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OCD (obsessive compulsive disorder)

Date: 09 Feb 2020
By: admin_campbell
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NHS Choices Syndication

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Obsessive compulsive disorder

'Many people are unaware that OCD can take a sinister angle'

Diana Wilson had obsessive compulsive disorder (OCD) for 26 years. Now working for OCD-UK, she shares her story here about how she finally overcame the disorder.

“My earliest memory of the illness was when I was about eight years old. The symptoms were a fear of stepping on the pavement cracks. I don’t know why, but it made me feel physically uncomfortable if I did it.

“That was one ritual. Another ritual, which was a compulsion, was the fear that if I didn’t say my prayers respectfully and sincerely, my mother might be killed in a car accident. I took on this huge responsibility as a child for another person’s life.

“A lot of people know about the hand washing and the checking of things, but many people are unaware that OCD can also take a sinister angle, where you have a fear that you may harm your own children very violently.

“When I had my fourth child I had intrusive thoughts at bedtime that I would go to the children’s bedrooms in my sleep, take out their dressing gown cords and strangle each one. This was horrendous to go through, because I didn’t know whether I was going to do it or not.

“People with OCD are not dangerous and they do not harm, but I was permanently exhausted.

“That was the obsession: the compulsion was to try to relieve some of the pain and terror that came from those thoughts. I would get out of bed, find their dressing gowns, take the cords out of the dressing gowns and tie them into as many knots as possible, so that I wouldn’t be able to put the cords around their necks.

“Then I’d go back to bed, but I still couldn’t sleep. I would get out of bed again, get the cords, put them in a bag, seal the bag, and put the bag in a high cupboard. This would give a little relief, but it was still terrifying.

“After I saw my GP, I saw a consultant psychiatrist. I was put on antidepressants, which helped me enormously. Medication gave me the strength to sleep and eat well, so I could then have cognitive behavioural therapy (CBT), which is a psychological treatment that deals with the present. I was able to put my heart and soul into my own recovery.

“I often used to ask myself what was wrong with my memory and why I couldn’t remember whether the gas has been turned off, even though I’d checked it 13 times and I only checked 10 seconds ago. In fact, people with OCD have a perfectly accurate memory, but what we don’t have is a confident memory. CBT can help to restore that.”

Published Date
2014-03-19 16:53:11Z
Last Review Date
2012-10-04 00:00:00Z
Next Review Date
2014-10-04 00:00:00Z
Classification
Obsessive compulsive disorder,OCD UK


NHS Choices Syndication

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Obsessive compulsive disorder

Causes of obsessive compulsive disorder (OCD)

Despite much research being carried out into obsessive compulsive disorder (OCD), the exact cause of the condition has not yet been identified.

However, in certain individuals OCD is thought to be triggered by a combination of genetic, neurological, behavioural and environmental factors.

Genetics

Genetics is thought to play a part in some cases of OCD. Research suggests OCD may be the result of certain inherited genes (units of genetic material) that affect the development of the brain.

Although no specific genes have been linked to OCD, there is some evidence that suggests the condition runs in families. A person with OCD is four times more likely to have another family member with the condition compared with someone who does not have OCD.

Genetic and family studies have also shown OCD may be related to other conditions such as:

  • tics – rapid, repeated, involuntary contractions of a group of muscles
  • Tourette’s syndrome – a condition that causes a person to make repetitive movements or sounds

Some people with OCD may also have tics or Tourette’s syndrome.

Brain abnormalities

Brain imaging studies have shown that people with OCD have abnormalities in some parts of their brain, including increased activity and blood flow, and a lack of the brain chemical serotonin.

The areas of the brain affected deal with strong emotions and how we respond to those emotions. In the studies, brain activity returned to normal after successful treatment with cognitive behavioural therapy (CBT) or selective serotonin reuptake inhibitors (SSRIs).

Serotonin

Serotonin also seems to play a part in OCD. It is a chemical in the brain (neurotransmitter) that transmits information from one brain cell to another. Serotonin is responsible for regulating a number of the body’s functions, including mood, anxiety, memory and sleep.

It is not known for sure how serotonin contributes to OCD, but people with the condition appear to have decreased levels of the chemical in their brain.

Medication that increases the levels of serotonin in the brain, such as certain types of antidepressant, have proven effective in treating the symptoms of OCD.

Life events

An important life event such as a bereavement or family break-up may trigger OCD in people who already have a tendency to develop the condition (for example, due to genetic factors).

A life event can also affect the course of your condition. For example, the death of a loved one may trigger a fear that someone in your family will be harmed.

Stress, which can also be caused by life events, seems to make the symptoms of OCD worse. However, stress does not cause OCD on its own.

Parenting and family

OCD is not thought to be linked to upbringing, but certain factors such as having overprotective parents could increase your chances of developing OCD. 

Sometimes it can be unhelpful if a family member of someone with OCD intervenes. For example, a person with OCD may ask a member of their family for constant reassurance about one of their fears, such as whether they have locked the door.

If the family member continually reassures them that they have done something in order to make them feel better, it may prevent them seeking the help and treatment they need.

Infection

There have been reports of some children and young people developing OCD after having a severe infection caused by streptococcal bacteria.

One theory is that antibodies (infection-fighting proteins) produced by the body react with part of the brain, leading to OCD. The infection itself does not cause OCD, but triggers symptoms in children who are genetically predisposed to the condition.

Symptoms of OCD that occur as a result of an infection will usually start quickly (within one to two weeks).

 

Published Date
2014-03-19 16:50:50Z
Last Review Date
2012-10-04 00:00:00Z
Next Review Date
2014-10-04 00:00:00Z
Classification
Obsessive compulsive disorder

Obsessive compulsive disorder (OCD) – NHS Choices

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Obsessive compulsive disorder (OCD) 

Introduction 

Obsessive Compulsive Disorder

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Diana Wilson talks about how OCD affected her, how she has dealt with it, and the support available to people with OCD.

Media last reviewed: 30/09/2013

Next review due: 30/09/2015

Who is affected by OCD?

It is difficult to know exactly how many people have OCD, as many are reluctant to visit their GP because they feel ashamed or embarrassed.

In Western countries, OCD is the fourth most common mental health condition. It can affect men, women and children.

In the UK, about 12 out of every 1,000 people are affected by OCD. This equates to around 741,500 people.

Perinatal and postnatal OCD

It’s thought about 2-4% of women develop obsessive compulsive disorder (OCD) during pregnancy or after giving birth.

For more information about this type of OCD, see the Maternal OCD website and the OCD-UK website.

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Obsessive compulsive disorder (OCD) is a mental health condition where a person has obsessive thoughts and compulsive behaviour.

An obsession is an unwanted, unpleasant thought, image or urge that repeatedly enters a person’s mind, causing them anxiety.

The word “obsession” usually describes something enjoyable, but in OCD the obsession is unpleasant and frightening.

A compulsion is a repetitive behaviour or mental act that someone feels they need to carry out to try to prevent an obsession coming true. For example, someone who is obsessively scared they will catch a disease may feel the need to have a shower every time they use a toilet.

OCD symptoms

OCD symptoms can range from mild to severe. For example, some people with OCD may spend an hour or so a day engaged in obsessive-compulsive thinking and behaviour. For others, the condition can completely take over their life.

Although OCD affects individuals differently, most people with the condition fall into a set pattern of thought and behaviour. The pattern has four main steps:

  • obsession – your mind is overwhelmed by a constant obsessive fear or concern, such as the fear your house will be burgled
  • anxiety – this obsession provokes a feeling of intense anxiety and distress
  • compulsion – you adopt a pattern of compulsive behaviour to reduce your anxiety and distress, such as checking all your windows and doors are locked at least three times before leaving the house
  • temporary relief – the compulsive behaviour brings temporary relief from anxiety but the obsession and anxiety soon return, causing the cycle to begin again

Read more about the symptoms of OCD.

What causes OCD?

A number of factors are thought to play a part in OCD. Evidence suggests that in some cases the condition may run in families and is linked to certain inherited genes that affect the brain’s development.

