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Obsessive Compulsive Disorder (OCD)
Obsessive-compulsive disorder (OCD) is characterised by constant obsessions and compulsions that cause significant distress to the person and often interferes with daily functioning. The person with OCD feels compelled to carry out behavioural or mental rituals in order to avoid an irrational feared outcome or reduce levels of anxiety.
Typical of the obsessions are fear of contamination or contaminating others by germs or poison. Common obsessions also include harming others or oneself or carrying out an offensive act. Research strongly indicates that people with OCD report an inflated sense of responsibility. For instance if a parent has a thought about his or her child being in danger, the parent actually believes he or she will cause harm to the child just for having such a thought. It is also suggested that people with OCD possess a very high standard of moralistic behaviour viewed in a black and white manner, i.e. there is either good or evil and no in between grey area. For example if a person with OCD experiences any negative emotion or thought about someone, the individual will feel he or she is totally evil and will constantly berate himself or herself, suffering guilt and self loathing at being such a malicious person who will undoubtedly be punished.
Compulsions are also referred to as rituals and may involve repeated acts of checking or cleaning and washing. These rituals may be extremely time consuming and cause the person significant distress. Mental rituals include repetition of words, counting, hoarding of items, and feeling certain items have to be placed in a particular order or sequence.
Research has suggested that more than 90% of those diagnosed with OCD have obsessions and compulsions with a small minority suffering from obsessions in isolation. Despite the individual having some awareness that the obsessions are only thoughts and will not ultimately lead to taking action (such as hurting someone or oneself) his or her fear of carrying out the act is so powerful, the person believes his or her unspeakable act is imminent. Sufferers believe that having a thought is equal to carrying out the action. This causes immense distress and the person will carry out avoidance techniques such as keeping away from others or certain places to prevent such a terrible act being carried out.
Common accompanying disorders include generalised anxiety disorder, panic disorder and phobias. Substance abuse is also a common factor with alcohol abuse effecting up to 24% of people with OCD. Medication (prescribed only by a GP or psychiatrist) and cognitive behavioural therapy (with a qualified psychotherapist) is recommended which includes exposure, response prevention and cognitive restructuring. Although most sufferers experience these distressing symptoms through their lifetime, symptoms can be treated and alleviated so the person can lead a more functional life.
Click here to listen to Vicki Jones, a leading UK Anxiety Therapist speak to Heart FM on OCD.