Obsessive compulsive disorder (OCD)
What is OCD?
Obsessions
Obsessions occur when people repeatedly get intrusive thoughts or ideas that can be frightening or distressing. For instance thinking that your mother is going to die, and then worrying that they will because you had this thought.
Compulsions
Compulsions are when people feel compelled to do certain things even when they don't want to. For instance some people feel compelled to wash their hands repeatedly in a certain ritualistic way to get rid of germs.
People who carry out these rituals are described as having OCD. The purpose of the ritual is to ward off or protect from the consequences of a potential danger.
Many common superstitions are based around obsessive compulsive behaviours! (don't step on a crack.... or you'll break your mother's back) so we all have them to some degree or another.
It's only a problem when actually stepping on the crack worries and causes you to panic, or that in avoiding stepping on cracks takes up a lot of time and or puts you in danger.
These behaviours become problems, when they start to affect us in a negative way.
Signs and symptoms
OCD affects about 1% of young people. Milder versions are very common among young children, for instance, having to arrange their toys in a certain way, or say good night in a certain sequence.
This is normal behaviour and only develops into OCD when:
- Obsessions and rituals severely interrupt daily activities because they are so time consuming.
- The person is upset by their compulsion but continues to do it
- Some compulsions might result in physical signs e.g. excessive washing can result in sore and chapped skin.
What causes OCD?
The precise causes of OCD are still unclear, but some possible causes include:
- An imbalance in brain chemistry, particularly involving serotonin.
- There may be a genetic factor as there's a tendency for it to run in families. Often other people in the family may have tics (involuntary jerky movements).
- Some people think those with a tendency towards perfectionism are more prone to developing OCD.
- A traumatic event could also trigger obsessive thoughts or behaviour.
Treatments: what can you do about it?
The two most effective treatments for OCD include
- Behaviour therapy
- Medication
Behaviour therapy
This is a practical therapy that involves clients developing a programme with the therapist, to gradually tackle their underlying anxiety and face their fear.
For example, someone with an obsession about cleanliness will be helped to follow a programme which lays down when and how often they wash. Your GP should be able to refer you to a therapist.
Medication
Anti-depressants such as fluoxetine and clomipramine can be helpful in treating OCD because they act upon the brain chemical serotonin. About 70% of people with OCD are helped to get better by taking medication.
Combining medication with behaviour therapy helps young people to learn techniques that will keep them better for longer and prevent relapse.
Most young people who need medication usually tolerate it well, but those who can't or don't want medication can be helped to get better by behaviour therapy alone.
