Obsessive Compulsive Disorder is often misunderstood in modern society. The letters OCD have become
synonymous with people favouring organisation, planning and regular hygiene. We have all
heard the terms “I’m a little OCD as I like to keep my room clean”, STOP. It's
likely you don’t suffer from OCD. OCD, is a debilitating condition, that impacts
the work, education, and social lives of those affected.
If you want to learn more keep watching as we will break down OCD in this video. So,
let's talk mental health.
I’m Dr Hart-Pinto and in this series, we aim to break down the social barriers of mental
health.
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Ok so what is OCD?
OCD, or obsessive-compulsive disorder, is an anxiety disorder characterised by obsessive
thoughts and compulsive behaviours. OCD can be distressing for those affected and has
a significant impact on an individual's daily life.
Who gets OCD?
Why OCD occurs is not fully understood, however, is thought to be associated with low levels
of the neurotransmitter serotonin in the brain. Research has also pointed to abnormal brain
activity in the basal ganglia and frontal cortex.
The condition is relatively common affecting up to 3% of the population, with symptoms
presenting in early adulthood, with the majority receiving their OCD diagnosis during their
20s. A genetic link is likely to further influence
the development of OCD. Therefore, individuals with an affected parent or sibling at higher
risk of developing the condition. OCD sufferers may have further co-existing
mental health conditions such as depression or schizophrenia.
What do OCD patients experience?
The symptoms of OCD can be broken down into 3 components, and should be considered as
a cycle:
1. First comes Obsessions a. These are unwanted, and often unpleasant;
intrusive, repetitive and persisting thoughts that cannot be shaken off.
b. Some common themes are: i. fear of deliberately harming yourself or
others ii. Accidentally harming yourself or others
iii. fear of contamination iv. a need for symmetry or orderliness
v. Violent or sexual thoughts that can be repulsive and distressing
2. Next is Emotions a. The obsessions discussed may cause significant
distress to individuals which can affect a persons function in daily life
b. These thoughts increase anxiety which in turn drive the compulsion coping mechanism
3. Compulsions a. These may be ritualistic behaviours or
mental behaviours individuals perform, relieving their anxiety
b. Sufferers recognise that this behaviour is irrational but feel compelled to complete
the rituals. They experience mounting tension which is immediately relieved on completion
of their compulsion. c. Some examples include:
i. Repeated hand washing to remove contamination ii. Checking doors are locked,
iii. Counting iv. hoarding
Unfortunately, the Obsessive thoughts soon re-occur resulting in a repeating of the cycle.
How can OCD be diagnosed?
If you are concerned that that you or a loved one is suffering from OCD you should discuss
your concerns with your regular doctor.
Your doctor can only make a diagnosis of OCD where obsessions and compulsions are present
on most days for a period of 2 weeks and there is an observable impact on daily activities
or significant distress.
Treatment
The symptoms of OCD are unlikely to improve on their own, but with the right treatment
you are able regain control. Treatment for OCD can be separated into 2 parts psychotherapies
and medication, so, lets take a look.
Psychotherapies for OCD are usually centred on Cognitive behaviour therapy, CBT for short.
In CBT you will work with your therapist on exposure and response prevention. Here your
therapist will break down your problems into thoughts, feelings and actions. You will be
encouraged to face your obsessive thoughts, and not neutralising them with compulsive
actions. This may be difficult at first but will improve over time. 9 in 10 people will
experience an improvement or resolution of their OCD, with CBT. How long this will take
can vary, if you have particularly challenging OCD, you may need a longer course of treatment.
If CBT hasn’t worked for you, or your symptoms are particularly challenging, your doctor
may recommend a trial of medication. First line are SSRIs, these medications work by
increasing the level of serotonin in your brain, helping to balance the brains biochemistry.
It can take some time to notice a difference in your OCD, when taking these medications.
So expect to have an initial trial of 12 weeks, so some perseverance is necessary.
For the minority of patients, their symptoms of OCD remain uncontrolled with a combination
of psychotherapy and SSRI medication. Amongst these individuals, an onward referral to a
psychiatrist may be helpful. Your psychiatrist may consider a trial of antipsychotics, or
several other therapeutic methods available, if you experience resistant symptoms.
Prognosis Up to 80% of individuals will experience an
improvement in their OCD symptoms with a combination of medication and psychotherapy. However,
for some symptoms are resistant and can worsen overtime.
Occasionally the symptoms of OCD become so challenging that people may consider harming
themselves or taking their life. you are at further risk If you have co-existing depression
If you are having thought of harming yourself, its important to tell someone. Speak with
your doctor, someone you can trust or a helpline. I will include the contact number for the
Samaritans in the description below.
I hope you have enjoyed this video.
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