What is OCD?
Obsessive-compulsive disorder (OCD) is described as an anxiety disorder. The condition has two main parts: obsessions and compulsions.
Obsessions
Obsessions are unwelcome thoughts, images, urges or doubts that repeatedly appear in your mind; for example, thinking that you have been contaminated by dirt and germs, or experiencing a sudden urge to hurt someone.
These obsessions are often frightening or seem so horrible that you can’t share them with others. The obsession interrupts your other thoughts and makes you feel very anxious.
Compulsions
Compulsions are repetitive activities that you feel you have to do. This could be something like repeatedly checking a door to make sure it is locked or repeating a specific phrase in your head to prevent harm coming to a loved one.
The aim of a compulsion is to try and deal with the distress caused by the obsessive thoughts and relieve the anxiety you are feeling. However, the process of repeating these compulsions is often distressing and any relief you feel is often short-lived.
Living with OCD
Although many people experience minor obsessions (e.g. worrying about leaving the gas on, or if the door is locked) and compulsions (e.g. rituals, like avoiding the cracks in the pavement), these don’t significantly interfere with their daily lives, or are short-lived.
If you experience OCD, your obsessions and compulsions will cause you considerable fear and distress. They will also take up a significant amount of time, and disrupt your ability to carry on with your day-to-day to life, including doing daily chores, going to work, or maintaining relationships with friends and family.
Many people with OCD experience feelings of shame and loneliness which often stop them from seeking help, particularly if they experience distressing thoughts about subjects such as religion, sex or violence.
This means that many people try to cope with OCD alone, until the symptoms are so severe they can’t hide them anymore.
OCD is also known to have a close association with depression and some people find obsessions appear or get worse when they are depressed.
What are the common signs of OCD?
Although everyone will have their own experiences, there are several
common obsessions and compulsions that occur as part of OCD.
Common obsessions
The three most common themes are:
- unwanted thoughts about harm or aggression
- unwanted sexual thoughts
- unwanted blasphemous thoughts
Obsessions often appear closely linked to your individual situation. For example, if you are a loving parent, you may fear doing harm to a child and if you are religious, you may have blasphemous thoughts.
Common compulsions
Common compulsions include physical compulsions, e.g. washing or checking, or mental compulsions, e.g. repeating a specific word or phrase.
Avoidance
You might find that some objects or experiences make your obsessions or
compulsions worse, and you try to avoid them as a result. For example,
if you fear contamination, you might avoid eating and drinking anywhere
except in your own home. Avoiding things can have a major impact on
your life.
What causes obsessive-compulsive disorder (OCD)?
There are different theories about why OCD develops, but none of these theories have been found to fully explain every person’s experience.
‘Dysfunctional’ beliefs
One theory suggests that OCD develops because of ‘dysfunctional’ beliefs and interpretations.
If you experience OCD, you might believe that you have more responsibility for a situation than you actually do. Because of this, your reaction may be out of proportion. For example, many people experience sudden and intrusive thoughts, such as thinking that they might push someone in front of a train on a crowded platform. Most people dismiss it as a passing thought and do not believe they would actually do it.
However, if you have OCD, you are more likely to believe that you might act on the thought. This makes you anxious or scared, and so you may then develop a compulsion to try and prevent it happening. This could start an OCD cycle.
Personal experience
Some psychological theories suggest that OCD is caused by personal experience. It is thought that if you have had a painful childhood experience or suffered trauma or abuse, you might learn to use obsessions and compulsions to cope with anxiety. However, this theory does not explain why people who cannot point to any painful experiences might experience OCD.
It could also be that one or both of your parents may have had similar anxiety and shown similar kinds of behaviour (such as obsessional washing), and you learned to use this type of behaviour as a coping technique.
Biological factors
Some biological theories suggest that a lack of the brain chemical serotonin may have a role in OCD. However, experts disagree about what that role is, and it is unclear whether a lack of serotonin causes OCD or is the effect of having the condition. Studies have also looked at genetic factors and how different parts of the brain might be involved in causing OCD, but have found nothing conclusive.
However, biological theories do not provide any explanation for how the condition develops differently in different people; for example, why one person might develop a contamination obsession while another develops an obsession about harming.
Some experts have noted that some children seem to develop OCD symptoms very suddenly after having a streptococcal (or strep) infection, such as strep throat or scarlet fever. However, it is currently not known why this might occur and no research has yet been able to identify a physical cause to explain the link.
Cognitive Behavioural Therapy (CBT)
CBT techniques helped me to see the intrusive thoughts for what they are, and put them in their place. Cognitive Behavioural Therapy (CBT) is a talking treatment which aims to identify connections between your thoughts, feelings and behaviour. It aims to help you develop practical skills to manage any negative patterns of thinking or behaviour that may be causing you difficulties. It can be done one-to-one, or in a group. There is considerable evidence to suggest that this therapy is especially effective in dealing with OCD.
The behavioural element (also known as Exposure Response Prevention – ERP) is strongly recommended for treating OCD. ERP works by helping you to confront your obsessions and resist the urge to carry out compulsions. The aim is to help you feel less anxious about obsessive thoughts over time, and make you less likely to engage in compulsive behaviour. For example, if you fear that you will harm someone and avoid sharp objects as a result, you might build up to a therapy session where you hold a knife while sitting in a room with other people. This technique needs to be carefully managed to avoid causing distress and anxiety, so it is important that you understand the treatment fully and feel comfortable with your therapist.
How can I help myself?
Treatment of OCD often includes a combination of strategies, including self-help. The following suggestions are some ideas you could try to help you manage your OCD.
Self-help materials
Some people use self-help books, computer programmes or websites to help manage their OCD. Many self-help materials are based on cognitive behaviour therapy (CBT) principles, which have been shown to be particularly effective in treating OCD.
There are many self-help resources available, and you may have to try a few before finding one that is right for you. You may decide to use materials alongside professional help, or you may use them to develop your own coping strategies.
Relaxation and mindfulness techniques
Learning a relaxation technique won’t help you resolve obsessive thoughts or compulsions, but it may help you deal with anxiety that you experience as a result of your OCD. Relaxation techniques can teach you:
- how to improve your breathing to reduce tension
- physical exercises that relax your muscles
- action plans to help you progress from coping with non-stressful situations to those that you find difficult.
Some people may also find mindfulness techniques helpful to manage unwanted or intrusive thoughts and reduce anxiety. Mindfulness is a way of paying attention to the present moment, using techniques like meditation, breathing exercises and yoga.
Physical activity
Doing some regular physical activity, whether it is going for a short walk or playing a team sport, can help improve your mental wellbeing – particularly if you do it outside. Exercise releases feel-good hormones and doing something active can distract you from unwanted thoughts.
Talk to someone you trust
Talking about OCD isn’t easy. But if you can manage to talk to someone you trust about your condition, it could help you feel it is less frightening, and make you feel less isolated. It may also help other people understand your OCD behaviour and how they can help you.
Talking with a therapist who is experienced in working with OCD can help you understand and manage your symptoms in order to enable you to lead a fuller life.
Contact us now in confidence at Arduna @ (01) 833 2733 to discuss making an appointment with one of our therapists who can help you with OCD.
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