Brain imaging studies have also shown that people with OCD have abnormalities, such as increased blood flow and activity, in some parts of their brain. The areas of the brain affected deal with strong emotions and the response to them.

Studies have also shown that people with OCD have an imbalance of serotonin in their brain. Serotonin is a neurotransmitter that the brain uses to transmit information from one brain cell to another.

Read more about the causes of OCD.

Seeing your GP

People with OCD are often reluctant to report their symptoms to their GP because they feel ashamed or embarrassed. They may also try to disguise their symptoms from family and friends.

However, if you have OCD, there is nothing to feel ashamed or embarrassed about. OCD is a long-term health condition like diabetes or asthma and it is not your fault you have it.

You should visit your GP if you have OCD. Initially, they will probably ask a number of questions such as how often you clean and whether you are concerned about putting things in a particular order.

If your GP suspects OCD, you may need to be assessed by a specialist.

Read more about how OCD is diagnosed.

Treating OCD

If you are diagnosed with OCD, your treatment plan will depend on how much the condition affects your ability to function.

Your treatment is likely to involve behavioural therapy to change your behaviour and reduce your anxiety, and medication to help control your symptoms.

OCD is usually treated with cognitive behavioural therapy (CBT) or antidepressants called selective seretonin reuptake inhibitors (SSRIs). CBT is a talking therapy that can help you manage your problems by changing the way you think and behave.

Depending on how severe your OCD is, you may need to be referred to a specialist mental health service.

Read more about how OCD is treated.

Complications

Some people with OCD also develop depression. You should not ignore feelings of depression because they can become more severe if they are left untreated. Untreated depression will also make it more difficult for you to cope with the symptoms of OCD.

You may be depressed if you have been feeling very down during the past month and things you used to enjoy no longer give you pleasure. If this is the case, you should visit your GP.

People with OCD and severe depression may sometimes have suicidal feelings.

Contact your GP or care team immediately if you are depressed and feeling suicidal. You can also telephone the Samaritans to talk in confidence to a counsellor on 08457 90 90 90. Alternatively, you can call NHS Direct on 0845 4647.

Outlook

If you have OCD, seeking help is the most important thing you can do. Left untreated, it is unlikely your OCD symptoms will improve, and they may get worse. Without treatment, nearly half of people with OCD still have symptoms 30 years later.

With treatment, the outlook for OCD is good and many people will achieve a complete cure, or at least reduce symptoms enough to be able to enjoy a good quality of life.

 

Page last reviewed: 05/10/2012

Next review due: 05/10/2014

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Comments

The 38 comments posted are personal views. Any information they give has not been checked and may not be accurate.

Barunj said on 18 August 2014

Hello,
I am 33 years old man. I am not sure if I have a mild OCD but I have some strange reactions every day. The volume of the TV/Radio has to be even not odd, If I have to choose between two things I always choose the one on the right, Infront of a statue I have to make the sign of the cross 3 times, at work I use a pencil that I think is lucky, if im typing and i see an error I delete all the word and write it again even if only the last letter is wrong,and there are more things which I can’t remember at the moment, and I do these things because I think that if I don’t do them something bad will happen or I will be unlucky. AM I OCD?????

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Forsyte said on 14 July 2014

I have been physically ill with bowel problems for the past two years. In that time, I have lost eight stones in weight and have been isolated quite a bit because I just haven’t been able to get about. Since then I have started piling up shopping by buying too much of everything to make me feel secure. I have got a thing with numbers, and when I am stressed, move my wrist four times in a certain way because if I don’t I feel I will be unlucky. When I am going out I check the things in my bag so many times that I feel sick. I cannot buy one of anything it always has to be an even number. I am a 65 year old lady.

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MilesK said on 17 April 2014

Sorry about all the typos. The Samsung dumbphone that I am typing this on registers keystroke errors easily.

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MilesK said on 17 April 2014

Strange thing about OCD, I don’t get it in a dream state or half-awake state. I have to be fully conscious . OCD is also attenuated under the influence of alicohol or nicotine. I must caution that it becomes exacerbated when the intoxicant or stimulant wears off. Alcohol or nicotine is not the solution. It is just my observation of my own condition.

Also, OCD rituals don’t put the sufferer at risk of harm or death. The OCD sufferer will not come out with rituals that are harmful or injurious The rituals try to mitigate harm, not cause harm. They are debilitating, yes. Tiring, yes. Hazardous or lethal, No. The mechanism is protective and defensive, at the base of it.

Hope this helps someone.

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MilesK said on 17 April 2014

It took me a long time to come to terms with my OCD. Accepting myself that I do not have to be "petfect" helps. Accepting that loved ones will eventually go helps and that the loss of a lived one has nothing to do with what ritual you do helps. Accepting that I will not find a mate and nit being avject about it helps. Seeing the funny side of one’s own life and condition helps. It is not resignation for rhat implies defeat. It is just acceptance and Tag, Life says that we are IT. Oh well.

To the outsider we appear "normal" and cruel remarks can be made about us by those who do not kbow what we are going through. I have been called lazy, incompetent, irresponsible, profligate, prodigal, creep, weirdo and all sorts of nasty epithets. I know that I am none of these.

OCD is really the mind trying to control what it has lost control over or knows not how to regain control. The rituals are the "best" means the OCD sufferer has to regain control over the recurring intrusive obsessive deep-seated fear of a bad event or events happening.

Do not be ashamed to come forward to seek help and ways to manage OCD if you have it or knows someone who has it. It is just brain biochemistry gone a little awry. Not your fault. Nobody’s fault. Just deal with it.

I plead for understanding of OCD sufferers from those who don’t have the disorder. Don’t mock us when you catch us doing our ritual. We are just trying to relieve anxiety. Like some would throw salt over the shoulder…

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MilesK said on 17 April 2014

I was also afraid of germs making me "impetfect". And wore latex gloves or wrapped Kleenex around doorknobs or bus-poles before touching them. I would line seats with Kleenex or a fresh towel before sitting down for fear of "contagion" making me "imperfect".

I had obsessive thoughts of masturbation which I abhorred. The nost it abhorred me the more I masturbated. It was exhausting (you bet), filled me with guilt and disgust and unpleasurable. I had fear of STDs which was big news then. Washed my genitals with concentrated Dettol 3 times daily. I had thoughts that I would hurt my girlfriend. Couldn’t have a relationship for as soon as I got close to a woman the recurring thought that I would hurt her intruded. I feared transmitting "disease" to thise I cared about.

Dropped out of uni. I read maths but the OCD for order and symmetry forced me to prove theorems in "set orderly" ways. I was looking for fixed "methods" of doing maths. And maths is not like that. Maths is about insight. But OCD got in the way of insight as it kept looking for "fixed ways" to solve a problem.

I guess our brains are biochemically imbalanced that trauma triggers off OCD. To a large extent OCD is a defence mechanism that tries to protect the sufferer from imagined harm. The rituals transmute the problem from a "harmful" imagined event such as the loss if a lived one to a "harmless" event such as wading your hands a set number times to ward off the event. The rituals are apotropaic. And most OCD sufferers have "superstitions" about numbers, colours, objects and orientations/sequences of objects or events. OCD is like a very personalised set of superstitions with a very personalised set of apotropaic rituals to "ward" then off. It is a mental defence mechanism expressed in debilitating ways that are less harmful than the intrusive obsessive deep-seated fear of the event.

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MilesK said on 17 April 2014

I am Miles. I am 50. I have had OCD for the last 40 years. I just found this webpage after reading an article in The Guardian. I am relating my experience here as well in the hope that sharing it will have someone towards his or her own management of the disorder.

First, do not feel ashamed by having OCD. Do not be ashamed or feel abnegation for who you are. It is the brain’s biochemistry gone awry. You are not "crazy". Thinking that you are "crazy" exacerbates the condition. Accepting it as a brain biochemistry issue will go along way towards managing it. It is like accepting that you are going to be 1.6m tall and never going to be 1.8m tall. So what? Come forward. Acknowledge it and manage it.

