Obsessive Compulsive Disorder
Maybe you’re superstitious and your friends tease you gently about having to knock on wood. Maybe you like to keep your home as shiny as a new pin, and feel uncomfortable if things are out of place. But when does habit end and obsession begin?
What is Obsessive Compulsive Disorder?
You have Obsessive Compulsive Disorder, or OCD, if you have one or both of:
- Obsession (distressing thoughts or worries that come into your mind repeatedly even if you try to stop them). Common ones include fear of germs making you ill; fear of being burgled if you leave doors unlocked; fear of the house burning down; a feeling that everything needs to be ordered.
- Compulsion (actions that you feel the need to do repeatedly, often in response to the obsession). Examples include repeated washing or cleaning; needing to check the door locks or that the gas is off many times; or counting or repeating words in particular patterns.
- The severity of symptoms varies hugely, from causing mild inconvenience to taking over your life. It’s not always easy to tell if someone is, say, simply naturally tidy or has mild OCD, but the key is probably that OCD gets in the way of your ‘normal’ functioning.
Who gets it?
OCD is remarkably common, affecting up to 1 in 30 people. If often starts in your late teens or early twenties, although it can come on later in life. It’s more common if other people in the family also suffer from it.
Is there effective treatment?
Fortunately, the vast majority of people with OCD can have their symptoms controlled, if not abolished, with medication, talking therapy or both.
Cognitive Behavioural Therapy (CBT)
CBT is based on the idea that negative thought patterns, which keep your condition going, can be challenged and changed.
In OCD, for instance, you may be taught to challenge the idea that you will come to harm if you do not wash for excessive periods, or that harm will come to those you love if you do not observe certain rituals. To do this, you need to accept that the obsessions themselves are not harmful, and that you do not have to ‘neutralise’ them with compulsive actions or behaviours. You may then be helped to change your compulsive behaviour gradually, often using a technique called ‘exposure and response prevention’. If your obsession is about checking the locks, your therapist may get you to leave the house (very briefly at first) without checking the doors. They help you to deal with the inevitable anxiety that results with relaxation techniques, and over time you should become less anxious.
Anti-depressant medicines are often effective in OCD, even if you aren’t depressed. They take a few weeks to work and usually need to be taken for at least a year if you have OCD.
Anti-depressant tablets – cure or killer?
Newspapers often run scare stories about the dangers of anti-depressants. While they do (like all medicines) have risks, anti-depressants have changed the lives of millions of people for the better.
At least 1 in 6 people will suffer from depression during their lifetime, with women twice as likely to be affected as men. Many sufferers will recover without needing medicines. But depression is every bit as much a ‘real’ disease as, say, diabetes or asthma. Some people with those conditions manage without regular medication, too, but nobody thinks they are weak if they don’t. Most anti-depressants work by increasing the levels of your body’s natural chemical, serotonin. They aren’t addictive – in other words, you don’t crave them if you miss a dose and you don’t need more as time goes on to get the same effect. Overall, they are very safe, although occasionally people may get suicidal thoughts in the first weeks of taking them. However, the number of people helped dwarves the numbers harmed.
With thanks to 'My Weekly' magazine where this article was originally published.