Although the clichés and jokes you may have heard about obsessive-compulsive disorder – or OCD – tend to focus on cleanliness and tidying, there is much more to it than that.
OCD is a mental health condition where obsessive thoughts and compulsive behaviours come together to create significant distress and disturbance in day-to-day life.
There are lots of misconceptions and unhelpful stereotypes about what OCD really is though, which can add to the challenges for people affected.
As OCD Awareness Week (October 10-15) begins, here are six things you might not know about obsessive-compulsive disorder…
1. Compulsions can be behavioural and mind-based
Yes, compulsions can be actions such as repeated handwashing, a need to put things in order or turn a light on and off a certain number of times, but they can also be mental.
“Compulsions are when you feel the repeated urge to do certain things. If you resist the compulsion, you might feel afraid or tense. If you carry out the compulsive action, the tension might ease for a short time, which motivates you to perform the action again repeatedly,” explains Dr Bryony Henderson, lead GP at Livi, which provides an online therapy service. “In this way, the disorder may gradually extend into multiple areas of your life and severely limit your everyday life.”
However, obsessive compulsions can also manifest in “thought-cancelling or thought-neutralisation”, explains Dr Marianne Trent, clinical psychologist and trauma specialist (goodthinkingpsychology.co.uk). “It is like bargaining with yourself: if I think or do something, it will make something else more or less likely.”
Entering into this kind of mental back and forth with yourself is exhausting and can make decision-making and interacting more challenging.
2. OCD can impact relationships
Performing compulsions or needing a lot of reassurance can impact on relationships.
“Many obsessive-compulsive actions are difficult to hide, like if someone washes their hands an excessive number of times a day, or arrives late for work because they need to check and recheck everything before leaving the house. Understandably, these actions can put tremendous strain on relationships,” says Dr Bryony Henderson, lead GP at Livi, which provides an online therapy service says.
“In extreme cases, someone might not feel able to leave their home and end up neglecting their work, friends and family because the entire day is taken over by their obsessive compulsions.
“But struggling with obsessive-compulsive thinking can often go unnoticed,” she adds. “Someone’s friends, family or colleagues may not be aware of, or understand the problem. This doesn’t mean that the suffering or pressure is any easier, and those struggling with OCD will often need help and support.”
3. We aren’t all just ‘a little bit OCD’
This may have become part of everyday language, but liking things done a certain way, or preferring a very tidy and organised space does not make you ‘a bit OCD’.
“We all experience obsessions and compulsions sometimes. But for those of us living with OCD, it can have a huge impact on our day-to-day lives,” says Kerry McLeod, head of information content at the mental health charity, Mind (mind.org.uk). “Compulsions can take up so much time that we may not be able to go to work, make plans to see friends and family, or sometimes even go outside.”
4. Obsessions are often irrational
The things someone with OCD may obsess over may seem highly irrational to someone without the disorder – and even to someone struggling with it. But, as Henderson explains, that doesn’t make them any less powerful.
“Obsessions are not always rational and although people with OCD might recognise their thoughts as being irrational or unpleasant, they can’t help but think them over and over again,” she says. “For example, people with OCD may worry that something terrible will happen if things aren’t ordered in a certain way.”
5. OCD can be triggered by traumatic events
A need for control following traumatic experiences may spiral into OCD for some people. “OCD and Post Traumatic Stress Disorder [PTSD] can both commonly occur in people with a history of trauma. Indeed, one study revealed the chances of a person developing OCD within one year of being diagnosed with PTSD is about 30%. A traumatic event can trigger the start of obsessive thoughts, which can then in turn lead to compulsive behaviour,” says Henderson.
6. OCD and hoarding may go hand-in-hand
When it comes to common stereotypes, OCD and hoarding might look like polar opposites. But in reality, hoarding can sometimes be a sign of OCD. Henderson says: “There are many types of compulsive acts, including hoarding. This can be because one obsessively collects things out of fear of accidentally throwing something important away.”
Seeking support…
OCD is largely rooted in fear, anxiety and control, and living with it can be very restrictive. Henderson urges anyone struggling with OCD symptoms to seek support.
“If you’re experiencing obsessive thoughts or compulsive behaviour and it’s affecting your daily life, it’s essential to talk to a doctor. They’ll ask you about your symptoms and look at your medical history. You may be referred to a mental health specialist for an assessment,” she says.
“It can be difficult to be honest about the range of thoughts and feelings you’re experiencing, especially if you feel guilty or ashamed about them. However it’s vital that your doctor fully understands the extent of your condition, so that you are offered the best treatment for your symptoms. This could be talking therapy, medication, or a combination of both.”
