Obsessive-Compulsive Disorder (OCD) is a serious anxiety related condition where a person experiences frequent, intrusive and unwelcome obsessive thoughts, often followed by repetitive compulsions, impulses or urges.
OCD affects as many as 12 in every 1000 people regardless of age, gender, social background or culture. At the time of writing this there are around 741,504 people living with OCD based on current estimates (source OCD.UK). OCD can be so debilitating and disabling that the World Health Organisation has ranked OCD in the top ten of the most disabling illnesses of any kind in terms of lost earnings and diminished quality of life.
People who suffer from OCD can often go undiagnosed for many years which can be due to personal feelings of embarrassment, guilt and shame associated with this ‘secret or invisible illness’ and so people can avoid looking for treatment for, on average, 10-15 years. As a result the disorder not only affects them personally but also their friends, family and anyone else who might be close to the person struggling.
OCD revolves around obsessions and compulsions.
People with OCD experience unwanted obsessions which take the form of persistent and uncontrollable thoughts, although obsessions can sometimes be persistent images, impulses, worries, fears or doubts or a combination of all these. They’re always intrusive, unwanted, disturbing and most importantly significantly interfere with the sufferers ability to function on a day-to-day basis as they are incredibly difficult to ignore.
The person will become besieged by these obsessions. The sufferer neither wants or welcomes the obsessional thoughts which cause such deep anguish and despair, the person being besieged will go to extreme lengths to block and resist them. Invariably they return within a short period of time, often lasting hours if not days, which can leave the person both mentally and physically exhausted and drained.
People with OCD usually realise that their obsessional thoughts are irrational, but at the same time feels so very real and they believe the only way to relieve the anxiety caused by them is to perform compulsive behaviours. These compulsive behaviours are carried out to prevent perceived harm happening to themselves or, more often than not to a loved one, even when there is no correlation between their thoughts and compulsive behaviour.
When someone is affected by Obsessive-Compulsive Disorder their natural response is to fight their unwanted and anxiety provoking intrusive thoughts with deliberate behaviours and deliberate actions (this includes both mental and physical actions, seeking reassurance and avoidance of people, places and objects), these behaviours are called compulsions.
Compulsions or compulsive acts are repetitious, purposeful physical or mental actions that the individual feels compelled to engage in according to their own strict rules.
The sufferer can experience a sense of resistance to the act but this is overridden by the strong, subjective drive to perform the action. Most often the main aim behind the compulsive behaviour is to generate relief (usually only temporary) from the anxiety elicited by the preceding obsession.
In some cases, the person recognises their compulsive actions are irrational, but none-the-less feels bound to carry them out. Often a person living with OCD will feel a heightened sense of responsibility to perform the neutralising behaviour simply because they feel doing so will prevent harm coming to themselves or loved ones. Equally, sometimes the person with OCD will have an overwhelming urge to obtain that ‘just right’ feeling with no other reason than to feel comfortable.
A compulsion can either be overt (i.e. observable by others), such as checking that a door is locked or covert (an unobservant mental act), such as repeating a specific phrase in the mind.
Overt compulsions typically include checking, washing, hoarding or symmetry of certain motor actions.
Covert compulsions, or ‘cognitive compulsions’, as they are sometimes referred to, are the carrying out of mental actions, as opposed to physical ones. Examples include mental counting, compulsive visualisation and substitution of distressing mental images or ideas with neutralising alternatives. For example, if a person has a negative violent image in their head they may try to neutralise this by repeating certain phrases over and over in their head.
Any relief that any of the compulsive behaviours provide is only temporary and short lived, they simply reinforce the original obsession and the need to carry out the compulsion, creating a gradual worsening cycle of OCD symptoms and the cycle, unfortunately, begins again this time more reinforced and with a stronger pull.
OCD can affect people in different ways. Some people may spend much of their day carrying out various compulsions and be unable to get out of the house or manage normal activities. Others may appear to be coping with day-to-day life while still suffering a huge amount of distress from obsessive thoughts. Some people with OCD may carry out their rituals and compulsions in secret or make excuses to avoid social interaction so they can complete compulsions.
The severity of OCD differs greatly from one person to another. Some individuals may be able to hide their OCD from their own family. However, the disorder may have a major negative impact on social relationships leading to frequent family and marital disconnect or dissatisfaction, separation or divorce. It also interferes with leisure activities and with a person’s ability to study or work, leading to reduced educational and/or occupational attainment and unemployment.
OCD is leaps and bounds away from how it is sometimes portrayed in the media. It is a hugely debilitating, constantly nagging, isolating, confusing and demoralising disorder that holds serious consequences for the sufferer. However, OCD is treatable and with cognitive behavioural therapy there is hope for those suffering.
Click here for more OCD information from the NHS.
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