What Is OCD?

Obsessive-compulsive disorder, or OCD for short, is a relatively common mental health disorder that causes a person to experience obsessive thoughts and indulge in compulsive behaviour. It is a chronic mental health condition that can be highly disabling.

The unwanted thoughts that arise are often negative and lead to irrational actions. In response to these intrusive thoughts, a person adopts behaviours and habits they believe can alleviate the obsessive thought process plaguing them and give them peace of mind. In a nutshell:

• Obsessive thoughts are repetitive thoughts or mental images that cause extreme, and often unwarranted, preoccupation or concern with something. Common obsessions are fear of contamination from germs or pathological focus on having things arranged symmetrically or put away in their exact place.
• Compulsions are the irrepressible urges a person gets to act in a certain way due to their obsessions. Common compulsions include constantly checking if the front door is locked, excessive hand washing, and endless rearranging of certain objects in a particular way.

OCD symptoms vary in intensity depending on the individual. In the most severe cases, sufferers may be unable to leave their houses or have physical contact with their families. They may struggle with the simplest actions of day-to-day life. Others suffering from OCD may lead a relatively normal existence, with their obsessions and compulsions limited to certain times of day (bedtime rituals, for example).

But whether compulsions are constant or intermittent, the unwanted thoughts that assail sufferers of OCD are relentless and cannot be resisted head-on. People can only try to find strategies to lessen their impact, hence the compulsive rituals that are the response to such obsessive thought processes. People with OCD struggle with negative thoughts, typically about situations they fear, which are almost always imagined or projected.

Not all compulsive behaviours are visible to a third-party observer. Many of the habits OCD sufferers engage in are mental. For example, they may repeat words or phrases in their mind, count compulsively in their head, or think certain thoughts on a loop, to neutralise the offending ones.

The presence of obsessive thoughts and compulsive patterns is not pathological per se. Nor are all rituals or habits compulsive in nature. Most people experience obsessive thoughts and compulsive urges at some point in their lives, or even cyclically. This alone does not constitute a diagnosis of OCD. What defines OCD is the degree to which obsessions, compulsions, and strong urges take over a person’s daily life. People with OCD usually find that:

• They have no control over and are completely at the mercy of their thoughts and behaviours. This is true even when they are fully aware their conduct is excessive.
• Obsessive-compulsive preoccupations and actions become very time-consuming, occupying at least an hour of a person’s day.
• They experience significant problems in everyday life due to their OCD.
• They don’t enjoy their compulsive rituals and, at best, gain only short-lived relief from feeling anxious.

Impact of Obsessive-compulsive Disorder on People’s Lives

The World Health Organisation lists obsessive-compulsive disorder, OCD, among the top ten most debilitating mental health disorders. It is estimated that 1 in 4 people in the UK will experience mental health problems of some kind each year. Those currently affected by OCD are evaluated at 1.2%. In reality, the number of people with OCD is undoubtedly at least double that. OCD is sometimes dubbed the secret illness because many suffer in silence. They may go to great lengths to hide their symptoms and be reticent to talk about their disorder, even with family members and friends.

OCD can negatively impact many or even all areas of a person’s life. Family life, work life, and social relationships can all be severely disrupted by somebody’s OCD. Below are examples of how OCD interferes with normal living.

Education

OCD symptoms often appear in adolescence or during early adulthood. This is the time of life when most young people are at the height of their education. OCD can interfere with schooling in many ways. Pupils may feel anxious around their classmates lest their compulsions are found out. They may have difficulty with basic study tasks like reading or writing because urges such as endlessly re-reading or re-writing certain passages may take over. Their symptoms may also interfere with concentration.

Work Life

OCD can make regular employment challenging. Anxiety about fitting in – with colleagues and a set work timetable – can worsen OCD symptoms. Some degree of stress is inherent to most work environments, but for people with OCD, it can be a trigger. Their compulsions may prevent them from focusing properly on their work, meeting deadlines, or doing things a certain way. Intrusive thoughts may completely interrupt the working day. In severe cases, a person may be unable to work at all – which then affects their income and livelihood.

Social Activities

Many people with an OCD disorder suffer from social anxiety. This is partly because there is much that is unpredictable in socializing and beyond their control. They find it difficult to mingle and have trouble enjoying social occasions. Even simple things like going for a meal can be complicated, as they may have an obsession with food and how to eat. The components of the meal may need to be arranged in a certain way on the plate, by size or colour, and eaten in a specific order. Small talk may also be challenging.

Family

It is an unfortunate fact that family life also suffers when a family member has OCD. A person’s mental health can be affected to the point where an obsession – with hygiene, for example – means they cannot even touch other family members or their own children. Needless to say, OCD can make intimate relationships complicated too.

Treatment

OCD treatment revolves around a few key approaches, namely therapy and sometimes medication. The support of family and friends who understand the condition is also considered very beneficial for managing the disorder in daily life.

Psychotherapy

Psychological approaches, in particular, behavioural therapies such as CBT (cognitive behavioural therapy), aim to help individuals resist the urge to turn away from their fears or alleviate them using their go-to compulsive rituals. People who have OCD easily slip into avoidance of things or situations that trigger their symptoms. Behavioural therapy encourages them not to do this and to learn to react differently instead. And it aims to suggest alternative responses to challenges and stressful life events.

Anxiety Management and Relaxation Techniques

Anxiety is central to any diagnosis of OCD, and those with OCD experience anxious feelings on a daily basis. Techniques that help people manage their anxiety levels and also their stress are useful in weakening the main causes of their symptoms. Support groups and group therapy can help nurture beneficial relationships with others struggling with mental illness.

Medication

Not all doctors prescribe medicine as a form of treatment. While it is true that certain medications, such as serotonin reuptake inhibitors (SSRIs), can help reduce symptoms, they do not address the root causes of OCD and therefore do not produce lasting effects.

However, when symptoms of OCD are very severe, appropriate prescribed drugs may improve a person’s quality of life.

OCD and Other forms of Mental Illness

OCD may put people at higher risk of depression and anxiety. Since anxious feelings are inherent to the condition, treating OCD can also mean addressing this aspect of a person’s mental health.

OCD, anxiety disorder and depression are often co-occurring; that is, they are diagnosed as being present simultaneously. However, the exact causal link between them can be complicated to establish precisely, as it depends on the individual and can change over the course of time.

A feeling of powerlessness in the face of relentless symptoms can also contribute to making people feel depressed. The temptation can then be to resort to alcohol, or even drugs, to self-medicate.

The causes of OCD are not fully understood. Genetic predisposition may be a contributing risk factor, as can brain chemistry. Low serotonin levels or unusually high activity in some areas of the brain may also explain obsessive and compulsive tendencies.

The Revoke Programme offers innovative and highly specialised outpatient health care services. We offer evidence-based therapies for most behavioural and mental health concerns, delivered with care and compassion by our experienced, qualified staff. We understand your struggles and aim to help you achieve optimal well-being. Please contact us to find out how we can be of assistance.