What is OCD (Obsessive compulsive disorder)

Updated: Apr 24

Obsessive compulsive disorder (OCD) can affect you in different ways. It usually causes a particular pattern of thoughts and behaviours.


Obsessive compulsive disorder (OCD) can affect you in different ways. It usually causes a particular pattern of thoughts and behaviours.

This pattern has 4 main steps:

  1. Obsession - an unwanted and distressing thought, image or urge repeatedly enters your mind.

  2. Anxiety - the obsession provokes a feeling of intense anxiety or distress.

  3. Compulsion - repetitive behaviours or mental acts that you feel driven to perform. These can be a response to the obsessive thought pattern.

  4. Temporary relief - the compulsive behaviour relieves the anxiety for a short while. But the obsession and anxiety soon return, causing the cycle to begin again.


It's possible to have obsessive thoughts, with or without the compulsion or urge to act. You may experience both.

Obsessive thoughts

Most of us, at some point, will have unpleasant or unwanted worrying thoughts or thoughts that make us anxious. This can be thinking you may have forgotten to lock the door of the house. You can even have sudden unwelcome violent or offensive mental images. Many of these thoughts go away as quickly as they appear.

You may have an obsession if you have a persistent, unpleasant thought that takes over your thinking. This thought may interrupt all your other thoughts. It can make it hard for you to focus on other daily activities.

Some common obsessions include:

  • fear of deliberately harming yourself or others

  • intense worry about catching a disease or infection

  • thinking about having to do things in a certain order or number of times to feel safe and reduce anxiety


You may have unwanted sexual thoughts or images which you fear you may act on. While these thoughts can cause extreme distress, it doesn't mean you will act on them.

Compulsive behaviour

Compulsions are things you do or ways you behave in response to the thoughts that make you anxious. The actions usually provide relief from the distress for a short while. 

For example, if you are afraid of catching germs, you may wash your hands over and over again. Washing your hands reduces the worry that you have germs on your hands. But as that thought comes back, the urge to wash your hands increases again.

People with OCD know that compulsive behaviour is irrational (does not make sense). But they do it because it reduces distress for a short while.

Common types of compulsive behaviour include:

  • excessive cleaning and hand washing

  • checking - such as checking doors are locked or that switches and appliance are off

  • counting and doing the same thing many times

  • ordering and arranging

  • hoarding

  • asking for reassurance

  • repeating words in their head

  • thinking 'neutralising' thoughts to counter the obsessive thoughts

  • avoiding places and situations that could trigger obsessive thoughts


Not all compulsive behaviours will be obvious to other people. When they are not obvious they are called "covert" behaviours. When they are obvious, they are called "overt" behaviours.

Getting help

Get help if you think you have OCD and it's having a negative impact on your life. If you think a friend has OCD, find out if their thoughts or behaviours are causing problems for them. For example, in their daily routines and quality of life.

OCD is unlikely to get better on its own. Treatment and support can help you manage your symptoms.

To get help, talk to your GP. They can refer you to local psychological support services.


Related problems

Some people with OCD may also develop other serious mental health problems, including:

- depression - eating disorders - generalised anxiety disorder - hoarding disorder

People with OCD and severe depression may also have suicidal feelings.


Treatment


Obsessive compulsive disorder (OCD) is a treatable condition. The type and course of treatment will depend on your own situation and circumstances. You and your healthcare professional can talk about this and agree on the right treatment options for you. The two main treatments types are: psychological therapy - helps you understand OCD and learn new ways of coping medication - usually an antidepressant, changes the balance of chemicals in your brain One or both of these may be best for you. Your healthcare professional will help you decide. Psychological therapy

The most effective treatment for OCD is Cognitive Behaviour Therapy (CBT). Cognitive Behavioural Therapy (CBT) helps you manage your problems by thinking more positively. It frees you from unhelpful patterns of behaviour. Exposure and Response Prevention (ERP) is a type of CBT that is used to treat OCD. You learn to understand the triggers for your thoughts and behaviours. It allows the obsessive thoughts occur without neutralising them with compulsive behaviours. This is called graded exposure. You start with situations that cause you the least anxiety first. You do this before moving onto more difficult thoughts. The treatment can be difficult and may sound frightening, but people do get better.


Medication

You may need medication to add to your psychological therapy. The main medications prescribed are selective serotonin reuptake inhibitors (SSRIs). These can help by increasing the levels of a chemical called serotonin in your brain. You may need to take the medication for 12 weeks before you notice any effect. You may need to take medication for at least a year. You may be able to stop if you have few or no troublesome symptoms after this time. Although some people need to take medication for many years. Your symptoms may continue to improve for up to 2 years of treatment. Don't stop taking SSRIs without speaking to your doctor first. Giving up SSRIs can cause unpleasant side effects. To reduce the chance of this happening, treatment should end gradually . Your doctor may need to increase the dose again if your symptoms return. Side effects

Possible side effects of SSRIs include: - feeling agitated, shaky or anxious - feeling or being sick - diarrhoea or constipation - dizziness - sleeping problems - headaches - low sex drive

There's also a very small chance that SSRIs could cause you to have suicidal thoughts or want to self-harm. Contact your GP or go to your nearest emergency department (ED) if this happens. Most side effects improve after a few weeks as your body gets used to the medication. Although some can persist. Further treatment

Your doctor may refer you to a specialist OCD service if other treatments have not worked. OCD support groups Many people with OCD find support groups helpful, as they can: - provide emotional support and coping advice - reduce feelings of isolation - offer a chance to socialise with others - provide information and advice for family members and friends

Your GP and mental health service can provide information about support groups in your area.


*Content supplied by the NHS and adapted for Ireland by the HSE.



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Other services you where you can reach someone to talk to:

Samaritans offers a 24 hour listening service over text message, text 'Hello' to 087 260 9090 to get started (standard text messaging rates apply) or call 116 123 to talk to someone over the phone.

Childline text and instant messaging services are available from 10am - 4am every day to young people under 18, text 'Talk' to 50101 to talk to a trained counsellor by text message or call 1800 66 66 66.



Visit Your GP:

We always recommend that you visit your GP with whatever health issues you are facing.  Don’t feel embarrassed or ashamed.  Your doctor is a professional health care provider and will be familiar with how you are feeling.  You mental health is just that - your health.  You would visit your GP if you had been feeling physically unwell right ?  Your emotional health is just as important as your physical well-being - in fact the two go hand in hand.  If you don’t have a current GP you can find a list of services in your area here.  You can also contact the CareDoc service on 1850 334 999




Contact the Emergency Services:

If you are an immediate danger to yourself and are going through a suicidal crisis  please contact the emergency services by dialling 999 or visit your nearest Emergency Department.

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