Introduction of obsessive compulsive disorder

Obsessive compulsive disorder (OCD) is a mental health condition where a person has obsessive thoughts and compulsive behaviour.

An obsession is an unwanted, unpleasant thought, image or urge that repeatedly enters a person’s mind, causing them anxiety.

The word “obsession” usually describes something enjoyable, but in OCD the obsession is unpleasant and frightening.

A compulsion is a repetitive behaviour or mental act that someone feels they need to carry out to try to prevent an obsession coming true. For example, someone who is obsessively scared they will catch a disease may feel the need to have a shower every time they use a toilet.

OCD symptoms

OCD symptoms can range from mild to severe. For example, some people with OCD may spend an hour or so a day engaged in obsessive-compulsive thinking and behaviour. For others, the condition can completely take over their life.

Although OCD affects individuals differently, most people with the condition fall into a set pattern of thought and behaviour. The pattern has four main steps:

• obsession – your mind is overwhelmed by a constant obsessive fear or concern, such as the fear your house will be burgled
• anxiety – this obsession provokes a feeling of intense anxiety and distress
• compulsion – you adopt a pattern of compulsive behaviour to reduce your anxiety and distress, such as checking all your windows and doors are locked at least three times before leaving the house
• temporary relief – the compulsive behaviour brings temporary relief from anxiety but the obsession and anxiety soon return, causing the cycle to begin again

Read more about the symptoms of OCD.

What causes OCD?

A number of factors are thought to play a part in OCD. Evidence suggests that in some cases the condition may run in families and is linked to certain inherited genes that affect the brain’s development.

Brain imaging studies have also shown that people with OCD have abnormalities, such as increased blood flow and activity, in some parts of their brain. The areas of the brain affected deal with strong emotions and the response to them.

Studies have also shown that people with OCD have an imbalance of serotonin in their brain. Serotonin is a neurotransmitter that the brain uses to transmit information from one brain cell to another.

Read more about the causes of OCD.

Seeing your GP

People with OCD are often reluctant to report their symptoms to their GP because they feel ashamed or embarrassed. They may also try to disguise their symptoms from family and friends.

However, if you have OCD, there is nothing to feel ashamed or embarrassed about. OCD is a long-term health condition like diabetes or asthma and it is not your fault you have it.

You should visit your GP if you have OCD. Initially, they will probably ask a number of questions such as how often you clean and whether you are concerned about putting things in a particular order.

If your GP suspects OCD, you may need to be assessed by a specialist.

Read more about how OCD is diagnosed.

Treating OCD

If you are diagnosed with OCD, your treatment plan will depend on how much the condition affects your ability to function.

Your treatment is likely to involve behavioural therapy to change your behaviour and reduce your anxiety, and medication to help control your symptoms.

OCD is usually treated with cognitive behavioural therapy (CBT) or antidepressants called selective seretonin reuptake inhibitors (SSRIs). CBT is a talking therapy that can help you manage your problems by changing the way you think and behave.

Depending on how severe your OCD is, you may need to be referred to a specialist mental health service.

Read more about how OCD is treated.

Complications

Some people with OCD also develop depression. You should not ignore feelings of depression because they can become more severe if they are left untreated. Untreated depression will also make it more difficult for you to cope with the symptoms of OCD.

You may be depressed if you have been feeling very down during the past month and things you used to enjoy no longer give you pleasure. If this is the case, you should visit your GP.

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

Contact your GP or care team immediately if you are depressed and feeling suicidal. You can also telephone the Samaritans to talk in confidence to a counsellor on 08457 90 90 90. Alternatively, you can call NHS Direct on 0845 4647.

Outlook

If you have OCD, seeking help is the most important thing you can do. Left untreated, it is unlikely your OCD symptoms will improve, and they may get worse. Without treatment, nearly half of people with OCD still have symptoms 30 years later.

With treatment, the outlook for OCD is good and many people will achieve a complete cure, or at least reduce symptoms enough to be able to enjoy a good quality of life.