Living with Obsessive Compulsive Disorder (OCD)

What is OCD?

Obsessive compulsive disorder (OCD) is categorised as a mental health condition which manifests in cycles of obsessions and compulsions, affecting people of all ages and circumstances. Obsessions often trigger feelings of distress through unwanted and unexpected intrusive thoughts, images and/or urges. Compulsions are behavioural attempts an individual engages in to get rid of the obsessions and alleviate some of distress they cause.
Although everyone has at some point experienced obsessions or compulsions, to be diagnosed with OCD, these must hinder one’s ability to engage in everyday tasks and must be so extreme they consumer a large proportion of the individual’s time each day. Whilst a certain criteria or threshold needs to be met for a formal diagnosis, we can also help individuals who are struggling with OCD-like symptoms.

What are obsessions?

Obsessions often feel out of a person’s control which adds to their resulting distress. While the term is often used colloquially in relation to positive obsessions like a hobby or passion, experiencing obsessions in the context of OCD can be a significant source of suffering on a daily basis.

Common obsessions include (but are not limited to):

• Fear of coming into contact with contaminants (such as dirt, germs/ disease, bodily fluids, environmental contaminants or household chemicals)
• Fear of violent images in one’s head
• Fear of committing acts of violence on oneself or others on impulse
• Fear of being responsible for a tragic/ horrible event or situation
• Perfectionism-related obsessions (such as fear of making mistakes or not executing tasks perfectly)
• Unwanted sexual thoughts or images and fear of acting on them
• Excessive concern with one’s sexual orientation or gender identity
• Excessive concern with what is ‘right’ or ‘wrong’
• Excessive religious concern (such as offending God)
• Excessive concern about one’s relationships (how meaningful they are, if they are reciprocated equally etc.)
• Excessive concern about life and death (existential crises)

What are compulsions?

Compulsions are repetitive actions used by people suffering from OCD to temporarily neutralise their obsessions. These can be used in a preventative sense, to avoid triggering obsessive thoughts or as a coping strategy once the obsessive thoughts are in action. Whether a repetitive act or ritual is classified as an OCD compulsion is determined by its context and associated feelings. Most OCD compulsions are associated with dread and are to escape distressing thoughts for the individual engaging in them, while most non-OCD compulsive behaviours are committed out of desire and act as source of pleasure.

Common OCD compulsions include (but are not limited to):

• Ensuring evenness or exactness in their surrounding
• Washing or cleaning oneself, belongings, or surroundings excessively
• Repeating tasks (to ensure perfection)
• Repeating activities or tasks in certain numbers (these are usually ‘safe’ or ‘right’ amounts of times to do things)
• Repeating movements (such as tapping or blinking)
• Checking to make sure nothing terrible has happened (their fault or otherwise)
• Checking one’s body or physical condition excessively
• Counting (uncontrollably) when engaging in task
• Mentally reviewing events repeatedly to make sure one has not inflicted harm on anyone else nor themselves
• Engaging in any behaviour to avoid situations that may trigger one’s obsessions

Emotional symptoms:
Often people experiencing obsessions and compulsions also experience feelings of:

• Fear
• Shame
• Anxiety
• Disgust
• Confusion/ uncertainty

How is OCD treated?

OCD is treated by tackling its symptoms in the hopes of improving daily functioning and reducing distress.

Common therapies include:

• Cognitive Behavioural Therapy (CBT), including Exposure and Response Prevention (ERP)
• Medication – SSRIs

CBT helps individuals to identify and challenge patterns of beliefs and behaviours that may be contributing to their distress. ERP was specifically developed to treat OCD in encouraging those suffering to confront their obsessions and resist the urge to carry out their compulsions, and is often part of a package of CBT for OCD. For some people experiencing severe levels of distress owing to their obsessions and compulsions, it may be that taking some medication to ease this, in conjunction with CBT or ERP, can produce positive results.

Outcomes:
The main goal for OCD treatment is to ease the frequency and intrusiveness of the obsessions and the level of distress associated with them, and as a result, limit compulsive behaviour. The most effective way of doing this is to teach you how to manage obsessive thoughts when they do occur and respond in an adaptive way. In this way, the hope is that your OCD symptoms are less negatively impactful on your day-to-day life.

Getting Help at SCC

Once a diagnosis is made by assessing your symptoms, a treatment plan can be put in place to combat your OCD symptoms.