My OCD was triggered off by the loss of my father when I was 9. The OCD struck at 10 and left one year later. With the onset of puberty and my first ejaculation at 12 the OCD returned and stayed for the next 40 years. I became fearful of all things related to or associated with funerals or deaths. So, I had rituals to dispel the fear. When I lost my mother 36 years after I lost my father the OCD largely disappeared. It was only then that I realised that I had feared losing my mother.

The other subset of my OCD came as a result of familial expectation to be a top performing student. When my grades started slipping the rituals came to dispel any event that could cause my grades to slip. I became fearful of getting close to people who are not regarded as being of "high intelligence" because of "contagion". I became fearful of thibgs that could "hurt" my brain and make me "less intelligent". And had rituals to deal with such events. It has to do with the approval system of me within my home. It was based on my being "intelligent". Being "less intelligent" implied less familial love and approval.

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michaelpharm said on 07 February 2014

Thanks everyone for all your comments. I knew I have had OCD for a good 5 or more years now but thought it did not affect much of my life since they just waste about 20 minutes every day, so havent seen the doctors yet. However, reading all your comments, I have noticed so many similarities in personalities, like being scared to get too close to someone, which I did not know was due to my OCD. I have always been very sensitive and conscious about what people think of me, and in lectures I am scared to speak to someone next to me out loud because the person sitting behind me might think I am strange or unfunny. So I realised from this page that my OCD explains a lot of my problems: my mum says I am too moany because when something is not done my way, I question their way and believe mine is a better method. Thanks so much, this is actually a massive relief that some people have gone through what I am going through so I am going to talk to the doctors and hopefully that helps me in the future.

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Mattstuart said on 23 January 2014

A poem I wrote about ocd..

Take me away from the demons in my brain
Take me away from this pain, there’s nothing left to gain
The strain on me, my dreams and life oh just take me away
When all is said and done, you think you know best , you always do
Take me away from the suffering
You think you have control and what’s more you do, if I let you
My head near dead, but that’s the way you wanted it
Take me away, there’s nothing left to drain away from me
Like a leach, you can suck the life out of me with less than a minutes notice
I want to shout til I explode, run away from my suppressed fears and never return
Take me away from the demons in my brain
Like the poison ivy, you root and and take growth, but I can’t feed your earth anymore
I’m drained of energy and time, and while I write this rhyme, oh the irony,it’s about you
Take me away from the fighting, cease fire, I will, if you do too
You take a mile given an inch, maybe I need a better shrink
To think of all the damage you’ve done, but giving you the satisfaction won’t be done
Oh take me away from the demons in my brain.

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Mattstuart said on 23 January 2014

I have had this condition for two years now. I’m not quite sure if a complete cure is likely.The condition is caused by a biochemical imbalance in the brain, and by a processing problem in the Caudate nucleus- the filtering system- certain things do not register, or go round In a loop. We get stuck in gear. The problem is the more you carry out compulsions the more you will do them, because you create neuro path ways, which can fix into memory and become second nature. Habits form and take root. Recovery from OCD starts with breaking the cycle. This takes a lot of courage and persistence. There will be times when the anxiety is too high so you carry out the behaviour to gain some relief, ironically this is the problem; doing behaviours to make you feel better. From my experience Control seems to be a big factor. Is some part of your life suppressed ? I.e you can’t control people around you, so you control your surroundings. Guilt? Inflamed sense of responsibility?( common in nurses and parents).
I’ve learned that OCD is FEAR. It’s the fear that makes you do the behaviour. You’re scared that something bad will happen. You listen to that fear, and stupidly you obey like a robot. Stop. Think and chose not to buy into and believe fearful thoughts. You have to be brave and break the cycle. It’s about getting out of your ‘comfort’ zone. You have a choice in this. Don’t be ruled by your mind, I know it’s hard when the plight of anxiety is high, but you mustn’t succumb to the feelings. It’s just a thought. That noise in your head. You don’t have to listen, you don’t. You have a choice. Just remember that. Ocd has nearly killed me, I know the pain you are all going through. The feeling of being out of control. The feeling of impending doom. You are not alone. Know this. I can feel the ocd in my brain, every Obessive thought wired to my gut instinct persuading me to do it. But I can’t listen anymore. I can’t . Too much time has been wasted on ocd. We must make a stand.

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meowxo said on 11 October 2013

I would just like to add a positive story, I suffered from OCD from the age of 6 to 18, I was diagnosed at age 16 and like many of you was overwhelmed with relief to know that I wasn’t alone, and that many others were like me. My OCD was mostly violent intrusive thoughts, not only that my family and boyfriend would come to harm, but that I would be the one to harm them. I tapped constantly, had lucky and unlucky colours, numbers and even shapes, I couldn’t even look as knives or any other "weapons", I barely left the house in the end. Anything could be made into a ritual, from brushing my teeth, to making a sandwich, to walking to the shop. OCD took over and left me an anxious, depressed mess. I ruined both school and college for myself and it took over most of my teenage years, I self medicated with alcohol and drugs for a long time, I was such an angry person for a long time. My mother also suffered from OCD as well as anorexia and depression for many years, and could not cope with listening to or watching my obsessions as it was a trigger for her. so she kicked me out of the family home. I lived in a garage and found a wonderful GP who referred me for CBT and after 18 months of treatment, and changing my lifestyle I can happily say that I haven’t carried out a ritual or compulsion for 6 years 🙂 I still have anxiety, which now manifests itself in different ways. but I am now much more able to live life as I should, I work in a job that I love and though I don’t have much of a social life I can make myself happy in many other ways. I still can’t "switch off" and worry quite a lot more than I’m sure is normal, but I am so much better! I hope for others to get through this as I have. Wish I could help you all!! There is hope!! xxxxxx

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Slickvik said on 30 July 2013

Would encourage very strongly for people to watch the BBC3 programme: OCD camp. Whether its to raise awareness, understand a loved one or its yourself that suffer on a day to day basis; well worth a watch.

I found some really useful techniques I could use to help me on a day to day basis. But most importantly: to see someone else going through some of the irrational consequential thoughts and cognitions that someone with OCD has, was a great source of comfort and hope for myself.

I ve improved an enormous amount in the last 5 years. Still struggle at times, but the key is to test your beliefs and set small goals.

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Tahlula said on 15 May 2013

Where to start! After years of this washing hands relentlessly, fear of household things like bleach, flash cleaner an now more recently dishwasher finish quantum tablets I came in here only to find I’m NOT alone. Honestly I could cry. I feel this has completely taken over everything I do an what used to take be minutes now takes hours because I’m worried about germs an my Ron catching something if I don’t do it right. It get me do anxious an sometimes I just feel like curling up in a ball. Everyone laughs at me washing hands do much in work so I make excuses as to why I’m doing it. I’m scared of blood, spit anything that carries germs. After putting dishwasher tablet in I washy hands better than thd dishes! I know it’s not right but can’t help myself. More recently we got ants again so I called a man out to put down some stuff to clear them. Well now that has me up the wall where it is! I just feel my heads going to explode. I’m definitely going to gp to discuss now I know I’m not alone and others have benefited from help

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Dyanna said on 15 May 2013

I am a long time sufferer of OCD since childhood and I’m now in my 50’s.
I was only diagnosed 8 years ago.
My OCD is thoughts and seeking reassurance from them.
I have been on fluoxetine since diagnosed and I also had a year of CBT.
I have a brilliant psychiatrist who found me the right medication at the right dose.
I also have anxiety too and depression when the OCD takes hold.
The medication has helped me so much along with the CBT.
I still have OCD thoughts at times ,especially if I am stressed,but with the medication and therapy I have learnt
to manage it.
I know I will be on medication for life.
It has been a life saver for me.

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jabba123 said on 28 April 2013

I am also a long time sufferer of OCD. I just want to know if anybody has symptoms similar to mine or even close.
When i walk around i think i am going to lose my braincells. It is an ordeal to even go on a bus or on a train (especially a car). Every time the bus/car/train goes over a bump and shakes my head i think my brain cells are being destroyed. When i finish my journey my head really hurts. I have tried to overcome this but i just can’t. Can anybody give me any help?

