OBSESSIVE COMPULSIVE DISORDER
Of all the anxiety disorders you may be aware of, Obsessive Compulsive Disorder (OCD) is often the most quoted, yet most misunderstood mental health condition. As obvious as it might seem given its name, OCD breaks down into two aspects; an obsession and a compulsion. Together they form an anxiety disorder known as OCD.
Here, you can find out everything you wanted to know about OCD (or at least we hope so!). You can click (or touch) each of the headings below to find out more about specific aspects of the condition.
We hope you find the information useful and if you do, please feel free to share it. If there’s anything you feel needs looking at or adding, let us know that too.
WHAT IS OCD? . . .
You might think that, like many other mental illnesses, it's normal to become anxious over certain things. You may believe that most people would get naturally anxious if they, for example, thought they hadn't locked their front door when they've left for work and, to some degree, you'd be right. The difference is that 'most people' would be able to put their fears into context. People with OCD don't have that luxury.
They will repeatedly worry about something, so much so that it will eventually impact on their whole day, and it soon becomes an obsession. Obsessions can be fairly small details, or they can be much more serious. People with OCD may, for example, repeatedly wash their hands, insist on the need to have food labels all facing the same way or repeatedly checking appliances before they leave the house.
When it comes to compulsions, these become acts (or rituals) that are carried out in response to the fears that their obsessions can bring. Using the examples above, if the obsession is repeatedly washing their hands, this maybe from a fear of catching a disease through bacteria. If appliances need to be switched off, this can be because they believe the appliance may catch fire. Once the compulsion has been carried out, the anxiety can be temporarily eased, but no pleasure will be gleamed from it and the need to do it again soon reappears. They get stuck in an endless, often debilitating, cycle of obsessive thought which in turn leads to anxiety which then leads to compulsive behaviour which leads to relief (albeit temproary) before it starts again.
Those living with OCD may share similar themes when it comes to their obsessions and compulsions. These include washing and cleaning (but again, it's not only those), counting, orderliness, following strict routines they believe will help and checking (and rechecking) doors, locks, light-switches, etc. Many will agree that their obsessions and / or compulsions don't make sense, but simply can't help themselves from doing so.
Despite what you might have heard, you can't be 'a little bit OCD'. You can't be a little bit 'obsessive' or a little bit 'compulsive'. OCD is a serious condition that can't be summed up in one flippant, throw-away line.
WHAT CAUSES OCD? . . .
Whilst there are has been quite a lot of research into OCD, scientists are still to identify one true cause. They many never do so. It has been suggested that OCD is a genetic condition and that the passing on of certain inherited genes may affect the development of the brain, although no specific genes have been identified.
It has been observed that some (but not ALL) of those with OCD have different brain patterns than other people. Studies have shown that some people with OCD have increase brain activity and blood flow in particular areas, and also lack a chemical called serotonin, a neurotransmitter responsible for regulating some of the body's functions including mood, anxiety and memory. These areas of the brain are those that deal with strong emotions and how we respond to them. This can be alleviated by CBT or SSRI medication.
OCD may be prevalent (although there is no concrete evidence) in those with a history of emotional, physical or sexual abuse. This can include social isolation, teasing or bullying. Some believe that stressful life events, i.e. the death of a family member, may trigger OCD symptoms. The thinking is that if, for example, a close relative dies, you may begin to fear for the safety of other living relatives. Similarly if you become seriously ill, the fear of future infections can trigger symptoms. While stress can make OCD symptoms worse, it doesn't cause the condition in itself.
OK, BUT DO MEN GET IT? . . .
In a word, Yes. In lots of words, then it's never quite that simple (is it ever!). OCD affects around 12 in every 1000 people, split pretty much equally down gender lines. There are no obvious differences in terms of race, ethnicity or social background.
Of course, men can be affected by OCD, just as much as women, but there is never any conclusive evidence as to why it occurs (see above). That said, some studies have shown that there are gender differences with various aspects of OCD.
As with many mental illnesses, more women than men are diagnosed, generally, because, well, you know. men and the whole 'I'm fine' thing. Men tend to have the condition diagnosed at an earlier age than women (generally between the ages of 8 - 12). This can mean that treatment for it is more specific. Obsessions with contaminants seem to be more prevalent in women, but men tend to display a higher degree of hoarding and sexual obsessions. The stereotypical obsession with cleanliness affects females more than males.
