Mental Health Conditions

Obsessive Compulsive Disorder (OCD)

Obsessive Compulsive Disorder (OCD) is a mental health condition related to anxiety that means affected individuals have a debilitating preoccupation with maintaining orderliness, perfectionism, and mental and interpersonal control. It may be helpful to distinguish between the two elements of OCD.

1. Recurrent obsessions of OCD
Obsessions associated with OCD include inappropriate and persistent ideas, thoughts, feelings and impulses that cause anxiety or distress. Examples might include repeated thoughts about contamination; repeated doubts about an action, ‘Have I locked the door?’; aggressive or horrible impulses, for example to shout obscenities in church, and sexual imagery. These obsessions are recognised by the individual as internally produced, by the mind.

2. Recurrent compulsions of OCD
These consist of repetitive behaviours, such as washing, cleaning, checking, counting, repeating words silently. The goal of compulsions is to reduce anxiety or distress. In most cases, the individual feels driven to perform the compulsion to reduce anxiety or prevent some dreaded event.
Psychological symptoms of OCD
• Inadaptable when faced with a new situation
• Rigid views, inflexible problem-solving approach
• Perfectionism
• Focus on trivial details
• Guilt; preoccupied with wrongdoing, stifling enjoyment
• Anxiety and tension from attempts to resist compulsion
• Sensitivity to criticism
• Often show little outward emotion, but hide anger and resentment
• Ruminations, eg internal debates or arguments, simple actions are endlessly reviewed
Behavioural symptoms of OCD
• Compulsions: persistent, ritualistic behaviours such as ordering, checking, washing hands
• Structured pattern for tasks; arranging things in a set order
• May excessively use alcohol, or sedative, hypnotic or anti-anxiety medications.

Social impact of OCD
While everyone may have some experience of repetitive thoughts or behaviour, OCD obsessions or compulsions cause distress, and are time consuming (over 1 hour every day). They interfere with the individual's normal routine, work, social activities and relationships.
Many individuals avoid objects or situations that provoke obsessions or compulsions, especially situations involving the content of obsessions, eg dirt, contamination. Performing compulsions may become a major life activity, leading to serious marital, occupational or social disability, eg they may lead to social isolation or, in severe cases, lead to the individual’s being housebound.

Treatments for OCD
Psychological therapies can be effective in the treatment of OCD, often CBT (cognitive behavioural therapy). This involves identifying the thought patterns and modifying behaviour through exposure and response prevention. Anti-depressant medication may also be helpful.

SANE offers emotional support and information to anyone affected by OCD, including family, friends and carers. If you or anyone you know may be affected, you can receive free mental health support via our Textcare and Support Forum services. Our helpline is also available on 0300 304 7000 6 pm – 11 pm.