13 March 2014
Obsessive Compulsive Disorder, or OCD as it is more commonly referred to, is a condition which many people may think they understand. The name of the condition may be used in jest to describe an annoying habit or minor ‘rituals’ we may undertake on a regular basis. Colleagues may say, “I’m a bit OCD when it comes to having matching shoes and handbags”. We may know people who like to have their coffee cups perfectly aligned in the kitchen cupboard, or have to check (and then double check) that the oven isn’t on when they leave the house or avoid getting married on the thirteenth of the month in case it brings bad luck.
However when does a habit, superstition or ritual become the debilitating mental health condition Obsessive Compulsive Disorder, which in some cases leaves its sufferers completely trapped in a cycle of fear and anxiety?
OCD comes in many forms, including obsessive thoughts which typically involve visualising harm or death coming to a loved one if a certain ‘ritual’ isn’t performed – such as tapping a surface, or switching a light switch on and off several times. Some people suffer from compulsive behaviour as a result of fearing being ‘infected’ by germs whether from other people, their kitchen worktops or public places – or all three. These sufferers typically display cleaning compulsions and have an overwhelming desire to wash their hands and/or body excessively in order to ‘neutralise’ their anxiety.
It is fair to say that most of us have an element of obsessive behaviour in our day to day lives, like saluting a magpie whilst driving into work or frequently 'touching wood’ after saying "I haven’t had a cold for ages" – but would you feel any stress or anxiety if you stopped?
Dr William Crook explains: “Many people have certain rituals or obsessions as described above like ‘touching wood’ or avoiding walking on cracks in the pavement. However people who suffer from OCD get trapped in a world of compulsions which cause huge levels of anxiety. Typically if the compulsion (or act, such as tapping or obsessive washing) is not performed, dark and irrational thoughts occur, such as ‘If I don’t wash my hands again, the germs will infect me and my family and we’ll all die as a result’. This thought process is completely unjustified, however when the compulsion is then performed, the sufferer feels a temporary relief from anxiety. However the obsession and anxiety soon return, causing the cycle to begin again.
“It is thought that genetics may play a part in this condition. Serotonin is a chemical in the brain which manages our anxiety levels, our mood, memory and general behaviour. It is not known for sure how serotonin may contribute to OCD, but people with the condition appear to have decreased functioning of serotonin in the brain."
Dr Crook continues: “An important life event such as a bereavement or family break-up may trigger OCD in people who already have a tendency to develop the condition (for example, due to genetic factors). However taking all this into account, no-one really knows the true reason why some people suffer from OCD and others don’t.
“Many people with OCD do not report their symptoms to their GP because they feel ashamed, embarrassed or in some cases that they will be diagnosed as ‘mad’. OCD is very much a silent condition as sufferers often try to disguise their symptoms from family and friends so the process of breaking the cycle and getting help is already difficult for them.
“OCD is typically diagnosed following an appointment with your GP. Your doctor will go through some questions to ascertain how severe the condition may be. Depending on the patient’s responses, the condition will be managed accordingly. Often patients who display early signs of developing the condition – ie, their obsessive thinking and compulsive behaviour occupies less than one hour of their day, may be offered counselling to find out the route of the anxiety and offer ongoing emotional support. Often patients overcome these anxieties very quickly.
“Patients who present with more severe symptoms, where obsessive thoughts or compulsive behaviours consumes their day to day life for more than three hours a day, will be referred to a specialist, like me, who can discuss breaking the cycle, often through cognitive behavioral therapy (CBT), exposure (facing the fear ‘head on’) or possibly medication."
Dr Crooks concludes: “It is so important that if a family member notices these patterns emerging with a loved one, not to reinforce or encourage their behavior. This condition is more common than anyone would think, so support is readily available. OCD sufferers are unlikely to see their GP on their own accord so family members play a huge part in aiding their recovery. Anyone who is worried about a friend or relative displaying such behaviours should make them an appointment to see their GP and it is surprising, with the right help, how quickly patients can overcome it."
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