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Kezza88 said on 21 March 2013

This may sound very strange, I’m paranoid of bugs especially sickness ones, my children suffer and my poor hubby. When I know there is a bug going round I stop my kids going out, to school or even to play I bleach the house repeatedly, wash my hands and my children’s hands, I feel like I’m helping my children but in hi site I’m not! It’s a circle that I can escape the thought of a bug coming to my house freaks me out, I’ll do anything, I’m wanting to know if this is a symptom of OCD please help

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flumpy88 said on 19 February 2013

Hello. I have so many issues inside but i hide them, close them up. I am too scared, cowardly and confused to face them, I dont understand. OCD is one of them and I have had it for about four years now and well I would say it affects everything i do. It goes through better and worse phrases, right now I am in a bad one. It is probably because I never deal with it or hit it face on. It just takes so much strength and energy to do so and I dont have it, I feel like I have lost to it, it beat me along time ago. I need help but I know I wont seek it, or if i do I will U turn and go back on myself. I have done that before. I hate getting all emotional about it with my family and the way it makes them look at me, I feel weak, like I’m exposing an weakness. They seem to look at me differently as if I am tragic or something, I hate it and I never open up because of it. It has changed who I am, I have an identity crisis and suffer from depression too. I mean, Why me!? I don’t understand!? I am a shadow with no energy, will power and anyone close to me because I dont make an effort or open up.
Anyway! some of my weird OCD things, well it affects everything i do to be honest. Everything i touch has to feel right and sometimes be even too. I often end up stroking things for minutes until i feel satisfied, relieved and can relax. So yeah, very touchy feely. I literally mean anything as well from doors, to chairs, to remote controls to people!
Saying things and typing and writing can be an issue too. It is so varied though, it is if it doesnt feel right and that determines it, if it makes me anxious but i dont understand why i feel anxious really. The letters d c o n effect me, i see them as all negative letters and end up having to write them an even amount of times and delete them an even amount of times. Certain words too i have to say in even amount so i often repeat things in my head or whisper them under my breath. a s e r are positive letters. Reply someone, Help!

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catherine1234 said on 17 February 2013

I am 16 years old,I used to have symptoms such as having to have the tv volume on 33 and if I wasn’t I would feel very uncomfortable and have an urge to change it.Another thing is that I don’t like when doors are left open in the room I am in which most people don’t but OCD takes normal things that would affect most people and takes them out of control so that you obsess over it and cannot feel at ease until you have carried out the compulsion. The major problems I faced were obsessive cleaning because of the fear of contamination. Also included in this fear was not being able to handle raw foods or chemicals (cleaning products especially bleach) I also had an obsession with morals and not saying the right thing or possibly offending someone with something I had said so I would repeat that I was sorry even over the smallest thing. This led me to second guess everything I said and relationships with my friends felt forced as I didn’t feel able to relax and just say whatever I thought of – I didn’t feel like myself and over time as the OCD progressed and took over more and more I forgot what I would normally have been like and so I felt as though I didn’t even have a personality anymore but instead my life consisted of constant worries no matter what I did. OCD links anything with your fears and asks you "what if that happened and that caused this to happen". I didn’t want to go and see anyone about my OCD at first but i had cognitive behavioural therapy which helped me so much and now I am hardly bothered by my OCD, even though it does flare up when I am stressed. growing up with ocd is difficult because teenagers stereotype ocd and so dont think it is a big deal when it is. CBT helps you to realise that OCD is separate from you and no matter how terrible the thoughts you are having its not you youre not a bad person and it teaches you how to manage your thoughts, after CBT you won’t even think about some of the things that used to bother you

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louisa16 said on 22 November 2012

I really think i have OCD i have not been diagnosed but my CAHMS worker says that i have it. i have wierd obsessions for example i can not type in ‘Slang’ i have to write formally, if i miss a letter i have to delete the whole text and start again. when i say something in my head i can not keep it in my head i have to say it out loud and if i have not said it the way i needed to i will repeat it over and over again until i get it exactly write i also have a bit of a phobia of the numbers 1, 5, 6 and 9. another problem is cleaning in my household i am the only one that cleans because in my opinion everybody does it wrong. another issue is control i like control and feel the need to be in control in every situation i am not a nasty person adn i do try to refrain but it is very hard. another issue is door handles, door frames etc i do not like touching them and i clean the door frame with cotton buds i do not know anybody else that does this. Ialso get very agitated in an unclean environment i start scratching my self and talking really fast and furiously.

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stringbeanjean said on 12 November 2012

hi, I’m not sure what to do. I think I have ocd, my aunt suffers from mental health problems aswell and I’ve spoken to my nan in the past. I repeat a phrase (from the tv or that someone has said) over and over again whilst tapping my fingers to each syllable. I tap the right, left, left, right over and over until the phrase ends on the fourth tap (the second right). I work in fours, everything has to be repeated until it goes into a multiple of four. This comes and goes. I can also psyche myself into believing terrible things will happen if I don’t do a certain thing, for example if I’m drinking tea and a bit drips down the side of the mug I tell myself that I have to wipe it off or something bad will happen. I used to have things when I was younger like I always needed a drink with me or I wouldn’t be able to swallow. Obviously I could but it was what I believed. I wonder if anyone can help? If I have ocd or not because I am embarrassed to go to a doctor right now incase I am just being silly. Thanks.

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IceSkater said on 19 July 2012

rachaelscotty I know what you mean – I have OCD and every night before I go to bed I have to say "If I should die before I wake, to heaven please my soul do take", three times as part of a ritual that takes around 5 minutes. I also have to pray constantly for my dog (who is ill.), saying "Please let her be okay. Please don’t let her die." I then have to say ‘Thankyou’ three times thirty times without breathing in the middle.
I have to do things in three’s and eights’s sometimes (like when I’m washing my face – I have to do it 8 times, and the last ‘8’ is 3 times.), and I do other rituals in doubles (like if I tap my finger once, I have to do the other one twice, and then the other one once again for it to be ‘equal’. Often, it’s more complex than that, and I have to do them a lot of the time (they’re not very noticeable, so no one really spots it.).) I also think that the number 1 is bad because then it’s ‘lonely’.
Hope this helps 🙂

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jennyk1977 said on 04 February 2011

I have picked my nails into the quick since five years old it is a terrible habit & is this why? It would explain a lot I also sometimes scratch ankles till they bleed.

It has effected every area of my life for obvious reasons & I would like just to have normal nails like everyone else any advice or treatment & yes I’m pretty sure I have OCD can you please help me out!

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rachaelscotty said on 23 January 2011

I reallywant to know if i have ocd but om not sure but i do have mental health in my family. Im not sure when it started but it must have been after the age of 10. I have theses patterns i hace to repeat and i feeel something bad will happen if i dont do them. For example i have to say this pattern before i go to sleep ‘touch wood my nan wont die'(repeat 3 times) ‘touch wood i wont die'(rrepeat 3 times) ‘touch wood jim wont die’ (repeat 3 times) theses are people i knoe obvisously but i must say this with my eyes shut and if i slightly open them i have to start the repetition again. I also have to do a lot of things in 3’s no way in 2’s another example i have to cover the light switch with finger 3 times before switching it off. These patterns are really time consuming and annoying can i have some advice please

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Skyx said on 19 November 2010

moses84 I thought the doctors would think I was crazy aswell, I didn’t tell anyone about it for a long time, but the more you sweep it under the rug, the worser it gets cause you can’t get any better unless you help yourself. I didn’t tell my mum till about 2 months ago, It was really hard because she didn’t know about OCD or that I had it, I was really imbarassed but she told me I’m not crazy and that loads of people have it in one way or another and it’s nothing to be ashamed of. Remember, the doctors aren’t going to start laughing at you or think your crazy, their job is to help people with physical or mental problems, they won’t judge you, And once you tell them they can help you and you will be happier. I know it’s hard to tell your GP, but remember, they are there to help!

