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."
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