Obsessive compulsive disorder (OCD) is a condition where you have recurring obsessions, compulsions, or both.
What are obsessions?
Obsessions are unpleasant thoughts, images, or urges that keep coming into your mind. Obsessions are not simply worries about your life problems. Common obsessions include:
- Fears about contamination with dirt, germs, etc.
- Worries about doors being unlocked, fires left on, causing harm to someone, etc.
- Intrusive thoughts or images of swearing, blasphemy, sex, someone harmed, etc.
- Fear of making a mistake or behaving badly.
- A need for exactness in how you order or arrange things.
These are examples. Obsessions can be about all sorts of things. Obsessive thoughts can make you feel anxious or disgusted. You normally try to ignore or suppress obsessive thoughts. For example, you may try to think other thoughts to ‘neutralise’ the obsession.
What are compulsions?
Compulsions are thoughts or actions that you feel you must do or repeat. Usually the compulsive act is in response to an obsession. A compulsion is a way of trying to deal with the distress or anxiety caused by an obsession.
For example, you may wash your hands every few minutes in response to an obsessional fear about germs. Another example is you may keep on checking that doors are locked in response to the obsession about doors being unlocked. Other compulsions include repeated cleaning, counting, touching, saying words silently, arranging and organising – but there are others.
How does obsessive compulsive disorder affect your life?
The severity of OCD can range from mildly inconvenient, to causing severe distress. You know that the obsessions and compulsions are excessive or unreasonable. However, you find it difficult or impossible to resist them.
OCD affects people in different ways. For example, some people spend hours carrying out compulsions and as a consequence cannot get on with normal activities. Some people do their compulsions over and over again in secret (like ‘rituals’). Other people may seem to cope with normal activities, but are distressed by their recurring obsessive thoughts.
Many people with OCD do not tell their doctor or anyone else about their symptoms. They fear that other people might think they are crazy. Some people with OCD may feel ashamed of their symptoms, especially if they contain ideas of harming others, or have a sexual element. As a result, many people with OCD also become depressed. However, if you have OCD you are not crazy or mad, and treatment often works.
What causes obsessive compulsive disorder?
The cause of OCD is not clear. Slight changes in the balance of some brain chemicals (neurotransmitters) such as serotonin may play a role. This is why medication is thought to help (see below). Other theories have been suggested, but none proved.
Who gets obsessive compulsive disorder?
About 1 in 100 people develop OCD. Anyone can develop OCD. However, the chance of developing OCD is higher than average in first degree relatives of affected people (mother, father, brother, sister, child). It usually first develops between the ages of 18 and 30. It is usually a chronic (persistent) condition.
What is the treatment for obsessive compulsive disorder?
The usual treatment for OCD is:
- Cognitive behaviour therapy (CBT), or
- Medication, usually with an SSRI antidepressant medicine, or
- A combination of CBT plus an SSRI antidepressant medicine.
Cognitive behaviour therapy (CBT)
What is CBT?
CBT is a type of specialist ‘talking’ treatment (a specialist psychological therapy). It is probably the most effective treatment for OCD.
Cognitive therapy is based on the idea that certain ways of thinking can trigger, or ‘fuel’, certain mental health problems such as OCD. The therapist helps you to understand your current thought patterns. In particular, to identify any harmful, unhelpful, and ‘false’ ideas or thoughts which you have. Also to help your thought patterns to be more realistic and helpful. For example, if you have OCD it may be helpful to understand that thoughts or obsessions in themselves do no harm, and you do not have to counter them with compulsive acts. The therapist suggests ways in which you can achieve these changes in thinking.
Morency Therapy provide obsessive compulsive disorder counselling for South Birmingham and Worcestershire, including Alvechurch, Barnt Green, Bromsgrove and Redditch.