Obsessive compulsive disorder (OCD) is characterised by the frequent presence of intrusive thoughts (obsessions) and compulsive behaviours or acts (compulsions). It can be misunderstood and related back to the idea of a person who likes to have things organised. OCD is in fact primarily an anxiety disorder characterised by the fear of something bad happening and the person being responsible.
The experience of unwanted and intrusive thoughts cause significant anxiety because of how the thoughts are appraised, which in turn causes compulsive behaviours. For example, if someone is worried that they haven’t switched off the oven before leaving the house, they may return home multiple times to check this. The anxiety caused by the fear of accidentally causing damage to themselves or others can be distressing and result in the person feeling compelled to complete checking behaviour to relieve this anxiety. However, the alleviation of these symptoms is usually short lived in those with OCD.
The specific symptoms of OCD and how they manifest differ between individuals, although there are some more common symptoms:
Obsession
Where an unwanted, intrusive and often distressing thought, image or urge repeatedly enters your mind. Most of us will experience unwanted thoughts from time to time. When this pattern of thinking causes persistent, unpleasant thoughts which start to interrupt your usual train of thought, this is when it starts to become disruptive and distressing for the individual.
Common obsessions usually focus around a fear of deliberately or accidentally harming yourself or others, fear of contamination by disease or infection, or fear of or a need for symmetry or orderliness.
Anxiety
The obsession provokes a feeling of intense anxiety or distress. To read more about symptoms of anxiety please click here (link to anxiety condition page).
Compulsion
Repetitive behaviours or mental acts that you feel driven to perform as a result of the anxiety and distress caused by the obsession. Compulsions arise as a way to reduce or prevent the anxiety caused by obsessions. For example an individual who fears contamination may repeatedly wash their hands. Most individuals with OCD realise that this behaviour is irrational, but many do it anyway just in case.
Some common types of compulsive behaviour are:
Temporary relief
The compulsive behaviour temporarily relieves the anxiety, but the obsession and anxiety soon return, causing the cycle to begin again.
Some individuals with OCD may only have compulsions or obsessive thoughts, but most will experience both.
If you think you or someone you know may be struggling with OCD, it is important to talk to someone about it. You can refer yourself to your local psychological therapies service privately or through the NHS service finder here. You can also speak to your GP about any concerns. They will likely ask a few more questions about your symptoms and can refer you to psychological therapy if required. In addition to this, you can talk to charities such as OCD action to find out more information or how you may be able to get support.
OCD differs in its severity and intensity. There are effective treatments for OCD. If it is impacting your life, it is unlikely to improve on it’s own, and treatment or support can help you to better manage your symptoms. The treatments prescribed for OCD usually depend on how much it is affecting you and your ability to cope with day to day life.
The two main forms of treatment are psychological therapy and medication. Psychological therapy for OCD usually focuses on a combination of cognitive behavioural therapy (CBT) and exposure and response prevention (ERP). CBT and ERP usually involve identifying intrusive thoughts and the meaning attached to these, and identifying compulsive behaviours and acts. Once you have an understanding of your OCD and what is maintaining it, your therapist will support you to work towards sitting with your anxiety and reducing your compulsive behaviours allowing you to re-examine your appraisals. The process is usually staged, and starts with the situations which cause you least anxiety first. If psychological therapy alone is not enough, you may also be prescribed an SSRI which is an antidepressant medication. When taken consistently these should help you to manage your symptoms.
