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The Royal College of Psychiatrists Improving the lives of people with mental illness

Mental Health and Growing Up Factsheet

Obsessive-Compulsive Disorder(OCD): factsheet for young people

ocd illustrationAbout this leaflet

This is one in a series of factsheets for parents, teachers and young people entitled Mental Health and Growing Up. This factsheet looks at some of the reasons why obsessions become compulsions and offers advice.

 

 

What is Obsessive-Compulsive Disorder (OCD)?

The word ‘obsessive’ gets used commonly. This can mean different things to different people. Obsessive compulsive disorder (OCD) is a type of anxiety disorder. In this condition, the person suffers from obsessions and/or compulsions that affects their everyday life, like going to school on time, finishing homework or being out with friends.

 

What are the symptoms?

An obsession is a thought, image or urge that keeps coming into your mind even though you may not want it to. An obsession can be annoying, unpleasant or distressing and you may want it to go away. An example of an obsession is the thought that your hands are dirty even though they are not. Different people have different obsessions.

 

Here are some examples:

 

  • fears about dirt and spreading disease
  • worrying about harm happening to you or someone else
  • fearing that something ‘bad’ may happen
  • worrying about things being tidy
  • worrying about having an illness.

Having an obsession often leads to anxiety or feeling uncomfortable and you may then have the urge to ‘put it right’. This is where compulsions come in.

 

Compulsions are things you feel you need to do usually to control your ‘obsessions’, even though you may not want to. You might even try to stop doing them, but this might not be possible.

 

Often, a compulsion means doing something again and again, as a ‘ritual’. By doing the compulsion you feel you can prevent or reduce your anxiety about what you fear may happen if you don’t do it. For example, turning the light on and off 20 times because you worry something bad may happen if you don’t.

 

Different people have different compulsions. Some examples include:

 

  • washing
  • checking
  • thinking certain thoughts
  • touching
  • ordering/arranging things or lining things up
  • counting.

Individuals who have these problems often try to avoid any situation that might set off obsessive thoughts (e.g. not using hands to open doors). When obsessions and compulsions take up a lot of your time, interfere with your life and cause you distress, it becomes obsessive-compulsive disorder (OCD).

 


Who does OCD affect?

OCD is common and can affect people of all ages irrespective of their class, religion or gender.

 

What causes OCD?

We do not know the cause of OCD for certain. However, research suggests that OCD may be due to an imbalance of a brain chemical called ‘serotonin’. It is likely that there may be someone in your family who has similar disorder (OCD) or have tics (jerky movements).

 

Sometimes the symptoms seem to start after a specific type of infection (cough and cold). It can also occur after a difficult time in your life like having an accident.

 

How is it treated?

There are psychological treatments and medications available to treat OCD.

 

One of the helpful psychological or talking treatments for OCD is cognitive behavioural therapy (CBT) that includes exposure and response prevention (ERP). CBT is a psychological approach that is effective in treating young people with OCD (see our factsheet on OCD).

 

In OCD people often think that by avoiding a certain situation or doing the ritual/compulsion helps to keep the worry (obsession) away or come true. However, this does not help the worry to go away. In the treatment for OCD, the therapist would help you to understand this reality and also teach you ways to face the worry rather than running away from it.

 

Eventually this helps to get rid of your obsessions and the compulsions.

In ERP the therapist helps you to facing the things that you fear and that you have been avoiding. They then help you to stop responding in your usual way (like not letting you wash hands when you worry it is dirty). To help you fight OCD, you will be taught a wide range of skills to manage the anxiety that OCD creates. This helps you to learn strategies to control the OCD rather than it controlling you.

 

Sometimes therapist may suggest someone in your family to be involved during the therapy.

 

When OCD is severe or you struggle to do the psychological treatment, you may need medication. This is usually given to help along with you trying the CBT.

 

Medication can help you get the most out of the psychological treatment.


How is it treated? There are psychological treatments and medications available to treat OCD.

 

One of the helpful psychological or talking treatments for OCD is cognitive behavioural therapy (CBT) that includes exposure and response prevention (ERP). CBT is a psychological approach that is effective in treating young people with OCD (see our factsheet on OCD).