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Delenas Teardrops said on 29 October 2010

I am 12 years old and OCD runs in my family. I have never been to a doctor but my mum is certain i have it. When i am on my comuter everything i write must be corrected such as capital letters, spellings. Everything on my side of the room has to be symmetrical and free of dust. i must carry anti-bacterial gel everywhere i go and if i dont have it i will go home or buy new ones. I have to brush my teeth for a certain amount of time. I count my steps and have to stop on an even number. My writing has to be perfect and straight. This does not particulary affect my life but i cant not do these things and they may take up lots of my time.

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ilovemykids said on 13 August 2010

I have been a sufferer of OCD since the loss of my Dad when i was in my teenage years,which affected me really badly i have had two nervous breakdowns and since then have had OCD all my life i am now 34yrs of age. I have a lovely and very supportive family but its a continuous struggle. I am on anti- depesenants and will probably never come off them. Most of the time i can control it but if i am anxious it can trigger i know my thoughts will stop and are not really me as its everything i am against. I was relieved that it is a recognised illness and i am not going mad. I dont like my close family seeing me like this but its so hard to deal with it on your own.Reading other people who are also feeling the same is help towards myself feeling better and hopefully others.

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graceex said on 28 February 2010

Hi, i’m 16 and i have never been to a doctor about any of this before, and OCD does run in my family, my mother and sister have it.
When i was little if i touched something, i would have to touch it in the exact same way with the other hand or foot or whatever, and i would repeat this process until i was completely satisfied that i had done it perfectly. I would also incessantly count my steps and i could never stop until i was in a completely different situation. Now, i obsess over a lot of things, for example, if there is something that even remotely worries me, it will nag at my mind incessantly until it is resolved, even things that dont concern me, or are not worth worrying about. I also get extremely anxious and obsessive over planning days out, for example, if i am going out with friends i have to take control over the train times and organise everyone so that i know i have complete control over every aspect so that i dont get anxious, i also have to plan exactly what i will at what exact time, because other wise i get very anxious and on edge. I also collect and hoard things wih little or no value, because i feel that i have an emotional link to them or something, i hoard thing such as old old magazines, makeup, pieces of paper, plasters, anything, and i simply cannot throw them away out of the fear that i will lose a sentimental link. I also get extremely anxious with some relationships with friends or boys, for example, i have a good friend at school, and i went to her house once, and the closeness of it made me feel extremely anxious and out of my comfort zone, that i tried to involuntarily close off all contact with her, like some sort of mental barrier, i also get it if i go out on a date with a boy, no matter how much i like them, i get extremely anxious and need to escape from the situation. I also get extremely obsessive before i leave the house, eg. i check my bag to ensure i have everything i need several times.
I hope that someone can help me!

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graceex said on 28 February 2010

I’m 16 and i’ve never been to a doctor or phychiatrist about any of my symptoms in fear that i am overreating of being a hypochondirac., and these feelings are starting to worry me.
When i was younger, if i touched something, i would have to touch it in the exact same way with the other hand or foot or whatever, and if i felt that i didn’t copy the movement exactly i would repeat it until i was satisfied, i would also incessantly count my steps and i wouldnt be able to stop. I also have sort of mental diasgreements (?) where i imagine/think of a scenario, but i want to change something in it, and i fight with my mind to change it and it’s quite crazy. i feel urges to keep useless, pointless things such as pieces of paper, old makeup, old magazines, absolutely anything, because i feel like i have some sort of emotional connection to it. and if i ever go out, i obsess over everything from train times, to organising and planning the day with exact times and activities, and if i don’t, or things don’t go to plan, it makes me feel extremely anxious. I also have some sort of crazily irrational fear of some relationships, for example, i have a really close friend at school, and i went to her house once, and the closeness of it made me want to block off our friendship as if it was a threat to me or something. and with boys, i feel that i like them, but if i go out with someone on a date, no matter how much i like them, it get awful feelings of extreme sickness and anxiety which makes me not eat, until i stop seeing them, again it’s like a mental block that tries to stop all close contact. However, i am absolutely fine with most of my other friends so it baffles me.
I hope someone can help me!!!!

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moses84 said on 25 February 2010

I have had what i think is ocd since i was about 13 i am now 25 i have not bein diagnosed as i have never been to the doctors and are a bit apprehensive about going as i thought people would think i was crazy. at an early age when it first started it would be a case of grindin my teeth and the thought of me not doing it rite made me do it more but i got past that then it started gettin worse as i got into my 20’s where i would hear a sound and repeat it in my head but somes times if it didnt sound like what i heard i would keep repeating it till it sounded rite it has lately got worse where i constantly am doing it and its starting to take over my life i am unemployed and my motivation to look for a job has gone and i am scared if i get 1 my ocd will effect this i constantly feel tired and agitated is there any help or information you would suggest thanks.

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moses84 said on 25 February 2010

I have had what i think is ocd since i was about 13 i am now 25 i have not bein diagnosed as i have never been to the doctors and are a bit apprehensive about going as i thought people would think i was crazy. at an early age when it first started it would be a case of grindin my teeth and the thought of me not doing it rite made me do it more but i got past that then it started gettin worse as i got into my 20’s where i would hear a sound and repeat it in my head but somes times if it didnt sound like what i heard i would keep repeating it till it sounded rite it has lately got worse where i constantly am doing it and its starting to take over my life i am unemployed and my motivation to look for a job has gone and i am scared if i get 1 my ocd will effect this i constantly feel tired and agitated is there any help or information you would suggest thanks.

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moses84 said on 25 February 2010

I have had what i think is ocd since i was about 13 i am now 25 i have not bein diagnosed as i have never been to the doctors and are a bit apprehensive about going as i thought people would think i was crazy. at an early age when it first started it would be a case of grindin my teeth and the thought of me not doing it rite made me do it more but i got past that then it started gettin worse as i got into my 20’s where i would hear a sound and repeat it in my head but somes times if it didnt sound like what i heard i would keep repeating it till it sounded rite it has lately got worse where i constantly am doing it and its starting to take over my life i am unemployed and my motivation to look for a job has gone and i am scared if i get 1 my ocd will effect this i constantly feel tired and agitated is there any help or information you would suggest thanks.

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braggo said on 06 February 2010

Understanding my mental health conditions has made me realise how, as a child I’d experience child hood anxiety and continuouly feeling unhappy, about friendships, myself and family. I remember being stressed and anxious and would suffer with mouth sores, due to the worrying. Those feelings went away untl about eight years ago and I began to experience depression, bouts of anxiety and following 20 years of binge drinking frequent hallucinatios of seeing spiders and first thought consistent with alcoholics, but continue to this day, and appear periodically, as will smelling smoke, when there’s nothing present and ocassionally hearing voices, but dissimiliar to those urging me carry out obsessive & compulsive tasks, like checking. The OCD has been present the past 8 years and has progressively worsened. I experience repetitive thinking and excessive doubting and disbelieve my own judgement, but also doubt the opinion and question others motives, making me suspious and mistrusting of them. I became upset when a health worker became opinated of me and described me, as being very pessimistic. I remember crying uncontrollably because the sort of people who you’d expect to understand. I could have forgiven her misunderstanding, but using my volatile behaviour against me, critise and misjudge the way I am.
I opted out of conventional treatments and walked away from local mental health service providers, as its too upsetting and my mental health won’t permit me to trust them. The person I trust with my mental healthcare was taken from me and the centre manager’s decided I’d out grown the service, but officially they couldn’t help me anymore? I use complementary & alternate methods of self care and Rethink are promoting the idea of sufferers beginning a support group, as therapy. I’ve begun an OCD support group for sufferers in Wolverhampton, called Reach Out. Contact: smattox@virginmedia.com

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Artistresearcher said on 17 November 2009

Hi,
I am a newly qualified teacher of Art and am on the Artist Teacher M A course at Liverpool John Moores University.

