Obsessive Compulsive Disorder (OCD)

Symptoms

Obsessive-compulsive disorder consists of two key symptoms: Obsessions and Compulsions. 

Obsessions are intrusive and unwelcome thoughts that continuously occupy your mind.  These thoughts are challenging to ignore and can be disturbing. Obsessions can manifest in various forms, including thoughts, images or specific situations. You may find it distressing that your mind generates these thoughts. 

Some common obsessions include: 

• Contamination fears: Worries about harming someone or making them ill due to contamination or lack of caution. Routine activities like shaking hands or visiting someone’s house can trigger intense fear or phobias, leading to an obsession with cleanliness and germ avoidance.  

• Intrusive thoughts: Consistent, distressing thoughts that may be violent, sexual or guilt-inducing. These thoughts can result in unwanted mental images or urges, causing atypical impulses, anxiety or even depression. 

• Constant doubt and the fear of harm: A persistent sense that something is wrong, accompanied by the fear that a negative event is imminent.  

• Excessive responsibility: An overwhelming fear of causing a serious incident due to a past action or inaction, leading to a constant sense of responsibility.  

• Perfectionism: The belief that even minor mistakes or omissions, such as honest errors or forgetfulness, are unacceptable.  

Compulsions are repetitive actions or behaviours to help the anxiety triggered by obsessions. These actions are repeated until a sense of relief is achieved. Compulsions can be physical or mental in nature. 

Common compulsions include:  

• Checking: Frequent checking of things to ensure they are secure, such as lights and appliances being turned off or doors being closed and locked. This can also include verifying the presence of personal belongings.  

• Repeating: Engaging in repetitive movements or routines, like going in and out of doors or tapping, touching or blinking repeatedly.  

• Counting: Repeatedly counting in a specific way to go through a sequence or reach a ‘safe number’.  

• Excessive washing: Frequent handwashing due to contamination fears, often accompanied by elaborate cleaning rituals, which can have physical, emotional and financial consequences.  

• Hoarding: The compulsive need to hold onto specific items because of personal significance or belief, even when it causes clutter and discomfort in the living space. Hoarding behaviours are now recognised as a separate mental health condition called hoarding disorder, but it can also co-occur with OCD.   

Perinatal OCD

A specific form of OCD that affects mothers’ mental health during pregnancy (perinatal period) or in the postpartum period characterised by particular symptoms is called perinatal OCD.  

Symptoms of perinatal OCD include: 

• Obsessions: Perinatal OCD obsessions often revolve around fears of harming the baby, intrusive thoughts about accidents or illnesses befalling the baby or concerns about being an inadequate parent.

• Compulsions: Compulsions in perinatal OCD might include excessive cleaning or washing, constantly checking on the baby’s safety, seeking reassurance from others or engaging in mental rituals like counting or praying. 

Causes 

While the exact causes of obsessive-compulsive disorder (OCD) are not fully understood, several contributing factors have been identified:  

• Personal experiences: Ongoing anxiety or stress can trigger OCD symptoms as a coping mechanism.  
• Biological factors: Changes in brain chemistry, particularly related to serotonin levels, are associated with OCD and may affect mood regulation.  
• Genetic predisposition: A family history of OCD can increase the risk of developing the condition.  
• Personality traits: Certain traits, like perfectionism, intolerance of uncertainty and overthinking, may make individuals more susceptible to OCD symptoms.  

Treatment for obsessive-compulsive disorder

OCD might cause a person to avoid social contact, forming relationships and even work. It might also delay help-seeking. It is very important that you talk to your GP if you experience any of the above symptoms.  

There are multiple forms of treatment strategies for people with OCD. Some include medication, other talking therapies like:   

• Cognitive Behavioural Therapy (CBT) aids in gaining insight into your thought processes, emotions, and actions. It provides a means to comprehend thought patterns and responses in various situations.  
• Exposure Response Prevention (ERP) entails systematic exposure to anxiety-inducing stimuli until they become more controllable. It is a technique employed for managing OCD aimed at helping individuals grasp and navigate their anxiety and obsessions.   

With the guidance of a therapist, your anxiety gradually diminishes becomes more manageable and alternative coping strategies are developed over time. 

How to help someone who has OCD?

Below are some useful tips how you can support a friend or loved one with their OCD: 

Helping Manage Compulsions 

• Agree on a shared approach. Talk about how you’ll handle compulsions together. Having a plan helps in tough moments. 
• Avoid giving reassurance. It may feel helpful, but reassurance often keeps OCD going. 

Working Together 

• Make a plan when things are calm. Decide how to respond during tough times. Write it down if helpful. 

Supporting Treatment 

• Help them prepare for appointments. Write notes or practise what they want to say. 
• Offer to go with them. Your support can make it easier. 

Be Kind and Patient with Them 

• Don’t judge their fears. Even if they seem irrational, they feel very real to them. 
• Encourage self-kindness. Remind them they’re doing their best. 

Be Kind and Patient with Yourself 

• Take care of your own wellbeing. You and your boundaries matter too. 
• Reach out for support. Talk to friends, join forums or seek help if you’re struggling.