 

In OCD people often think that by avoiding a certain situation or doing the ritual/compulsion helps to keep the worry (obsession) away or come true. However, this does not help the worry to go away. In the treatment for OCD, the therapist would help you to understand this reality and also teach you ways to face the worry rather than running away from it. Eventually this helps to get rid of your obsessions and the compulsions.

 

In ERP the therapist helps you to facing the things that you fear and that you have been avoiding. They then help you to stop responding in your usual way (like not letting you wash hands when you worry it is dirty). To help you fight OCD, you will be taught a wide range of skills to manage the anxiety that OCD creates. This helps you to learn strategies to control the OCD rather than it controlling you.

 

Sometimes therapist may suggest someone in your family to be involved during the therapy.

 

When OCD is severe or you struggle to do the psychological treatment, you may need medication. This is usually given to help along with you trying the CBT. Medication can help you get the most out of the psychological treatment.


 

How can I get help?

It is important to seek help early and remember that having OCD does not mean you are ‘mad’ and ‘losing control’.

 

If you are worried about yourself, you should talk to someone you trust such as your parents or carers, or a teacher. A lot of adults with OCD never got any help for their problems when younger, and now wish they had.

 

Your GP or school nurse can give you advice and help you get specialist help from the child and adolescent mental health service (CAMHS). They will talk with you in order to understand the difficulties you are experiencing.

 

It can be hard or embarrassing to discuss the details of their obsessions or compulsions. But giving as much detail as possible will help the therapist or psychiatrist to give you the right treatment. If your life has become severely affected by OCD, you may also need help from other professionals for example, teachers to help you get back to ordinary life at school or college.


 

John, 18,  writes about his OCD

"It started without me really noticing it. I got anxious about someone in my family dying – so I began to tap three times, when I got worried, for good luck and that would calm me down. Then I had to do it before I could go to sleep at night –not once but 3 x 3.

When I watched the programme on TV about those germs in hospital it began to get worse. I couldn’t tell my Mum or Dad about it because it sounded so silly. I had to wash my hands all the time because I thought I would pass on an infection and someone would die. It was mainly at home, but then I began to worry that I would catch something at school.

I made my Mum wash my school uniform every day. She tried to say no, but I would get so worked up that she would give in. It came to a head when I couldn’t get to school on time because I was spending hours in the bathroom in the morning. I had to wash my hair three times as well as going through washing in a set order. If I was interrupted because someone needed the bathroom, I had to start again.

Mum got me some help. I didn’t want to be seen as some psycho person, but Dr Roberts was really nice and understood why I was so worked up about everything. That was when I was 14. Now I am 18. It was hard work doing the therapy. It is called CBT. You have to try and work out why you are so anxious and try and control it. Now I am at College and doing a course that I like. I still do some counting, but I can keep it under control."

 

Further info

Epic friends - Mental health problems are common. This website is all about helping you to help your friends who might be struggling emotionally.

OCD Action - National charity for people with OCD.

OCD Youth info - A website written by and for young people with OCD, giving information on the disorder and its treatments.

OCD UK - OCD-UK is the charity dedicated to improving the mental health and well-being of almost one million people in the UK whose lives are affected by Obsessive-Compulsive Disorder.


Further reading

NICE guidance written for patients and carers, CG31, Core interventions in the treatment of obsessive-compulsive disorder and body dysmorphic disorder (2005).

 

 

References

Naomi Fineberg and Angus Brown (2011). Pharmacotherapy for obsessive–compulsive disorder, Advances in Psychiatric Treatment, 17:419-434.

 

David Veale, (2007). Cognitive–behavioural therapy for obsessive–compulsive disorder, Advances in Psychiatric Treatment, 13:438-446.

 

National Institute for Healtth and Clinical Excellence: CG31, Core interventions in the treatment of obsessive compulsive disorder and body dysmorphic disorder, 2005.


Revised for the Royal College of Psychiatrists’ Child and Family Public Education Editorial Board.

Series Editor: Dr Vasu Balaguru

With grateful thanks to Dr Kashmeera Naidoo and Dr Vasu Balaguru.

 

This leaflet reflects the best possible evidence at the time of writing.

© March 2012. Due for review March 2014. Royal College of Psychiatrists.

 


Please note that we are unable to offer advice on individual cases. Please see our FAQ for advice on getting help.

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