I have been effected by OCD for most of my life and have read a lot about it so have decided to make it the subject of my art work.

I have a blog where I put all my ideas and art works in progress. I would like people to share their stories on my blog to contribute to the ideas in my art work:

http://artistresearcher.wordpress.com/

Thanks

Ruth

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shamous said on 18 September 2009

hi every one i have had ocd for my whole life when i was younger i had it under controll untill latley i have been stressed alot and i have the obbsesion where i have to bring up the same things over and over again. I am just so happy that i have a girl thats suports me through it all when we first started dating there was no real sign of me having ocd but as it went i get more jelous and i asked more questions it has got to the stage where i made her upset, and that just really breaks my heart to think i have done that to someone that i love more then anything on this earth
it has been really good to discover this site and i am currently undergoing treatment for it i just hope to god it works i want to be the guy that the lady that i love with all my heart has the guy back that she fell in love with the happy guy thanks even if no one reads this it makes it better to just type it in kinda like talking aloud
thanks for you time.SO EVERYONE KNOE U ARE NOT ALONE OR DIFFRENT.

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shamous said on 17 September 2009

Hi everyone i have had ocd for 20 years i had it under controll untill latley i have been stressed out alot and it has come into play alot more i have trouble controlling it. i mainly have an obsesion with what people are thinking and how i treat othere witch is never bad just some time i feel that i could treat them better also i also have realised that having ocd makes me very jelous even when i try not to be i always do something to stuff everything up i have a very understanding girlfriend and i wanted to get some things off my chest and not have to give it all to her to carry around without her i would not be as good as i am today i also have a problem count things and always second guessing myself untill i got on here and i see that i am not the only one having trouble controlling it i would just like to say that this is a helpful site thanks. to who ever made it .

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jess4 said on 31 August 2009

Hi I have lived with ocd for over 15 years and was very afraid to go to the doctors in case they thought I was going mad.I have been taking anti depressant ‘s to help with my obsessive thoughts , they help me keep on top of my condition.
I found by relaxing through my thoughts rather than fighting them helps me deal with my illness. I also keep positive and remember the good things about myself as you can feel it is all your fault which is not the case.I have been on the waiting list for CBT for over 2 years (NHS CWM Taf ) which makes me VERY angry .I am very lucky I have a wonderful family who support me. Please remember it is an illnes and we all deserve to get better.

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ann0580 said on 31 August 2009

hi i am a OCD sufferer,i have lived withOCD for many years and felt very much alone,but reading the above comment i know i am not alone. my OCD is im afried off contracting HIV/AIDS and the fear of germs. i have to do many rituals throughout the day and a jobs that would take someone 3 min would take me 10 min at a time i wash my hands all the time and its on my mind all day every day and i dont get a break,and the worst thing about it is that 2 years after i i got OCD i found out that my brother had got HIV and it stops me from having contact with my brother which makes me very unhappy.also i feel for my partner and my doughter, has to watch me and sometime help me carry out my rituals throughout the day and i wish that they did not have to do so. i was so glad that i have found this site and all the information will hopfully help me and hope that alot more people will come forward with there comments.

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Laurey said on 27 August 2009

I am a long time sufferer of OCD and I think that sites like this are very good at raising awareness of the illness. I suffered in silence for years because I thought that I was crazy and was too scared to tell anybody. When I first read about the symptoms of OCD in particular the intrusive thougths I was overwhelmed with releif that this was a real illness, it wasn’t just me. I think the more people know about this condition the better, I think that knowing about it would encourage alot more people who need help to seek it.

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Moodzone: Anxiety control training

Dr Chris Williams explains how you can take control of anxiety. This podcast is one of an eight-part series for Moodzone

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Obsessive compulsive disorder

Diagnosing obsessive compulsive disorder (OCD)

It is very important you visit your GP if you have symptoms of obsessive compulsive disorder (OCD).

The impact of OCD on your day-to-day life can be reduced if the condition is diagnosed and effectively treated.

Many people with OCD do not report their symptoms to their GP because they feel ashamed or embarrassed. They may also try to disguise their symptoms from family and friends.

However, if you have OCD, you should not feel ashamed or embarrassed. Like diabetes or asthma, OCD is a chronic (long-term) health condition, and it is not your fault you have it.

Initial screening

When visiting your GP, they will probably ask a series of questions.

The questions, which are part of the Fineberg-Zohar screening questionnaire, will help determine whether you are likely to have OCD. But like all screening questionnaires, people who do not have OCD may score positively.

The questions you will be asked may be similar to those listed below:

  • do you wash or clean a lot?
  • do you check things a lot?
  • do you have thoughts that keep bothering you that you would like to get rid of but cannot?
  • do your daily activities take a long time to finish?
  • are you concerned about putting things in a special order or are you upset by mess?
  • do these problems trouble you?

Assessment

If the results of the initial screening questions suggest you have OCD, the severity of your symptoms will be assessed either by your GP or a mental health professional.

There are several different methods of assessment. All involve asking detailed questions to find out how much of your day-to-day life is affected by obsessive-compulsive thoughts and behaviour.

During the assessment, it is important you are open and honest, as accurate and truthful responses will ensure you receive the most appropriate treatment.

Severity of OCD

The severity of OCD can be determined by how much your symptoms affect your ability to function normally on a day-to-day basis.

Healthcare professionals refer to the disruption of daily function as functional impairment. OCD is classified into three levels of severity. They are:

  • mild functional impairment – obsessive thinking and compulsive behaviour that occupies less than one hour of your day
  • moderate functional impairment – obsessive thinking and compulsive behaviour that occupies one to three hours of your day
  • severe functional impairment – obsessive thinking and compulsive behaviour that occupies more than three hours of your day

Getting help for others

The friends and relatives of a person with OCD sometimes “play along” with their strange behaviour to avoid upsetting them.

However, this is not recommended because it can reinforce the person’s obsessive-compulsive behaviour. It is better to confront them with the reality of their unusual behaviour and suggest they seek medical advice.

Published Date
2013-02-20 10:29:26Z
Last Review Date
2012-10-04 00:00:00Z
Next Review Date
2014-10-04 00:00:00Z
Classification
Anxiety,Obsessive compulsive disorder


NHS Choices Syndication

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Obsessive compulsive disorder

Introduction

Obsessive compulsive disorder (OCD) is a mental health condition where a person has obsessive thoughts and compulsive behaviour.

An obsession is an unwanted, unpleasant thought, image or urge that repeatedly enters a person’s mind, causing them anxiety.

The word “obsession” usually describes something enjoyable, but in OCD the obsession is unpleasant and frightening.

A compulsion is a repetitive behaviour or mental act that someone feels they need to carry out to try to prevent an obsession coming true. For example, someone who is obsessively scared they will catch a disease may feel the need to have a shower every time they use a toilet.

OCD symptoms

OCD symptoms can range from mild to severe. For example, some people with OCD may spend an hour or so a day engaged in obsessive-compulsive thinking and behaviour. For others, the condition can completely take over their life.

Although OCD affects individuals differently, most people with the condition fall into a set pattern of thought and behaviour. The pattern has four main steps:

  • obsession – your mind is overwhelmed by a constant obsessive fear or concern, such as the fear your house will be burgled
  • anxiety – this obsession provokes a feeling of intense anxiety and distress
  • compulsion – you adopt a pattern of compulsive behaviour to reduce your anxiety and distress, such as checking all your windows and doors are locked at least three times before leaving the house
  • temporary relief – the compulsive behaviour brings temporary relief from anxiety but the obsession and anxiety soon return, causing the cycle to begin again

Read more about the symptoms of OCD.

What causes OCD?

A number of factors are thought to play a part in OCD. Evidence suggests that in some cases the condition may run in families and is linked to certain inherited genes that affect the brain’s development.

Brain imaging studies have also shown that people with OCD have abnormalities, such as increased blood flow and activity, in some parts of their brain. The areas of the brain affected deal with strong emotions and the response to them.

Studies have also shown that people with OCD have an imbalance of serotonin in their brain. Serotonin is a neurotransmitter that the brain uses to transmit information from one brain cell to another.

