What is it?
Obsessive compulsive disorder (OCD) is a mental health condition where you have unwanted thoughts that keep coming back (obsessions), and feel you have to do certain things to ease the anxiety they cause (compulsions).
It can affect anyone, and it often starts around puberty or early adulthood. OCD is a health condition like any other. It isn’t your fault, and it doesn’t mean you’re “mad”.
Common signs
- Obsessions. Unwanted, unpleasant thoughts, images or urges that keep pushing into your mind and cause anxiety, disgust or unease.
- Compulsions. Things you feel you have to do, physically or in your head, to make that feeling go away for a while. For example, checking the doors and windows are locked again and again because you’re afraid of being burgled.
The relief doesn’t last, so the cycle starts again. Over time it can eat up hours of your day.
What can cause it
It isn’t clear exactly what causes OCD. It’s more common if someone in your family has it. Differences in the brain, and life events such as bullying, abuse, neglect or a bereavement, may also play a part. People who are generally anxious, or feel a very strong sense of responsibility, may be more likely to develop it.
How it can affect everyday life
OCD can be exhausting and take up a lot of time. People often keep it hidden because they feel ashamed or embarrassed by their thoughts, which means they go a long time without help. It’s unlikely to get better on its own, but treatment works.
Getting assessed
In England you can refer yourself to NHS Talking Therapies, or see your GP, who can refer you. In Ireland, start with your GP, who can help you decide on treatment and refer you to a trained therapist.
You won’t shock them. Doctors and therapists understand that intrusive thoughts are a symptom, not a reflection of who you are.
Treatment and support
There are two main treatments, and some people have both.
- Talking therapy. Usually cognitive behavioural therapy (CBT) with exposure and response prevention (ERP). With a therapist, you gradually face the thoughts without doing the compulsion, starting with the easiest situations first. It’s hard work, but the anxiety usually eases over time. Mild OCD often needs around 8 to 20 sessions.
- Medicine. Usually an antidepressant called an SSRI. It can take up to 12 weeks to notice a difference, and most people take it for at least a year.
Don’t stop an SSRI suddenly. Talk to your doctor first. In rare cases SSRIs can bring on suicidal thoughts or urges to self-harm. If that happens, contact your GP or go to A&E (the emergency department in Ireland) straight away.
Things that can help day to day
- Talk to someone you trust about what’s going on.
- If you’re in therapy, keep up the exercises between sessions. That’s where much of the progress happens.
- Join a support group. OCD-UK and OCD Ireland can point you to one, and many people find it eases the feeling of being alone with it.
Myths and common questions
“OCD means being neat and tidy.” Some people with OCD do have cleaning or ordering compulsions, but many don’t. It’s about distressing thoughts and the urge to neutralise them, not liking things tidy.
“If I have a disturbing thought, I must secretly want it.” No. Intrusive thoughts in OCD are unwanted and upsetting precisely because they go against what you want.
“Everyone is a bit OCD.” Liking things a certain way is not OCD. OCD causes real distress and gets in the way of life.