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This page seeks to provide basic information and facts about mental health issues. If there is any particular mental health issue that you would like to see on the Facts page, please let us know by sending us an email at colchestermind@btconnect.com
OBSESSIVE-COMPULSIVE DISORDER
WHAT IS OBSESSIVE COMPULSIVE DISORDER (OCD)?
Obsessive-compulsive disorder (OCD) means you have no control over certain thoughts, ideas or urges that enter your mind. These thoughts, or what could be termed obsessions, may seem so frightening or unacceptable that you find it difficult to talk about them with other people, and it can often it can lead you to believe that you or others may come to harm no matter how hard you try to dismiss those thoughts. This can lead to severe anxiety and helplessness – the only solution being to perform a particular ritual that neutralises the thoughts you are having.
The urge to perform these rituals is known as ‘compulsion’ - repeatedly washing your hands or counting for example. Repetition of these actions often occurs because the individual feels that they were not carried out properly the last time or because the thoughts they were having may come back. Relief from the anxiety is temporary.
OCD is said to be similar to a phobia in that it brings on anxiety or panic attacks where you can experience breathlessness, dizziness and nausea. The difference between the two is that phobias involve an exaggerated fear of something that does not represent a realistic danger but which others can relate to – like being scared of heights or spiders. OCD on the other hand involves a fear of your own thoughts – something which others cannot relate to and are unlikely to understand.
OCD is not a psychotic disorder like schizophrenia; it is often only your own thoughts or obsessions that torment you. Some individuals can experience obsessive thoughts without having any compulsions; others have compulsions without realising why they need to carry them out. People with OCD can often also be depressed.
SIGNS OF OCD
Up to four-fifths of us may experience minor obsessions or compulsions from time to time - individuals may be compulsive in cleaning more than is required for example. Being ‘obsessed’ forms part of our everyday language but it is the severity of the obsession that determines whether someone has OCD or not. Someone diagnosed with OCD will find that their problems (obsessions/compulsions) are so severe that they interfere with their everyday life - spending eight to ten hours a day washing for example.
Many people who suffer from OCD do not realise how common such problems are. It is understood that up to three percent of the population can experience the symptoms although only the most severe cases ever ask for help. All ages can be affected.
CAUSES OF OCD
Different theories exist as to why OCD develops. One theory is that the origins lie in childhood and early experiences: one or both parents may have experienced similar behavioural traits or it may be linked to past trauma experienced such as sexual abuse. Obsessions can be offset by certain memories and experiences. An individual’s personality can determine whether any response to those past incidents occurs and if so how they will respond. It has been suggested that people who are perfectionists are more likely to suffer from OCD.
Lack of serotonin (a brain chemical) is thought to be another theory for the cause of OCD, although it is still unknown exactly what its role is.
The way in which an individual views the world will largely determine how they respond to the challenges life throws at them. These views can sometimes be based on flawed or incorrect assumptions that the individual will not recognise as being flawed because they have never been challenged to believe differently. For example, if an individual has been brought up by anxious parents who have misunderstood information given to them by a doctor, it can lead to all parties feeling like they live in a very threatening environment. Some people can react to this by believing that if they don’t wash constantly for example; dangerous germs can make them feel ill.
TREATMENT
There is no instant cure for OCD but there are various treatments and coping strategies available to help you overcome the symptoms. As with many things in life there are different approaches that work for different people and it is often a question of finding the treatment or coping strategy that is right for you as an individual. Many people do opt to visit their GP as a first step, who could then refer you to a psychiatrist or a psychologist.
Medication:
Drug treatment is often used to treat OCD, either alone or combining it with talking treatments. The most commonly prescribed drugs are SSRI anti-depressants like Prozac or Seroxat for example. These drugs can cause side-effects to start with such as headaches, nausea or increased anxiety. Tricyclic antidepressant clomipramine (Anafril) can also be prescribed to adults. Drugs from the benzodiazepine group such as diazepam (Valium) were previously prescribed, but as a result of overdependence on them it is now discouraged and they are now only issued to those suffering from very severe anxiety, for short periods of time.
Talking Treatments:
Talking treatments can come in the form of counselling, psychotherapy and cognitive behaviour therapy. You can access talking treatments either through the NHS or privately. Counselling provides support on a weekly basis to help those with specific problems; psychotherapy is normally a more frequent long-term treatment focusing on the causes of distress and coping strategies.
Cognitive Behaviour Therapy (CBT):
CBT is well known for being particularly effective in treating OCD, as it aims to identify connections between thoughts, feelings and behaviour and helps to develop practical skills to manage them.
Psychosurgery
Also known as neurosurgery. This is where surgery on the brain takes place. It is a strictly regulated treatment and only takes place in very severe cases of OCD.
WHAT HELP IS AVAILABLE?
Care Programme Approach (CPA) (ENGLAND)
Every person referred to a psychiatrist is normally given an assessment of their health and social care needs, a care plan, a care coordinator and a regular review. You are also given the opportunity to have an advocate (which can be a family member or someone from a recognised advocacy service) who can speak on your behalf. The assessment can, if you wish, include the needs of carers and relatives.
Community Mental Health Teams
A local Community Mental Health Team (CMHT) can carry out the above mentioned assessment and through their team of social and health care professionals can offer you community services. A CMHT would often include a social worker, psychiatrist, psychologist and a community psychiatric nurse and sometimes can also include a counsellor and community support worker – one member of this team would act as the care coordinator.
Community Care Services
Community care services aim to provide services in the home or in supported accommodation. If you require community care services e.g. day care or housing needs and advice, social services can carry out an assessment of your individual needs.
Direct Payments
Direct payments allows the individual to buy the care they require themselves, if they are eligible, rather than social services providing it for you. This can only occur once the community care assessment has confirmed the services are required.
SELF-HELP
Treatment for OCD can include a combination of different approaches, including self help. Individuals wishing to devise their own self-help programme may do so based on cognitive therapy techniques.
Self-Help Groups
Many people find sharing their experiences and coping methods with others a useful experience – self-help groups can offer the encouragement and support regardless of whether the individual is receiving professional help.
Relaxation Techniques
Relaxation techniques can help someone to improve their breathing, thereby lessening the tension they feel; physical exercises can also help to relax muscles; and action plans can help individuals to make progression with the way they cope with different kinds of situations ranging from non-difficult to very difficult.
Family and Friends Help
If you are a family member or a friend of someone with OCD, simply accepting the feelings of and understanding how difficult it is for that person to cope with those feelings can be extremely helpful. If someone with OCD is working to a self-help programme, you may be able to support them with this in one way or another. Also talking to others in the same situation as you may be helpful, as well as understanding the complexity of the problem.
If you would like more details on Obsessive-Compulsive Disorder you can refer to the Mind Publications Booklet
Understanding Obsessive-Compulsive Disorder (OCD)
http://www.mind.org.uk/Information/Booklets/
Understanding/Understanding+Obsessive-Compulsive+Disorder.htm
For further information:
Contact MindinfoLine 0845 766 0163
info@mind.org.uk
For other publications and information
www.mind.org
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