Read more about the causes of OCD.

Seeing your GP

People with OCD are often reluctant to report their symptoms to their GP because they feel ashamed or embarrassed. They may also try to disguise their symptoms from family and friends.

However, if you have OCD, there is nothing to feel ashamed or embarrassed about. OCD is a long-term health condition like diabetes or asthma and it is not your fault you have it.

You should visit your GP if you have OCD. Initially, they will probably ask a number of questions such as how often you clean and whether you are concerned about putting things in a particular order.

If your GP suspects OCD, you may need to be assessed by a specialist.

Read more about how OCD is diagnosed.

Treating OCD

If you are diagnosed with OCD, your treatment plan will depend on how much the condition affects your ability to function.

Your treatment is likely to involve behavioural therapy to change your behaviour and reduce your anxiety, and medication to help control your symptoms.

OCD is usually treated with cognitive behavioural therapy (CBT) or antidepressants called selective seretonin reuptake inhibitors (SSRIs). CBT is a talking therapy that can help you manage your problems by changing the way you think and behave.

Depending on how severe your OCD is, you may need to be referred to a specialist mental health service.

Read more about how OCD is treated.

Complications

Some people with OCD also develop depression. You should not ignore feelings of depression because they can become more severe if they are left untreated. Untreated depression will also make it more difficult for you to cope with the symptoms of OCD.

You may be depressed if you have been feeling very down during the past month and things you used to enjoy no longer give you pleasure. If this is the case, you should visit your GP.

People with OCD and severe depression may sometimes have suicidal feelings.

Contact your GP or care team immediately if you are depressed and feeling suicidal. You can also telephone the Samaritans to talk in confidence to a counsellor on 08457 90 90 90. Alternatively, you can call NHS Direct on 0845 4647.

Outlook

If you have OCD, seeking help is the most important thing you can do. Left untreated, it is unlikely your OCD symptoms will improve, and they may get worse. Without treatment, nearly half of people with OCD still have symptoms 30 years later.

With treatment, the outlook for OCD is good and many people will achieve a complete cure, or at least reduce symptoms enough to be able to enjoy a good quality of life.

 

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Published Date
2013-08-06 14:41:35Z
Last Review Date
2012-10-04 00:00:00Z
Next Review Date
2014-10-04 00:00:00Z
Classification
Anxiety,Cognitive behavioural therapy,Depression,Mental health conditions,Obsessive compulsive disorder


NHS Choices Syndication

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Obsessive compulsive disorder

Living with obsessive compulsive disorder

Many people with obsessive compulsive disorder (OCD) can trace some of their anxieties and compulsions back to their childhood.

On average, compulsions start to interfere significantly with a person’s life when they are 17-20 years of age. However, it can be as early as five years of age or as late as 70.

The unwelcome and obsessive fears that threaten to become overwhelming as the condition develops vary from person to person. So too does the compulsive behaviour that the person uses to try to control the fears.

How much impact OCD has on a person’s life depends on:

  • the amount of time spent on a compulsive behaviour or ritual
  • the intensity of the behaviour
  • how much of it happens in their mind rather than in their actions

Rituals that involve checking can affect different people in different ways. For example, when leaving the house, a person with OCD might shut the door behind them and then think about it again and again for much of the day.

Their worry about the door being properly locked is constant, and so is the misery and depression that goes with it. Despite this, some people with OCD are able to hold down demanding jobs.

For others, the behaviour can take up all of their focus. When they try to leave the house they get stuck in the hallway, repeatedly checking the lock. In the most extreme cases, the anxiety and the thought of carrying out these rituals can prevent a person from moving for hours.

Supporting family members with OCD

Naturally, family members of someone who is openly affected by these behaviours will want to help. For a person who has not had mental health training and is unaware of the treatment options, this usually means trying to share the load. For instance, they may take on some of the rituals of a compulsive cleaner or checker.

This might seem the natural thing to do, but the whole family may end up constantly trying to protect the person with OCD from their own fears. However, this is counter-productive because the problem is not resolved and there is no hope of moving on. In this way, the whole family ‘suffers from OCD’.

The best approach is to help the person with OCD to seek treatment and to support them as they change and recover. Once therapy has begun, the contribution and support of a partner is invaluable.

Sometimes, the person with OCD can feel embarrassed or ashamed and they will try to hide their rituals from others. When this involves a physical activity, such as hand washing, the first sign that something is wrong may be the appearance of their hands, or the length of time they spend in the bathroom. Mental rituals are often more difficult to notice.

Fortunately, when someone with OCD decides to get help, a good GP will be able to recognise the signs and seek further advice and support from specialists.

Published Date
2013-08-06 14:45:01Z
Last Review Date
2012-10-04 00:00:00Z
Next Review Date
2014-10-04 00:00:00Z
Classification
Obsessive compulsive disorder


NHS Choices Syndication

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Obsessive compulsive disorder

Symptoms of obsessive compulsive disorder (OCD)

Obsessive compulsive disorder (OCD) affects people differently, but usually causes a particular pattern of thought and behaviour.

Most people with OCD tend to follow a set pattern of thought and behaviour. This pattern has four main steps:

  • obsession – where your mind is overwhelmed by a constant obsessive fear or concern, such as the fear your house will be burgled
  • anxiety – the obsession provokes a feeling of intense anxiety and distress
  • compulsion – you then adopt a pattern of compulsive behaviour to reduce your anxiety and distress, such as checking all the windows and doors are locked at least three times before you leave your house
  • temporary relief – the compulsive behaviour brings temporary relief from anxiety, but the obsession and anxiety soon return, causing the pattern or cycle to begin again

Obsessive thoughts

Almost everyone has unpleasant or unwanted thoughts at some point in their life, such as a nagging worry that their job may not be secure, or a brief suspicion their partner has been unfaithful.

Most people are able to put these types of thoughts and concerns into context, and they can carry on with their day-to-day life. They do not repeatedly think about worries they know have little substance.

However, if you have a persistent, unwanted and unpleasant thought that dominates your thinking to the extent it interrupts other thoughts, you may have developed an obsession.

Some common obsessions that affect people with OCD include:

  • fear of deliberately harming yourself or others – for example, fear you may attack someone else, even though this type of behaviour disgusts you
  • fear of harming yourself or others by mistake or accident – for example, fear you may set the house on fire by accidentally leaving the cooker on, which leads you to repeatedly check kitchen appliances are off
  • fear of contamination by disease, infection or an unpleasant substance
  • a need for symmetry or orderliness – for example, you may feel the need to ensure all the labels on the tins in your cupboard face the same way
  • fear of committing an act that would seriously offend your religious beliefs

Compulsive behaviour

Compulsions arise as a way of trying to reduce or prevent the harm of the obsessive thought. However, this behaviour is either excessive or not realistically connected at all.

For example, a person who fears becoming contaminated with dirt and germs may wash their hands 50 times a day, or someone with a fear of causing harm to their family may have the urge to repeat an action multiple times to try to “neutralise” the thought of harm. This latter type of compulsive behaviour is particularly common in children with OCD.

Most people with OCD realise that such compulsive behaviour is irrational and makes no logical sense, but they cannot stop acting on their compulsion.

Some common types of compulsive behaviour that affect people with OCD include:

  • cleaning
  • handwashing
  • checking (such as checking doors are locked, or that the gas or a tap is off) 
  • counting
  • ordering and arranging
  • hoarding 
  • asking for reassurance
  • needing to confess
  • repeating words silently
  • prolonged thoughts about the same subject
  • “neutralising” thoughts (to counter the obsessive thoughts)
Published Date
2013-02-20 10:28:00Z
Last Review Date
2012-10-04 00:00:00Z
Next Review Date
2014-10-04 00:00:00Z
Classification
Anxiety,Obsessive compulsive disorder


NHS Choices Syndication

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Obsessive compulsive disorder

Treating obsessive compulsive disorder

If you have obsessive compulsive disorder (OCD), your treatment will depend on the how much the condition is affecting your ability to function.

