Obsessive Compulsive Disorder
Obsessive compulsive disorder (OCD) is defined by the presence of obsessions, compulsions or both. Obsessive thoughts are recurring OCD thoughts that are distressing and also lead to repetitive behaviours. For example, obsessive thoughts that you didn’t lock the front door, could lead to repeated checking of the locks (compulsions). A person with OCD can also experience what is termed intrusive thoughts. These can be distressing thoughts or images that are out of character for the person, such as “what if I hurt my parents”. It seems that for someone with OCD thinking it is parallel with doing it.
Signs & symptoms
To receive a diagnosis of OCD a person must experience obsessions or compulsions or both.
- Recurrent and persistent thoughts, images, or urges that are intrusive and unwanted. These obsessions cause significant anxiety or distress.
- Attempts are made to suppress the obsessions with either some other thought or behaviour (compulsion)
- Behaviours that are repeated excessively (e.g., hand washing, checking) or mental acts (e.g., praying, counting, repeating words quietly). The person feels driven to engage in the behaviour as a consequence to and obsession, or according to rigid rules they have.
- The compulsions are designed to prevent or to decrease anxiety, or to prevent a terrible event or situation. These behaviours are not realistically linked with what they are suppose to neutralise and are clearly excessive.
The obsessions or compulsions must also take a lot of time (e.g., more than an hour a day) and cause significant distress and impede the persons ability to function day to day. If you would like to read more about what are the more common types of obsessions and compulsions experienced by people with OCD, please open the toggle box below.
Common obsessions & compulsions
Some of the more common obsessions and compulsions that are experienced by people with OCD are:
- Counting – repeatedly counting items such as lines in footpath
- Hoarding – items such as newspapers, junk mail
- Cleanliness – obsessive hand washing or cleaning to reduce unrealistic fear of germs
- Order – over concern with symmetry of items such as glasses, books
- Safety/checking – concern about possible harm, so constant checking of locks, or that electrical items are turned off
- Sexual issues – having a level of revulsion that is irrational concerning sexual activity
- Religious/moral issues – having to pray a certain number of times a day
Around 3% of Australians will be diagnosed with OCD in their lifetime, and approximately 2% will experience OCD in a 12 month period. OCD occurs at any time of life, although symptoms tend to develop during adolescence.
- Psychological treatments, in particular Cognitive Behaviour Therapy (CBT) has been found to be effective in treating OCD. CBT explores a persons cognitions (thinking) and their actions (behaviour) and how it is impacting on how they are feeling. Psycho-education is also a part of this approach, which helps the person understand what they are experiencing and to see how the pattern of their thinking and behaviour is contributing to their anxiety (rather than reducing it). CBT treatment for OCD looks at identifying the distorted thinking patterns and challenging them and replacing them with more constructive thoughts. Behaviourally, the compulsions are targeted by gradually reducing the behaviour, such as, only gradually reducing the amount of checking a person does.
- Medication may also be used in the treatment of OCD, in particular some antidepressants can be useful in reducing anxiety. Benzodiazepines are only used in the very short term, and as only a part of a specific treatment plan. Their use is closely monitored because of their addictive nature.