Obsessive Compulsive Disorder
Many of us have small habits that make us feel better, but we can also live without them. For example, we might think of something as ‘lucky’ or have a routine that feels comforting. But for people who experience Obsessive-Compulsive Disorder (OCD), these behaviours are much more intense and disruptive and are fuelled by unwanted thoughts that don’t go away. OCD is not always easy to understand, but it’s a real illness that causes difficulties in a person’s life.
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OCD is a mental illness. It’s made up of two parts: obsessions and compulsions. People may experience obsessions, compulsions, or both, and they cause a lot of distress. Obsessions are unwanted and repetitive thoughts, urges, or images that don’t go away. They cause a lot of anxiety. For example, someone might worry about making people they love sick by bringing in germs. Obsessions can focus on anything. These obsessive thoughts can be uncomfortable. Obsessions aren’t thoughts that a person would normally focus on, and they are not about a person’s character. They are symptoms of an illness. Compulsions are actions meant to reduce anxiety caused by obsessions. Compulsions may be behaviours like washing, cleaning, or ordering things in a certain way. Other actions are not obvious to others. For example, some people may count things or repeat phrases in their mind. Some people describe it as feeling like they have to do something until it feels ‘right.’ It’s important to understand that compulsions are a way to cope with obsessions. Someone who experiences OCD may experience distress if they can’t complete the compulsion. People who experience OCD usually know that obsessions and compulsions don’t make sense, but they still feel like they can’t control them. Obsessions and compulsions can also change over time.
OCD can affect anyone. Researchers don’t know exactly what causes OCD, but there are likely many different factors involved, such as family history, biology, and life experiences. OCD used to be considered the result of family troubles or attitudes learned in childhood. It is now believed that the disorder has a neurological and genetic basis. Current research into its causes focuses on the workings of the brain and the influences of personal circumstances. OCD can occur in people of all ages, but it generally begins before 40. Studies show that the disorder usually begins during adolescence or early childhood. It affects men and women equally.
People with OCD are under great stress. The intensity of their symptoms varies – at times symptoms are like background noise; at other times, they are a deafening roar. Because individuals with OCD may spend an hour or more every day carrying out rituals, their ability to conduct a balanced life is impaired and their relationships at work and home can suffer.
With early diagnosis and the right treatment, people can avoid the suffering that comes with OCD. They also have a greater chance of avoiding depression and relationship problems that often come with OCD. Unfortunately, OCD tends to be underdiagnosed and undertreated. This is partly because many people with OCD are ashamed and secretive about their symptoms, and some do not believe they have a problem. Another factor is that many healthcare practitioners are not well informed about the condition.
Two effective treatments for OCD have been developed: medication and Cognitive-behavioural therapy (CBT). Used together, these treatments can be effective. CBT teaches skills like solving problems, managing stress, realistic thinking and relaxation. Support groups can also be very helpful. They are a good place to share your experiences, learn from others, and connect with people who understand what you’re going through. OCD can make people feel very isolated and alone, so support groups can be a good way to build a support network. There are many self-help strategies to try at home. Small steps like eating well, exercising regularly, and practicing healthy sleep habits can really help. You can practice many CBT skills, like problem solving and challenging anxious thoughts, on your own. Ask your support team about community organizations, websites, or books that teach CBT skills. And it’s always important to spend time on activities you enjoy and connect with loved ones.
The drugs used to combat OCD symptoms are those which affect levels of serotonin, a chemical messenger in the brain. Antidepressants are the most common medication for OCD. Antianxiety medications (benzodiazepines) may be less effective for OCD, so they are not usually the first option to try. Psychotherapy techniques used to combat OCD symptoms are exposure and response prevention. These involve encouraging a person to stay in contact with the object or situation that forms the obsession, and to not perform the ritual to ease the pressure of that obsession. Depending on the intensity of the therapy, improvement may be seen within two or more months.
If you have OCD, it is important to be aware that doubts and discomfort during treatment are normal. Work with your doctor to adjust medication, and don’t hesitate to ask for second opinions about Cognitive-behavioural therapy. It can help to know that, once you get your OCD under control, keeping it there is easier.
Many adults diagnosed with OCD report that their symptoms begin in childhood. Coping with embarrassing compulsions and trying to hide them from friends and family can place great stress on a child. Children with OCD appear to be more likely to have additional psychiatric problems. They may suffer from conditions such as panic disorder or social phobia, depression, learning disorders, tic disorders, disruptive behaviour disorders and body dysmorphic disorder (imagined ugliness). Cognitive-behaviour therapy can help a child gain relief from OCD symptoms. Medication is generally given to children only when CBT has not achieved the desired results.
Supporting a loved one who experiences OCD can be challenging. Many people feel like they have to follow along with a loved one’s compulsions. Some people who experience OCD avoid certain things or activities, and other people may feel like they have to do everyday things for a loved one. You may have many different complicated feelings. You may feel upset when a loved one is experiencing distressing symptoms of OCD, but you may not see why a normal task could be a problem. You may want a loved one to be more independent, but see how challenging certain things can seem. If a loved one’s experience with OCD affects others, especially young people, it’s a good idea to seek counselling for everyone. Family counselling is a good option for the entire family. Here are more tips to help you support someone you love:
- A loved one who experiences OCD usually understands that their experiences don’t make sense. Trying to argue with obsessions or compulsions doesn’t help anyone.
- Avoid ‘helping’ behaviours around OCD—for example, helping a loved one avoid things that cause anxiety. This can make it harder to practice healthy coping skills in the long run. Instead, it may be more helpful to focus on the feelings behind the behaviours.
- Signs of OCD can be more difficult to manage during times of stress—and even happy occasions can be stressful. Recognize that a loved one may need extra supports, and try to plan ahead.
- Every small step towards managing OCD behaviour can take a lot of courage and hard work, so celebrate every victory.
- Set your own boundaries, and seek extra support when you need it. Support groups for loved ones can be very helpful.