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, causing increasing anxiety. 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 unwell 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 alleviate 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.

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 

Whilst the exact causes of obsessive-compulsive disorder 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 and overthinking, may make individuals more susceptible to OCD symptoms. 

Treatment for obsessive-compulsive disorder

There are multiple forms of treatment strategies for people with OCD: 

• 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 specialised 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.