Obsessive compulsive disorder (OCD)

Obsessive compulsive disorder (OCD)

Obsessive compulsive disorder (OCD) is a mental health condition. It causes a person to have obsessive thoughts and carry out compulsive activity.

This can be distressing and can have a big impact on your life. Treatment can help you keep it under control.

Symptoms of OCD

OCD affects people differently. It usually causes a particular pattern of thought and behaviour.

This pattern has 4 main steps:

1. Obsession – where an intrusive, distressing thought, image or urge repeatedly enters your mind.
2. Anxiety – the obsession provokes a feeling of intense anxiety or distress.
3. Compulsion – repetitive behaviours or mental acts that you feel you have to do as a result of the anxiety and distress caused by the obsession.
4. Temporary relief – the compulsive behaviour brings temporary relief, but the obsession and anxiety return, causing the cycle to begin again.

Obsessive thoughts

Almost everyone has unpleasant or unwanted thoughts at some point in their life. This might be a concern that you’ve forgotten to lock the door of the house or that you might get a disease from touching other people. It could be sudden unwelcome violent or offensive mental images.

Most people are able to put these types of thoughts and concerns into context. They can then carry on with their day-to-day life. They do not repeatedly think about worries they know have little substance.

If you have persistent and unwanted thoughts that dominates your thinking, you may have developed an obsession.

Some common obsessions that affect people with OCD include:

• fear of deliberately harming yourself or others – for example, fear you may attack someone else, even though this type of behaviour disgusts you
• fear of harming yourself or others by mistake or accident – for example, fear you may set the house on fire by accidentally leaving the cooker on
• fear of contamination by disease, infection or an unpleasant substance
• a need for symmetry or orderliness – for example, you may feel the need to ensure all the tins in your cupboard face the same way

Compulsive behaviour

Compulsions happen as a way of trying to reduce or prevent the harm of the obsessive thought. However, this behaviour is either excessive or not connected at all.

For example, a person who fears becoming contaminated with dirt and germs may wash their hands repeatedly. 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 type of compulsive behaviour is particularly common in children with OCD.

Most people with OCD realise that such compulsive behaviour is irrational. They might know it makes no logical sense, but they cannot stop acting on their compulsion.

Not all compulsive behaviours will be obvious to other people.

Related problems

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

• depression
• eating disorders
• generalised anxiety disorder
• a hoarding disorder

People with OCD and severe depression might also have suicidal feelings.

Causes of OCD

The exact cause of OCD is not known. There are some factors that could make a person more likely to have OCD.

These factors might include:

• genetics
• life events
• personality traits
• chemical differences in the brain

Diagnosing OCD

Diagnosis and treatment can help to reduce the impact of OCD on your day-to-day life.

Speak to your GP if:

• you think you might have OCD

Many people do not tell their GP about their symptoms because they feel ashamed or embarrassed. They may also try to disguise their symptoms from family and friends.

If you have OCD, you should not feel ashamed or embarrassed. Like diabetes or asthma, it’s a long-term health condition, and it’s not your fault you have it.

Your GP will probably ask you a series of questions to see if it’s likely you have OCD.

If the results of the initial screening questions suggest you have OCD, the severity of your symptoms will be assessed. Either your GP or a mental health professional will carry out the assessment.

It’s important you’re open and honest. Accurate and truthful responses will ensure you receive the most appropriate treatment.

If you think someone you know may have OCD, it’s a good idea to:

• talk to them carefully about your concerns
• suggest they speak to their GP

Treating OCD

Treatment for obsessive compulsive disorder (OCD) depends on the how much the condition is affecting your daily life.

The 2 main treatments are:

• cognitive behavioural therapy (CBT)
• medication

If your OCD has a severe impact on your daily life, you’ll usually be referred to a specialist mental health service. Here you’ll likely receive a combination of intensive CBT and a course of antidepressants called selective serotonin reuptake inhibitors (SSRIs).

Children with OCD are usually referred to a healthcare professional with experience of treating OCD in children.

It can take several months before a treatment has a noticeable effect.

Further treatment

You might be offered specialist treatment if you’ve tried other treatments and your OCD is still not under control.

Most people improve after receiving treatment.

OCD Action have online support groups where you can connect with other people with similar experiences.