It’s normal, on occasion, to go back and double-check that the iron is unplugged or your car is locked. But if you suffer from obsessive-compulsive disorder (OCD), obsessive thoughts and compulsive behaviours become so excessive they interfere with your daily life.
No matter what you do, you can’t seem to shake them. But help is available. With treatment and self-help strategies, you can break free of the unwanted thoughts and irrational urges and take back control of your life.
Obsessive-compulsive disorder (OCD) is an anxiety disorder characterised by uncontrollable, unwanted thoughts and repetitive, ritualised behaviours you feel compelled to perform. If you have OCD, you probably recognise that your obsessive thoughts and compulsive behaviours are irrational – but even so, you feel unable to resist them and break free.
Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, you may check the stove twenty times to make sure it’s really turnoff, wash your hands until they’re scrubbed raw, or drive around for hours to make sure that the bump you heard while driving wasn’t a person you ran over.
Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. You don’t want to have these ideas but you can’t stop them. Unfortunately, these obsessive thoughts are often disturbing and distracting.
Compulsions are behaviours or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts.
In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviours often end up causing anxiety themselves as they become more demanding and time-consuming.
Most people with obsessive-compulsive disorder (OCD) fall into one of the following categories:
• Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.
• Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.
• Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen to them or others or they will be punished.
• Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colours, or arrangements.
• Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use.
The most effective treatment for obsessive-compulsive disorder is often cognitive-behavioural therapy. Antidepressants are sometimes used in conjunction with therapy, although medication alone is rarely effective in relieving the symptoms of OCD.
CBT for OCD involves a treatment called Exposure and response prevention (E-RP). It involves repeated exposure to the source of your obsession. Then you are asked to refrain from the compulsive behaviour you’d usually perform to reduce your anxiety. For example, if you are a compulsive hand washer, you might be asked to touch the door handle in a public restroom and then be prevented from washing.
As you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way, you learn that you don’t need the ritual to get rid of your anxiety—that you have some control over your obsessive thoughts and compulsive behaviours.
Your therapist will talk to you about the length of treatment after during the assessment stage. The Department of Health guidelines suggest therapy will be in excess of 10 treatment sessions..
For more information on OCD please see: www.nice.org.uk