What is it?

Obsessive–Compulsive Disorder (OCD) is a serious anxiety-related condition where a person experiences frequent intrusive and unwelcome obsessional thoughts, often followed by repetitive compulsions, impulses or urges.

The illness affects as many as 12 in every 1000 people (1.2% of the population) from young children to adults.

It has traditionally been considered that there are four main categories of OCD.  Although there are numerous forms of the illness within each category, typically a person’s OCD will fall into one of the four main categories:

  • Checking
  • Contamination / mental contamination
  • Hoarding
  • Ruminations / intrusive thoughts

To some degree OCD-type symptoms are probably experienced, at one time or another, by most people, especially in times of stress. However, OCD itself can have a totally devastating impact on a person’s entire life, from education, work and career through to social life and personal relationships.

OCD is diagnosed when the obsessions and compulsions:

  • consume excessive amounts of time (approximately an hour or more)
  • cause significant distress and anguish
  •  interfere with daily functioning at home, school or work, including social activities and family life and relationships.

How you might feel

OCD has three main parts:

1. the thoughts that make you anxious (obsessions)

2. the anxiety you feel

3. the things you do to reduce your anxiety (compulsions).

What you think (obsessions)

  • Thoughts - single words, short phrases or rhymes that are unpleasant, shocking or blasphemous. You try not to think about them, but they won't go away. You worry that you might be contaminated (by germs, dirt, or cancer), or that someone might be harmed because you have been careless.
  • Pictures in your mind - showing your family dead, or seeing yourself doing something violent or sexual which is completely out of character - stabbing or abusing someone, or being unfaithful. We know that people with obsessions do not become violent, or act on these thoughts.
  • Doubts - you wonder for hours whether you might have caused an accident or misfortune to someone. You may worry that you have knocked someone over in your car, or that you have left your doors and windows unlocked. 
  • Ruminations - you endlessly argue with yourself about whether to do one thing or another so you can't make the simplest decision.
  • Perfectionism - you are bothered, in a way that other people are not, if things are not in the exactly the right order, not balanced or not in the right place e.g. if books are not lined up precisely on a bookshelf.

The anxiety you feel (emotions)

  • You feel tense, anxious, fearful, guilty, disgusted or depressed.
  • You feel better if you carry out your compulsive behaviour, or ritual - but it doesn't last long.

What you do (compulsions)

  • Correcting obsessional thoughts - you think alternative 'neutralising' thoughts like counting, praying or saying a special word over and over again.  It feels as though this prevents bad things from happening. It can also be a way of getting rid of any unpleasant thoughts or pictures that are bothering you.
  • Rituals - you wash your hands frequently, do things really slowly and carefully, perhaps arrange objects or activities in a particular way. This can take up so much time that it takes ages to go anywhere, or do anything useful.
  • Checking - your body for contamination, that appliances are switched off, that the house is locked or that your journey route is safe.
  • Avoidance - of anything that is a reminder of worrying thoughts. You avoid touching particular objects, going to certain places, taking risks or accepting responsibility. For example, you may avoid the kitchen because you know you will find sharp knives there.
  • Hoarding - of useless and worn out possessions. You just can't throw anything away.
  • Reassurance - you repeatedly ask others to tell you that everything is alright. 

What you can do

There are different types of help or treatments that can help you feel better. Most people with OCD won’t have to go to hospital unless their problems are very serious.

Visit your GP

If you have some of the symptoms of OCD then speak to your doctor and explain how you are feeling. There are various treatments or ways to help that your GP can offer you.  Left untreated, OCD is unlikely to get better and could get worse.

Self-help

If your symptoms are mild, you may be given a self-help book or video to follow on your own at your own pace with occasional contact with a professional.

Cognitive Behavioural Therapy (CBT)

There are two types of CBT used to treat OCD, Exposure and Response Prevention or Cognitive Therapy.

Exposure and Response Prevention (ERP)

CBT is a psychological therapy that helps you to understand your thoughts and behaviour and teaches you to think differently about things. ERP involves being exposed to things that make you feel anxious but with support from a therapist to help you think about things differently. You could be offered this therapy on your own or as part of a group with other people who have OCD. By being exposed to what had made you feel anxious before, it gradually reduces the anxiety and helps you to face your fears.

Cognitive Therapy

Cognitive Therapy is a psychological therapy which helps you change your reaction to thoughts that make you anxious rather than getting rid of the thoughts.  This therapy is suitable if you have worrying thoughts but do not perform any rituals.

Medication

Antidepressants may be prescribed as the only treatment for OCD or alongside therapy such as CBT so you have medication and therapy at the same time. SSRIs are prescribed for depression but can also help with OCD. It can take a few weeks for you to feel the benefits of antidepressants so don’t worry if you don’t feel different overnight. Do speak to your GP if you experience any side effects or if you don’t feel any different after you have been taking them for a few weeks.

Specialist help

If your symptoms of OCD are serious and ERP and CBT are not helping you, then the GP may refer you to get specialist help from a child and adolescent psychiatrist who would discuss further treatment with you.

Useful websites and organisations

Young person’s OCD guide - www.ocduk.org

NHS - www.nhs.uk/conditions/Obsessive-compulsive-disorder


OCD Action - www.ocdaction.org.uk 

Further resources can also be found on the Health and Wellbeing page of our website