- obsession – where your mind is overwhelmed by a constant obsessive fear or concern, such as the fear your house will be burgled
- anxiety – the obsession provokes a feeling of intense anxiety and distress
- compulsion – you then adopt a pattern of compulsive behaviour to reduce your anxiety and distress, such as checking all the windows and doors are locked at least three times before you leave your house
- temporary relief – the compulsive behaviour brings temporary relief from anxiety, but the obsession and anxiety soon return, causing the pattern or cycle to begin again
In Obsessive Compulsive Disorder, the condition revolves around obsessive thoughts which in turn causes anxiety and a very real distress if something isn’t done to help those thoughts go away. The compulsion is to do that ‘something’ which will make the obsessive thought reduce or go away.
The most common obsessive thoughts for people with the condition are:
-fear of deliberately harming self or others
-fear of accidentally harming self or others
-fear of contamination by disease, infection, or unpleasant substance
-fear of offending religious beliefs
-having a need for symmetry/lines
these Obsessive thoughts lead to the anxiety and the Compulsive Behaviour to do something about the thoughts, to reduce or eliminate them:
the most common compulsive behaviours are:
-cleaning, hand washing, checking (doors locked etc), counting, ordering and arranging (tins in the cupboard etc), hoarding, asking for reassurance, needing to confess, repeating words silently, prolonged thoughts about the same topic, neutralising thoughts to try to eliminate the obsessive thoughts.
Treatment for OCD can differ from person to person depending how mild or severe the condition is with the person.
If the OCD is mild, then a short course of Cognitive Behavioural Therapy (CBT) will usually be recommended; this aims to change the way the person thinks and behaves with regard to their OCD.
Treatment for a moderate case of OCD is a more intensive CBT and that intensity depends on how moderate to severe the OCD is; If it is more moderate to severe rather than moderate from mild, then medication may be added to the treatment.
In severe cases, medication is usual with intensive CBT treatment.
Here are the names of a range of medications used for OCD:
These medications are in the group of medicines called Selective Serotonin Reuptake Inhibitors (SSRI’s). They are medicines that increase the level of serotonin and take a few weeks to become effective. Serotonin is a chemical that the brain uses to pass messages. However, SSRI’s have side effects that some people cannot tolerate as they may increase the anxiety and bring suicidal thoughts. For the reasons of side effects, there is another medication which can be taken, named Clomipramine; this also has side effects but not as severe as those of the SSRI’s. Clomipramine has side effects on your body with such symptoms as a dry mouth, blurred vision, constipation, dizziness and feeling very tired.
The behavioural therapy involves a gradual exposure and response prevention (ERP). The patient and the therapist find out, in order, which of the patient’s situations cause the most anxiety and continue down to the least anxiety, and from that list, together they tackle the least anxiety causing situation first by performing the task without acting upon the compulsion which usually follows it. This situation of performance of the task without the compulsion is repeated several times until the anxiety of not performing the compulsion stops. Once the anxiety has stopped for the least anxious situation, they will proceed up to the next situation on the list until all are completed.
There are OCD support groups and they can be very helpful when the patient or the family of sufferers need advice or other information. Groups are very good at helping people feel less isolated.
OCD Action http://www.ocdaction.org.uk/support-groups/
Surgery Surgery is only an option when all else has been explored and is not considered to be the best treatment with a very low success rate although there is a new treatment being researched at the moment which could look promising; it isn’t surgery of the brain, its more an implant and electrodes. The implant is put into the chest and the electrodes into the brain. The electrodes receive signals from the implant. No doubt the research will continue and make good progress as this looks a promising treatment.
information source NHS, OCD-UK, OCDAction