Obsessive Compulsive Disorder

Obsessive compulsive disorder (OCD) affects at least 1% of the population.  People often seem surprised that OCD is so common, as they may have felt uncomfortable talking to others about their symptoms; for example, due to worries about what others will think or concerns about stigma.

The main symptoms of OCD are obsessions (unwanted and intrusive thoughts that pop into a person’s mind unexpectedly), and compulsions (repeated mental or physical actions or rituals, to prevent worry/harm associated with obsessions).  Obsessions and compulsions vary from person to person.  Common obsessional themes relate to fears about the person or other people becoming ill, harmed or contaminated, worries about losing control, unwanted sexual thoughts, superstitious thoughts, and unwanted religious thoughts.  Common compulsions include checking, excessive washing and cleaning, and repeating mental or physical actions.  OCD often impacts substantially on everyday life; for example, people may find it difficult to leave the house, use public amenities (such as public transport, cafes, restaurants), or socialise.  Left untreated, OCD can increase the risk of depression, anxiety and panic, and can be associated with thoughts of suicide.  Not feeling able to talk to others about OCD and the accompanying distress this causes, can contribute to a sense of isolation and negative self-beliefs about being different, faulty or worthless.

How does OCD develop?

Several theories have been proposed to explain why OCD develops.  There is a small amount of research evidence in favour of genetic, neurobiological, and chemical imbalance causes – yet, studies have tended to include small samples, and so it is difficult to be fully confident in these findings.  There is more evidence in  support of psychological explanations for OCD.  These include that symptoms may occur in response to stress, that some people have high levels of responsibility coupled with a high estimation of the probable threat of something negative happening (derived from cognitive theories), or that, over time, compulsions/rituals become associated with short-term reduction in anxiety, reinforcing their use (derived from behavioural theories).

What can help?

High quality research consistently indicates that OCD can be effectively treated.  Cognitive Behavioural Therapy is the recommended therapy of choice.  Sometimes, strategies from other therapeutic approaches, in particular, Mindfulness-based Approaches and Acceptance and Commitment Therapy are useful for addressing symptoms associated with OCD, including low mood, general anxiety, difficulties tolerating uncertainty, and self-critical or negative thoughts or beliefs.