As OCD develops, the unwelcome and obsessive fears that can be overwhelming vary from person to person. This is also the case for the compulsive behaviour people use to try to control their fears.

How much impact OCD has on a person’s life depends on:

  • the amount of time spent on a compulsive behaviour or ritual
  • the intensity of the behaviour
  • how much of it happens in their mind, rather than in their actions

Your treatment plan

Your treatment programme is likely to involve:

  • behavioural therapy – to change the way you behave and reduce your anxiety 
  • medication – to control your symptoms 

Healthcare professionals refer to the disruption of daily function as functional impairment.

OCD that causes mild functional impairment is usually treated with a short course of cognitive behavioural therapy (CBT). CBT is a talking therapy that can help you manage your problems by changing the way you think and behave.

If you have OCD that causes moderate functional impairment, it may be recommended that you have a more intensive course of CBT, or a type of antidepressant medication known as selective seretonin reuptake inhibitors (SSRIs). You may also be referred to a specialist mental health service.

If your OCD causes severe functional impairment, you will be referred to a specialist mental health service for a combination of intensive CBT and a course of SSRIs.

Children with OCD are usually referred to a healthcare professional with experience of treating OCD in children.

Behavioural therapy 

CBT that involves graded exposure and response prevention (ERP) has been shown to be an effective treatment for OCD.

Exposure and response prevention (ERP)

ERP involves identifying a number of situations that cause you anxiety. These are placed in order from the situations that cause you the most to the least anxiety.

You and your therapist will identify tasks that will expose you to the situations that cause anxiety, but at a level you can cope with. You need to do the exposure tasks without carrying out your anxiety-relieving compulsions (the actions you usually take to help you cope with the situation).

Although this sounds frightening, people with OCD find that when they confront their anxiety without carrying out their compulsion, the anxiety disappears completely in one to two hours.

The same exposure task should be repeated two to three times a day. Each time, the anxiety is likely to be less and last for a shorter period of time. Once you have conquered one exposure task, you can move onto a more difficult task, until you have overcome all of the situations that make you anxious. 

People with mild to moderate OCD usually need about 10 hours of therapist treatment, combined with self-treatment exposure exercises between sessions. Those with moderate to severe OCD may need a more intensive course of CBT that lasts longer than 10 hours.

Medication

You may need medication if CBT fails to treat mild OCD, or if you have moderate or severe OCD. The different types of medication you may be prescribed are discussed below.

Selective serotonin reuptake inhibitors (SSRIs)

Selective serotonin reuptake inhibitors (SSRIs) are a type of antidepressant that increase the levels of a chemical called serotonin in your brain. Serotonin is a neurotransmitter that the brain uses to transmit information from one brain cell to another.

Possible SSRIs that you may be prescribed include: 

You will usually need to take an SSRI for 12 weeks before you notice any benefit. Most people with moderate to severe OCD need to take SSRIs for at least 12 months. After this time, your condition will be reviewed and if it causes few or no troublesome symptoms, you may be able to stop taking the medication.

Possible side effects of SSRIs include headaches and feeling sick. However, these should pass within a few weeks.

There is a small chance SSRIs will increase your anxiety, which may cause you to have suicidal thoughts or a desire to self-harm.

Contact your GP immediately or go to your nearest hospital if you are taking an SSRI and have suicidal thoughts or want to self-harm.

It may be helpful to tell a close friend or relative you are taking SSRIs. Ask them to tell you if they notice changes in your behaviour, or if they are worried about the way you are acting.

You may also have side effects when you stop taking SSRIs, so you shouldn’t stop taking your medicine suddenly. If you no longer need the medicine, your GP will gradually reduce your dose. 

To find out more about possible side effects, see the patient information leaflet that comes with your medicine or the medicines information tab above.

Some people respond better to one SSRI than another. If you have been taking full recommended doses of an SSRI for three months without any benefit, you may be prescribed a different type of SSRI.

The doses of SSRI recommended for OCD are higher than those usually used for depression. There is evidence that low doses of SSRIs are ineffective.

Clomipramine

Clomipramine is a tricyclic antidepressant (TCA) that can be used as an alternative to SSRIs for treating OCD. TCAs are not as commonly used as SSRIs because they cause more side effects. However, they can be effective in treating people with OCD who cannot tolerate SSRIs.

Possible side effects of clomipramine include:

Clomipramine is not suitable for people who have:

If you are at risk of cardiovascular disease (conditions that affect the heart or blood vessels), your GP may recommend you have a blood pressure test and an electrocardiogram (ECG) before starting your treatment. An ECG measures the electrical activity of your heart.

As with SSRIs, a 12-month course of clomipramine is usually recommended, after which time your symptoms will be reviewed.

To find out more about the possible side effects, see the patient information leaflet that comes with your medicine or the medicines information tab above.

If SSRIs or clomipramine prove ineffective, you will be referred to a specialist mental health service.

Support groups

Many people with OCD find support groups helpful, as they can:

  • give you reassurance 
  • reduce feelings of isolation you may have 
  • give you a chance to socialise with others

Support groups can also provide information and advice for family members and friends who may be affected by your condition.

OCD Action and OCD-UK are both national charities for OCD that can provide information about support groups in your area. You can find information on their websites at the links below:

Surgery

Surgery is the very last resort for treating severe OCD when all other forms of treatment have failed. It should not be considered at all until someone has:

  • received at least two full trials of different SSRIs or clomipramine at recommended doses
  • had treatment for refractory OCD (OCD that does not respond to treatment) as well as antipsychotic medication or higher doses of SSRIs or mood stabilisers
  • received unsuccessful CBT treatments both in a clinic and at home, as well as having been treated by the National Service for Refractory OCD 

National Service for Refractory OCD

After the National Institute for Health and Clinical Excellence (NICE) published guidelines in 2005, the Department of Health (DH) commissioned a centre to treat people with severe, long-term refractory OCD. The National Service for Refractory OCD has been funded by the DH since April 2007 to treat people with the most severe form of the condition.

The National Service offers assessment and treatment to people with OCD who have not responded to treatments provided by their local and regional OCD speciality services. To be eligible for the National Service, you must have had a number of previous treatments and meet the severity criteria.

Most people improve after receiving treatment from the National Service. Very few people, perhaps one to two a year, may be considered for neurosurgery.

Read more about the NICE guidelines for OCD and the National Service for Refractory OCD.

Ablation neurosurgery

A very small number of people with OCD will need neurosurgery. During ablation neurosurgery, a neurosurgeon (a surgeon who specialises in surgery of the brain and nervous system) uses an electric current or a pulse of radiation to burn away a small part of the limbic system. The limbic system is a structure in the brain responsible for some of the most important brain functions, such as higher emotions, memory and behaviour.

Neurosurgery for OCD has never been subjected to controlled clinical trials. However, a survey conducted by the Royal College of Psychiatrists found that out of 478 people who had surgery for OCD, more than half felt they had improved. However, up to 15% felt unchanged or worse.

In addition, surgery for OCD carries the risks of both short- and long-term side effects, such as memory loss and mental confusion, which can be serious and irreversible.

Deep brain stimulation

Deep brain stimulation is an alternative surgical technique that may be used more frequently to treat OCD in the future. Currently, it is only used as part of medical research.

Deep brain stimulation involves implanting an electrical generator into your chest and electrodes (small metal discs) into your brain. An electrical signal is sent from the device in your chest to the electrodes in your brain.

Some small studies looking at deep brain stimulation for OCD have reported an improvement in symptoms. However, there are some possible serious side effects associated with the technique, including infection and bleeding inside the brain.

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Published Date
2013-05-15 07:01:34Z
Last Review Date
2012-10-04 00:00:00Z
Next Review Date
2014-10-04 00:00:00Z
Classification
Anxiety,Brain,Cognitive behavioural therapy,Depression,Mental health conditions,Mental health specialists,Obsessive compulsive disorder,Psychotherapists,SSRIs,Treatments,Tricyclic antidepressants

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