OCD
Obsessive compulsive disorder (OCD) is a manifestation of anxiety, and is often marked by a cycle of compulsive or repetitive behaviours to help cope with intrusive or unwelcome thoughts. Therapists, particularly specialists in Exposure Response Prevention, can help people manage these symptoms.
Do I have OCD or am I just tidy?
OCD describes a cyclical pattern of intrusive thoughts and compulsive behaviours that affects a person’s quality of life and ability to live normally.
OCD is a mental health problem that people can spend years learning to manage. Keeping your environment clean or tidy is not the same as OCD, and people with OCD might feel offended if people confuse the two.
If keeping your environment clean or tidy feels compulsive, is an ever-present preoccupation, affects your quality of life or stops you living normally (for example, working or spending time with loved ones), then cleaning might be a sign of OCD.
What OCD is not
Intrusive thoughts, which form one part of the OCD cycle, are absolutely normal. What makes them part of an OCD presentation is an urge that follows, or a reaction to them that feels compulsive or out of control.
What types of OCD are there?
- Checking – Checking OCD might rely on checking physical objects such as locks, letters, cars, or taps, or it might involve checking memories, text, emails, or getting reassurance. Some checking OCDs give people unreasonable doubts about whether or not they have accidentally become pregnant, caught an infectious disease such as HIV, or been aroused by something they don’t want to be.
- Hoarding – If a person is unable to get rid of useless or worn-out objects, this type of OCD is commonly referred to as hoarding.
- Contamination – Excessive doubts and worries about getting dirty or catching something are part of a common type of OCD. For example, people with contimatination OCD might struggle to have sex or masturbate, go out in public or crowds, or visit the GP or hospital. People with OCD might also fear ‘mental contamination’.
- Ordering – People with OCD might feel an unreasonable amount of anxiety when objects are disordered or asymmetrical. People with an ordering OCD might feel a sense of dread or doom (for example, fear that a parent or child will die) for as long as objects appear disordered or unaligned.
- Rumination – A person with rumination OCD finds it hard to accept or come to a satisfying conclusion to thoughts, to the extent that their inner life stops them working or enjoying relationships or interests. Rumination feels compulsive – that the train of thought cannot be left alone or concluded without risk of serious harm. Rumination might also lead to checking or reassurance-seeking.
- ‘Pure O’ – Although this type of OCD has been discredited by leading voices, the description of the condition might still be a useful way for people to recognise rumination OCD and ‘invisible’ compulsions. ‘Pure O’ was an attempt to classify OCD that appears to feature intrusive thoughts without compulsive behaviour; in fact, the compulsions people experience when they self-diagnose with ‘Pure O’ will simply be harder to identify. For example if a person can hide compulsive checking (such as reassurance-seeking) or ruminating then the OCD might go unnoticed or unremarked on.
How long does OCD last?
OCD can develop at any time in life, but tends to appear in puberty or adolescence. OCD is a chronic illness, but it can be managed and treated successfully, even if the first type of treatment does not work as well as hoped.
How many people in the UK have OCD?
Current estimates suggest 1.2% of the population is affected by OCD.
What causes OCD?
OCD might be triggered by stress or anxiety but doesn’t have a cause, per se. OCD might develop during a stressful period but people with OCD also describe it appearing ‘out of the blue’ or ‘out of nowhere’.
Even if people are not sure why they have OCD or where it came from, they still have as much right to treatment as someone whose OCD follows a stressful experience. Therapists do not need to know where OCD comes from or why to treat it.
What treatments are there for OCD?
Therapy for OCD
Many therapists specialise in treating OCD, and psychotherapy or talking therapies are a recommended treatment.
Exposure therapy for OCD
Exposure therapy helps people learn to cope with things that make them anxious on a very gradual, well-managed process. It is particularly well-suited to treating OCD.
Medication for OCD
Taking medication to manage anxiety can help a person manage OCD symptoms and also supports therapeutic work. SSRIs are one example of a common medical treatment for OCD symptoms.
Books, podcasts and events about OCD
The Man Who Couldn't Stop (2016)
David Adam's memoir of his experience of OCD became a Sunday Times bestseller after its publication.
Help and information about OCD
OCD UK
A national OCD charity with good campaigns and resources on recovery.
OCD Action
A charity that provides information about OCD, and aims to improve rates of diagnosis in the UK.