaws.
- Don’t scold or tell them to stop performing rituals. They can’t comply and it will make the behaviour worse.
- Try to be as kind and patient as possible. Praise any successful attempts. Focus on the positive in the person and remember each person will recover in their own time and at their own pace.
- Do not join in with rituals. This will only reinforce the behaviour. Support the person instead.
- Be clear and positive in any communication. Communication is important in any relationship, but you shouldn’t have to walk on eggshells either. If you find your relationship has suffered as a result please seek couple counselling or family therapy as soon as possible.
- Find the humour. The use of laughter can be a good de-stressor for everyone. But make sure the person with OCD is willing to join in too and still feels respected. Laughing together over the funny and absurdity of some OCD symptoms can help your loved one become more detached from the disorder.
- Don’t let OCD take over family life. Again I’d recommend family therapy to help you all cope. Sit down as a family and decide how you will work together. Try to keep family life as normal as possible and the home as a low-stress environment for everyone.
Helpful Organisations
Please check other OCD support where you live. They will have a wealth of knowledge and support available for you.
Work With Me.
We need time to come to terms with diagnosis and extra support can help. If you need extra support then you can also work with me. We all struggle with stress and overwhelm from time to time. If you find this has become a problem for you and you’d like some support then schedule an appointment with me.
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