WHAT ARE THE SYMPTOMS OF OCD? . . .
OCD symptoms tend to appear gradually and get worse over time, to the point where it can be completely debilitating. As you may expect, most of those with OCD exhibit symptoms that are both obsessive and compulsive, but this isn't necessarily always the case.
Some people do only display obsessive symptoms whilst others can have only compulsive symptoms. Around a third of those with OCD also have a condition that involves sudden, intermittent movements or sounds which only happen briefly, but can be embarrassing for them.
For the sake of this page, we're going to break the symptoms down into two separate sections, but please bear in mind that those with OCD may exhibit both sets of symptoms.
Obsessions, in regard to OCD, are repeated, persistent or unwanted behaviours and thoughts that cause distress and / or anxiety. They often occur when you are trying to think about or do other things, they overtake your train of thought and are difficult to ignore. These obsessions aren't, as many people believe, always motivated by cleaning, although that does occur.
Obsessions can be quite benign, but can occasionally be frightening and sometimes so horrible that people are unwilling to share them with others. They include:
- Fear of being contaminated when coming into contact with other people.
- Doubting that you have locked the door or turned off electrical equipment when leaving the house.
- High levels of stress when things aren't ordered as you like them.
- Images of hurting yourself or other people.
Avoiding situations that will trigger your obsessions, i.e. shaking hands with people or touching things used in communal areas.
Compulsions are repeating behaviours that you feel driven to perform. They will be designed to reduce your anxiety levels or prevent a situation you fear. OCD sufferers can create rituals that they believe will control their anxiety for a short period, but often don't.
- Symptoms of compulsive behaviour include:
- Washing your hands so often that your skin becomes raw.
- Repeatedly checking doors, lights or on/off switches to make sure they're safe.
- Counting in certain patterns.
- Repeating a saying or phrase over and over again to yourself.
Like any illness, mental or physical, there are specific signs (3 in this case) that need to be present before a diagnosis can be performed. It probably won't suprise you to learn that there are:
- That a person has obsessions.
- That a person is displaying compulsive behaviours.
- Finally, that those two things are taking up a lot of their time and stopping them doing important tasks that are valued (e.g. going to work, socialising, etc).
WHAT TREATMENTS ARE AVAILABLE? . . .
The most effective treatment for OCD tends to be a form of CBT (Cognitive Behaviour Therapy), called Exposure and Response Prevention (ERP).This will need to be carried out by a trained mental health professional.
Some people also use medication to manage their symptoms either in conjunction with therapy or instead of. Medication for OCD will be known as Selective Serotonin Reuptake Inhibitors (or SSRIs).
The balance, if there is one to be had, will be based on an individuals own unique circumstances. There are some things that you can do to help ease the symptoms including exercising regularly, getting enough sleep, staying away from alcohol and smoking and practising various relaxation techniques like meditation, yoga, breathing exercises, etc.
WHAT CAN BE DONE TO HELP SOMEONE WITH OCD? . . .
First things first. If you need (or want) to help someone with OCD, then there is one simple rule to follow, you have to look after you too. Helping someone with any mental illness can be an emotional rollercoaster for you and them, so make sure you understand your own capabilities. It will require patience, so make sure you have some. It'll also be challenging for you both, but you can do it.
First thing to do is learn all you can about the condition. As good as we like to think our guides are, they are only meant to be a jumping off point, so do some research and read as much as you can. The more you know about any mental illness, the better placed you are to help them navigate it. It's also important to be able to recognise the symptoms of OCD. Far too often people think it's just about cleaning. It isn't. The symptoms can differ from person to person, so keep an open mind to what you think OCD is and don't think you can treat it yourself.
Naturally, everyone will be at a different place in terms of their own OCD journey, so if the condition is currently undiagnosed, then support them in seeking professional help. That could be as simple as accompanying them to the Doctor, or self-referring to therapy (if apppropriate).
If you suffer with OCD, there may be some organisations on our Where To Turn pages that can help you. If not, and you know of one, please let us know and we'll look into it.
Also, if you'd like to share your experiences of living with OCD with our community so they can better understand how it feels, please take a look at our 'Men Tell' section.