[EDITED] What is Obsessive-compulsive disorder?

The College of Psychiatrists of Ireland > External Affairs & Policy > Public Information > Mental Health Problems > [EDITED] What is Obsessive-compulsive disorder?

What is Obsessive-compulsive disorder (OCD)?

OCD is an anxiety disorder that can have a big impact on the lives of those who suffer from it.

There are people with certain personality traits that that may like to do things in a certain way, or keep things very clean and orderly. These people  may described as “obsessive”, however, this is not the same as having OCD.

People with OCD suffer with obsessions and compulsions, which are explained below:

Obsessions

  • These are intrusive, repeated thoughts, images or urges which are unwanted and are very difficult to shake off or resist.
  • Examples of obsessive thoughts could be a doubt that you have locked your front door, a worry that you will cause an accident, or a fear that you have been contaminated by germs.
  • Another example of an obsession could be a violent or sexual image which enters your head without warning.
  • Obsessions are not pleasurable and usually leave the person feeling worried, uncomfortable or frightened.
  • These often do not make any sense to the person experiencing them.

Compulsions

  • People with OCD may repeat certain actions or rituals with the goal of reducing the worry.
  • An example of a compulsion could be frequent hand-washing, counting, repeating a phrase in their head or checking appliances again and again to make sure they are switched off.
  • This could also include asking people for reassurance that everything is alright.
  • Compulsions often take up a lot of time for people which can impact on their usual daily activities e.g. school, work or socialising. This can lead to a vicious cycle of feeling worried and finding it hard to stop your compulsions.

How common is OCD?

OCD will affect about 2% of people (2 out of every 100 people) at some stage in their life.

Children often have mild compulsions such as tapping, or jumping over cracks in the pavement. These usually do not cause a problem and will generally resolve.

Adult OCD usually becomes a problem for people in their teens or early adulthood.

It can be many years before people look for help, due to stigma or shame.

What causes OCD?

Like many mental health conditions, OCD does not have one single cause.

Stressful life events, or having a family member with OCD may make you more likely to develop this condition.

It is thought that certain brain chemicals (serotonin and dopamine) and brain structures play a role in the development of OCD.

What are the treatments for OCD?

People with OCD can get better, and treatment may take many forms.

There are times when people with OCD might need a lot of help and other times when they may manage the symptoms well by themselves.

Psychotherapy

  • Cognitive Behavioural Therapy (CBT) is one form of therapy which can treat OCD. It involves learning to understand OCD and developing new ways to cope.
  • Exposure Response Prevention (ERP) involves learning to confront your fears, and letting obsessive thoughts occur without needing to do the compulsion. Over time the worry caused by the obsessive thought will lessen.

Medications

  • Medication is very effective for many people with OCD.
  • The most common medications used are SSRIs, however, other medications can be helpful, such as tricyclic and antipsychotics. It is important to note that people with OCD are not suffering from psychosis.

Reducing stress

People may find reducing their stress can improve their OCD symptoms.

Examples of ways to reduce stress include:

  • Good quality sleep
  • Physical activity
  • Spending time with friends and family
  • Reducing alcohol and drug use
  • Relaxing activities, like yoga or mindfulness.

Other treatments

Transcranial Magnetic Stimulation (TMS) and Deep Brain Stimulation (DBS) are other potential treatments for OCD.

TMS and DBS may be useful for people with OCD who do not respond to traditional treatments.

These treatments are still undergoing research to assess their safety and efficacy, and are not readily available to patients in Ireland at present.

Where can I find further information?

  • Key Facts about OCD (Royal College of Psychiatrists, UK website)
  • What is Obsessive-compulsive disorder? (American Psychiatric Association)
  • Overview of OCD – Symptoms and signs, in addition to main treatments. Also further links for online supports and information. (Helpguide.org)
  • Obsessive-compulsive disorder (OCD) (Mind.org.uk)
  • YouTube video explaining OCD

For more resources on psychiatry and mental illness, click here.