Do you find you need to check repeatedly if you turned the lights off or locked the front door before you leave your house? Do you insist on a spotless, organised kitchen, or feel compelled to straighten the pictures on your friends’ walls? Many people joke about “their” OCD, but when the real obsessive compulsive disorder strikes, it causes deep disruption to the lives of sufferers, and a great deal of distress!
Here is what two people with OCD said about their experience with the condition:
OCD is like having a bully stuck inside your head and nobody else can see it.
Krissy Mc Dermot
It’s like a broken machine. Thoughts go into your head. They get stuck and keep going around and around.
(Quotes from: www.themighty.com).
Obsessive-compulsive disorder (OCD) affects about 750 000 people in the United Kingdom. The condition is characterised by recurrent intrusive thoughts, feelings, or sensations that cause worry or anxiety which is only relieved if the person does something to neutralise the intrusions they experience.
Some common forms of OCD:
Someone with contamination OCD is terrified of coming into contact with any form of infection. Compulsions include hand washing rituals, avoiding places such as public restrooms, and excessive cleaning. People with checking OCD feel a compulsive need to check a variety of things repeatedly, including that doors are locked or lights switched off. Hyperresponsibility OCD involves obsessing about feeling responsible for possible accidents or disasters (such as having inadvertently run someone over). People with this form of OCD are often racked by guilt about their potential infringements of the law or their own moral codes and will go to great lengths to reassure themselves that they have not caused harm to others.
If you suffer from any of these forms of OCD, you may be quite aware that your thoughts are irrational and your compulsive actions out of the ordinary. Appreciating how strange and irrational it all might seem to others – and to yourself – only adds to the distress caused by this devastating condition.
The neuroscience of OCD
Recent advances in neuroscience have started to shed light on the way OCD works in the brain.
Neuro-imaging studies have shown that a dysfunctional “loop” can explain how the rituals of OCD are maintained. The main components of this loop are brain regions that control the way in which we filter our thoughts, and those that control the balance between goal directed behaviour and habits. When this loop is overactive, as in OCD, we are unable to stop ourselves responding with habits (ritualistic behaviour) to our incorrectly filtered thoughts, no matter how irrational they are. Medication that increase the availability of the chemical serotonin in the brain, helps to bring this dysfunctional look back under control.
The OCD cycle
The dysfunctional brain loop referred to above may take many forms. Everyone who suffers from OCD is likely to experience their own, personal worry cycle. Below is an example of a contamination OCD cycle:
Repeatedly going around and around this cycle, with different situations triggering the same fear of picking up a bug, can be very distressing. In fact, the World Health Organisation considers OCD to be one of the most distressing mental health conditions there is. So what can be done to help?
OCD can be treated successfully
Effective, evidence based treatments consist of a combination of medication and talking therapy. As mentioned earlier, the most effective treatments by medication target serotonin and are also known to help for anxiety and depression. However, according to OCD-UK, a charity that advocates for people with OCD, psychological therapy is the treatment of choice for OCD.
Cognitive behaviour therapy (CBT) help patients to understand how their OCD is triggered and maintained by their own, personal OCD cycle. They learn new techniques such as behavioural experiments, exposure and response prevention (ERP), and cognitive restructuring:
- Behavioural experiments include trying out new behaviours and seeing if they lead to more helpful outcomes.
- ERP involves seeking out situations that trigger obsessions, while at the same time replacing or preventing the associated compulsions, and
- Cognitive restructuring involves developing the ability to challenge one’s own unhelpful thinking patterns and replacing these with more rational thoughts.
Where to find help for OCD
Despite the tremendous distress OCD can cause, there are highly effective treatments available. Your GP is your first port of call for help and advice, and will be able to refer you on to the relevant mental health professionals for assessment and treatment within the National Health Service (NHS).
Within this practice, we are also able to help with expert psychological treatment available in person or via telephone or online chat/video call. Contact us today if you would like to find out more.
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