What is OCD Obsessive Compulsive Disorder?

This week is OCD Awareness Week which aims to raise the awareness of this life changing condition and educate the wider public on the incapacitating nature of OCD.

These days, quite often you hear the words OCD used loosely in conversation – ‘oh, I’m about a bit OCD about that’. But having OCD is much more than being very focused on something. OCD, or Obsessive Compulsive Disorder to give it its full name, is a very real and distressing anxiety disorder which involves the sufferer experiencing very high levels of anxiety over a particular idea or thought (an obsession) coupled with the urge to repeat an activity (a compulsion) to deal with that thought.  It is a difficult illness to address and usually needs intensive treatment in severe cases.

Obsessions are usually frightening, and therefore induce a state of anxiety.  Common examples of obsessive thoughts include forgetting to do something, such as locking a door or turning off a gas hob; becoming infected by germs or developing a disease; harming someone else either accidentally or on purpose; or requiring absolute order of all possessions.  Obsessions usually revolve round two areas:

1)       Safety and security

2)      Cleanliness and hygiene

The compulsions that accompany these obsessions are rituals that help the sufferer reduce the anxiety caused by the obsessions.  For example, checking and re-checking the door was locked, or the gas hob was turned off; washing and disinfecting both oneself and the surrounding area and even insisting on certain standards of cleanliness in other people; saying prayers or repeating phrases to reduce the likelihood of accidents; or counting and placing possessions in a certain manner.

Most OCD sufferers have both obsessions and compulsions, although some only have obsessive thoughts and others have compulsions but do not know what is driving them.

The level of intrusion into the normal life of the person with OCD gives a key to the severity of the condition.  If life has become difficult because of the time taken in completing the rituals and the levels of anxiety induced by the disturbing thoughts, it is time to seek help.

Dr Adrian Winbow of Private Psychiatry highlights this example, “I once treated a 42 year old man who was having increasing difficulty driving past cyclists and was constantly worried that he had hit the cyclist with his car.  He would turn round down the road and check that the cyclist was safe.  This made it impossible for him to travel anywhere by car.  If he could not find the cyclist, he would go to the Police Station and report the incident as an accident. The Police were angry with him wasting their time.”

OCD can sometimes be addressed by the use of self-help guides which cover a step by step programme of exposure to the obsession without undertaking the associated ritual.  While this technique increases anxiety levels in the first instance, it works over time.   A more formalised programme of a type of Cognitive Behavioural Therapy called Exposure and Response Prevention (ERP) Therapy can help many individuals with OCD without the need for medicinal intervention.  This is the current recommended treatment for OCD sufferers.   However in some cases medication in the form of SSRIs (selective serotonin reuptake inhibitors) is prescribed in conjunction with a programme of ERP therapy.

In the case of the driver detailed above, he received a combination of a large dosage of SSRIs and also intensive cognitive behavioural therapy weekly for 15 sessions.  By the end of the treatment programme, he was able to drive his car again and no longer had to attend the police station to report possible incidents.

The consultant psychiatrists at Private Psychiatry have many years’ experience in diagnosing and treating OCD. If you think that you may be suffering from OCD, please get in touch to make an appointment.

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