What is OCD?

Obsessive Compulsive Disorder is described as an anxiety disorder. The condition has two main parts: obsessions and compulsions. An obsession is an unwanted or unpleasant thought, image or urge that repeatedly enters your mind, causing feelings of anxiety, disgust or unease. These obsessions are often frightening or seem so horrible that you can't share them with others

A compulsion is a repetitive behaviour or an act that you feel you need to carry out. The aim of a compulsion is to try and deal with the distress caused by the obsessive thoughts and relieve the anxiety you are feeling. However, the process of repeating these compulsions is often distressing and any relief you feel is often short-lived.

What Causes OCD?

There has been a range of theories and a considerable amount of research been carried out but so far scientists have not been able to identify the exact cause of OCD.

However, it is believed that OCD is most likely to be a result of a combination of factors including neurobiological, genetic, behavioural, cognitive, or environmental that can trigger OCD.

The Symptoms

Most people with OCD have both obsessions and compulsions however some people may just experience just one or the other. OCD affects people differently, but usually causes a particular pattern of thought and behaviour.

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 have left the iron on. 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.

Other common thoughts in OCD include:

  • Fear of being contaminated by germs or dirt

  • Fear of causing harm to others

  • Excessive focus on religious or moral ideas

  • Excessive attention to something considered lucky or unlucky

Compulsive Behaviours

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.

Other common compulsive behaviours in OCD include:

  • Excessive double checking of things such as locks, appliances and switches

  • Repeatedly checking on a loved one to make sure they are safe

  • Spending a lot of time washing or cleaning

  • Praying excessively or engaging in rituals triggered by religious fear

Some people with OCD may also have or develop other serious mental health problems, including:

  • Depression

  • Generalised anxiety disorder

  • Eating disorders

(for further information regarding the above condition see other sections)

Self Help

There are many ways you can help yourself if you are suffering from OCD, the first thing you can do is learn about your condition, and also learn what anxiety does to you and your body. In order to break the vicious cycle of OCD we need to change the way that you think (and think about your thoughts) and change what you do. Easier said than done!!

  • You can try to refocus your attention when you are experiencing OCD thoughts and urges and try shifting your attention to something else. Try doing something you enjoy for at least 15 minutes, you could go for a walk, jog, play a game or give a friend a call. This can delay your responses to the obsessive thought or compulsion; in many cases the urge will no longer be as intense, the longer you delay the urge the more likely it is to change.  

  • You could try writing down your obsessive thoughts, keep a notepad and pen, iPad or your phone with you and when you feel you are beginning to obsess, you can write it down.  By writing it down you can keep a track of just how repetitive your obsessions are. Also writing your thoughts down is much harder work than just thinking them, so your obsessive thoughts are likely to disappear much quicker.

  • Relaxation can also help with stress, even though stress doesn't cause OCD and a stressful event can trigger obsessive and compulsive behaviour. There are a few different types of relaxations techniques you can try such as meditation, yoga deep breathing and relaxation CD's.

  • Eating healthier and eating frequent smaller meals throughout the day also helps as going too long without eating can lead to low blood sugar, which can make you feel more anxious.

  • Regular exercise is a very effective anti-anxiety treatment that helps to control OCD symptoms by refocusing your mind when obsessive thoughts and compulsions arise.

  • Join a local support group and as this is a reminder that you are not alone. You will be able to share your experiences and learn from others who are going through the same or people who have recovered.

Treatment

Treatment for OCD depends on how much your condition is affecting your daily life. There are two main treatments for OCD:

  • Cognitive Behavioural Therapy (CBT): a therapy that aims to help you learn to change the way you think and act.

  • Exposure and Response Prevention (ERP): the Exposure in ERP refers to exposing yourself to the thoughts, images, objects or situations that make you anxious and or start your obsessions, while the Response Prevention part of ERP refers to making a choice not to do a compulsive behaviour once the anxiety or obsessions have been triggered. (This is all supervised by a therapist to begin with).

Your GP or therapist may also prescribe medication to help control your symptoms by altering the balance of the chemicals in your brain. You may be given antidepressants regardless if you have depression or not as they have shown to work well with people who suffer from OCD

Recovery

There is so much help available to help you overcome your OCD, all you have to do is to be prepared to take the help and work with it to change the habit you're stuck in.

A full recovery is possible but it will take time, lot of willpower and accept that you need to make changes to your way of thinking and behaviour. You may even relapse a few times but you must get right back to your recovery and not let if effect you too much as it can set you back and all your hard work may be lost.

NHS Choices - Obsessive Compulsive Disorder