OCD – what is it?

• To sufferers it represents constant fear, frustration, panic, foreboding, dread, risk,
  humiliation and doubt
• OCD is an anxiety disorder
• OCD is a neurological malfunction in the frontal part of the brain causing cells to misfire during information processing and decision-making
• Most people display OCD-like behaviour and it is often labelled “superstition”, e.g. using one's foot to flush a toilet for fear of germs, throwing salt over one's shoulder to ward off bad luck. It becomes OCD when these rituals intrude on day-to-day tasks or when no amount of incentive can prevent the sufferer from carrying them out
• OCD affects 2.5-4% of the population making it the second most common mental health disorder after depression
• The severity of OCD ranges from mildly inconvenient to severe where patients can become housebound or hospitalised (approx. 20%)
• OCD is currently incurable but it is very manageable

What is happening to the person?

The essential features of OCD are recurrent obsessions (intrusive thoughts) that create an awareness of alarm or threat, e.g. "I might get AIDS from the germs on that door knob;" "Since I had the thought of killing my baby, I might be capable of doing it;" or "If I don't pick up that dirty litter someone else might get sick from it, and I would hold myself responsible;" etc.) They are more usually followed by a compulsion carried out to relieve the discomforting thought, e.g. excessive washing or repetitive rituals. Obsessions take the form of either a perceived threat of physical harm to oneself or others. Common OCD Obsessions revolve around:

• Contamination
• Harming self/others
• Losing control
• Sexual worries
• Excessive religious or moral issues
• Forbidden thoughts
• Excessive perfectionism
• A need to tell/confess
• Hypochondria

Compulsions are carried out in response to the obsessions. They take the form of repetitive behaviours or rituals. Although they are carried out to relieve/reverse the discomfort felt by the obsession, they only relieve the discomfort in the short-term but in the longer-term exacerbate the condition. The effects of rituals and repetitive behaviour are cumulative, the more sufferers repeat the stronger the compulsion to repeat becomes. Common OCD compulsions are:

• Washing
• Ruminating (thinking obsessively)
• Repeating/checking
• Repeating words/ speech/conversation
• Touching
• Counting
• Seeking reassurance
• Ordering/arranging
• Hoarding
• Praying
• Hair pulling

OCD – What it isn’t

• OCD isn’t a character flaw
• OCD isn’t a sign of personal weakness
• OCD isn’t a sign of mental instability
• OCD isn’t insanity
• OCD isn’t schizophrenia
• OCD isn’t an addiction (compulsive drinking, eating or drug-taking should not be confused
  with OCD)

It’s not all bad!

On the contrary, OCD sufferers tend to be:

• Intelligent
• Articulate
• High achievers
• Creative
• Perfectionist
• Conscientious
• Sensitive

What causes it?

There is no single, scientifically proven cause of OCD but there are various well researched theories:

• Studies are inconclusive as to what triggers the OCD in individuals but an OCD gene has now been isolated and there is an hereditary component, so that OCD tends to run in families
• Studies are currently underway to examine a link between the onset of OCD in childhood and streptococcus throat infection. It is suggested that the throat infection produces an autoimmune mechanism or antibodies which attack and damage the brain’s neurotransmitters

Treatment

• There is no known cure for OCD but it is very manageable and sufferers can go on to achieve everything a person without OCD can achieve (and more....)s
• There is no OCD-specific medication
• What medication there is, particularly SSRI’s (anti-depressants), may help alleviate some of the symptoms of OCD
• The most effective treatment is OCD specific cognitive behavioural therapy
  (generalised CBT tends to be less successful)
• It is preferable that the therapy be tailored towards OCD and that the practitioner has extensive knowledge of this complicated disorder
• The key to recovery (management of OCD) is the correct application of CBT and consistency on the part of the patient
• Without determination and commitment, patients will find recovery minimal or very slow
• It is vital that the individuals families/carers understand the disorder and interact appropriately with the OCD individual, their actions are vital to managing the disorder and it is important that any therapist works with the family as well as the person with OCD