Obsessive-Compulsive Disorder (OCD): Information, Symptoms, Treatment and More

Obsessive-Compulsive Disorder (OCD) is a mental health condition characterised by an individual having obsessive thoughts and compulsive behaviours. OCD can interfere profoundly with the day-to-day life of an individual.

Obsessions are unwelcome thoughts or worries that repeatedly appear. Compulsions are the subsequent (repetitive) actions that an individual does to reduce the anxiety caused by obsessions.

Unfortunately, OCD is a very misunderstood condition. The good news is that with the right treatment and support, many people will gain full remission.

OCD should not be confused with the personality disorder called Obsessive-Compulsive Personality Disorder.

What are the symptoms of Obsessive-Compulsive Disorder?

An individual with OCD will normally experience obsessive thoughts that repeatedly appear. As a result, the individual will carry out compulsive behaviours – the subsequent actions that an individual does in order to reduce the anxiety caused by their obsession:

Obsessions: An obsession is an unwanted and unpleasant thought, doubt, image or urge that repeatedly enters a person’s mind. As a result, the person experiences anxiety or general unease. Examples include fear of contamination, and a need to organise items symmetrically.

Compulsions: A compulsion is a repetitive action that the person then carries out to temporarily relieve the anxiety brought on by the obsession. Examples include rituals, checking and reassurance.

An example would be where someone who has an obsessive fear of their oven catching fire. They may spend significant time each day checking their oven is turned off, even when they know they hadn’t used the appliance.

Another example is an individual has an obsessive preoccupation with cleanliness. They may wash their hands an excessive amount each day, especially when they are about to touch something. This behaviour may seem abnormal and irrational to others.

Many people have very minor obsessions and compulsions. Examples would be to ensure their front door is locked. Unfortunately, society appears to act like some people have OCD because they like to be organised.

However, checking a door is locked and having organisation as a personality trait is very, very different to OCD. It is regrettable that in some circles, OCD is trivialised.

Someone with OCD will have their life impaired significantly by their symptoms. Their symptoms lead to behavioural changes such as:

• Disruption to life
• Struggle to attain employment
• Difficulty forming relationships
• Loneliness

This is not an exhaustive list of symptoms – with everyone experiencing OCD in different ways.

What are the causes of Obsessive-Compulsive Disorder?

It isn’t entirely known that causes OCD. However, some factors do appear to be involved with OCD developing. Often, a range of factors contribute to the onset of OCD. Other times, the cause of OCD may simply be unknown.

It appears that genetics is an important area, as OCD does have the potential to run in families. A family history of OCD puts an individual at heightened risk of developing the condition themselves [1].

Some research suggests that those with OCD may have minor differences in brain activity, with some chemicals in the brain having increased activity and others having decreased activity [2].

As with other mental health conditions, trauma can instigate OCD. People can react to things like illnesses in unpredictable ways – including to obsess over things.

Finally, personality traits such as high attention to detail, anxious, and low self-esteem are additional risk factors.

Those with OCD will often suffer from another mental health condition at the same time, such as Depression or Anxiety.

Diagnosis of Obsessive-Compulsive Disorder

It is important to see a Doctor or mental health professional if an individual believes they are suffering from OCD. If the life of an individual is being significantly affected, then it is particularly important to seek help.

At an appointment, a Doctor will ask the patient several questions about their symptoms, thoughts, feelings, and their overall wellbeing.

If a doctor believes that OCD may be present, they will often refer them to a secondary care team, who will be able to assist further.

For OCD to be diagnosed, an individual will generally fit the below criteria:

• Evidence of repetitive obsessions
• Followed by a related compulsion
• Failure to carry out a compulsion causes emotional distress
• The individual tries to ignore their obsessions
• The symptoms impact the life of the individual
• The symptoms cannot be attributed to substance abuse
• The symptoms aren’t better explained by an alternate mental health condition, or a different Obsessive-Compulsive Disorder e.g. Excoriation Disorder.

A tool called the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS) has proven useful as an additional agent that can be used to assist in diagnosis, if necessary. Once a diagnosis has been made, treatment can proceed.

How is Obsessive-Compulsive Disorder treated?

Treatment is available for OCD. The aim is for full recovery. In many instances, the patient will at least see a reduction in the impact their symptoms have on their life.

Self help

Engaging in self-help materials on the internet and doing certain things can help. Regular exercise, a healthy diet and sleeping well can often help.

Moreover, there are several discussion groups available on the internet for OCD, which can provide an individual with support, or contact with others going through similar experiences.

Talking Therapy

Talking therapy plays a crucial role in the treatment of OCD. A therapy like Cognitive-Behavioural Therapy is especially useful – due to its focus on the effect of thoughts. This is a key area in OCD. Common types of therapy for OCD include:

Cognitive Behavioural Therapy (CBT): CBT is a type of therapy that is used to treat a range of mental health conditions. CBT involves an individual talking face-to-face with a therapist, although sometimes CBT can be conducted in a group setting. CBT attempts to improve an individual’s wellbeing and mood. The therapy focuses on the link between thoughts, feelings and actions. This can be useful for those with low self-esteem, anxiety, unhelpful personality traits or intrusive thoughts. CBT can help an individual understand their feelings more, and in the long run should lead to an improvement in quality of life.

Hypnotherapy: Hypnotherapy is a form of therapy that uses hypnosis in an attempt to treat a condition. Hypnotherapy normally involves an individual being in a deeply relaxed state. The therapy also uses focused attention and concentration to induce a heightened state of awareness. This allows the patient to focus on specific thoughts or factors. Hypnotherapy will commonly involve suggestion therapy, which allows a person to be more inclined to changing behaviours (including pain management). It can also be used to explore causes of a condition or symptom. This may include events that have been hidden in an individual’s unconscious memory.

As well as the above, there are a range of other types of talking therapies available. For more information, you can see our Therapy section.

Medication

In cases where necessary, medication can be prescribed. Antidepressants can be used to treat OCD. They can help to make the intrusive thoughts seen in OCD less prominent.

Antidepressants: Antidepressants can help to improve and regulate mood. They should improve motivation and restore energy. SSRI Antidepressants are the most commonly prescribed. They act on the brain chemical serotonin – which is thought to help in regulating mood and emotion. They may include side-effects such as a dry mouth, sexual problems and nausea, though these should hopefully be short-term. Other classes of antidepressants are available in the event of an inadequate reaction.

Other

OCD can normally be treated through talking therapy, and antidepressants if deemed necessary. But in cases where a person does not respond adequately, the last line of treatment can be Neurosurgery.

But the UK’s National Institute for Health and Care Excellence does not support the use of Neurosurgery for OCD.

Summary

Overcoming OCD can be very challenging. But help is available and a full recovery is possible.

It is important for anyone with OCD, or any other mental health problem, to seek treatment. Our website has plenty of information to assist you.

See Also

• Obsessive-Compulsive Spectrum Section
• What is the Prognosis for Obsessive-Compulsive Spectrum Disorders?
• Therapy Homepage
• Medicine Homepage