Almost all people have unwanted and unpleasant thoughts, such as a nagging worry that their job may not be secure or that they may have an illness. Most people can usually put these type of thoughts and concerns into context and are able to carry on with their day-to-day lives.
However, one could have Obsessive Compulsive Disorder (OCD) if -
- One gets persistent, unwanted and awful thoughts coming into one's mind, even when one tries to keep them out , and/or
- One has to touch or count things or repeat the same action like washing over and over again
OCD has three main parts:
- An unwanted thought, image or urge that repeatedly enters the mind (obsessions). One tries to drive away such thoughts but is unsuccessful
- The anxiety one feels after this
- A repetitive behaviour or mental act that one feels compelled to perform to reduce the anxiety (compulsions).
Some examples of such repetitive thoughts are:
- Single words, short phrases or rhymes that are unpleasant, shocking or blasphemous.
- Worry about being contaminated (by germs, dirt, cancer etc)
- Worry that one or someone else might be harmed because of one's carelessness
- One sees pictures in one's mind showing one's family dead or seeing oneself doing something violent
- Doubts wondering whether one might have caused an accident or misfortune to someone
- One endlessly argues with oneself about whether to do one thing or another. This means that one finds it difficult to make the simplest decision.
- One is bothered, in a way that other people are not, that things are not in the exactly the right order, not balanced or not in the right place.
- One worries that one will commit an act that would seriously offend one's religious beliefs.
- One fears that one will make a mistake that has serious consequences. For example, one's house will burn down because one left the gas on, or that one's possessions will be stolen because one forgot to lock the door.
When one has such repetitive thoughts, one feel tense, anxious, fearful, guilty, disgusted or depressed.
Some examples of what one does to reduce the anxiety are:
- One thinks alternative thoughts like counting, praying or saying a special word over and over again. It feels as though this prevents bad things from happening.
- One washes one's hands frequently, does things really slowly and carefully, perhaps arrange objects or activities in a particular way.
- One repeatedly keeps checking one's body for contamination. One avoids touching particular objects, going to certain places, taking risks or accepting responsibility.
- One repeatedly checks that doors are locked, and that gas and light switches are turned off. .
Such compulsive behaviours brings temporary relief from anxiety, but the obsession and anxiety soon returns, meaning that the pattern or cycle begins again.
John: My whole day is spent checking that nothing will go wrong. It takes me an hour to get out of the house in the morning, because I am never sure that I've turned off all the electrical appliances like the cooker, and locked all the windows. Then I check to see that the gas fire is off five times, but if it doesn't feel right I have to do the whole thing again. In the end, I ask my wife to check it all for me again anyway. At work I am always behind as I go through everything several times in case I have made a mistake. If I don't check I feel so worried I can't bear it. Its ridiculous I know, but I think if something awful did happen, I'd be to blame.
How common is OCD?
About 1 in every 50 people suffer from OCD at some point in their lives, men and women equally.
How bad can OCD get?
It varies a lot, but work, relationships and family life are all more productive and satisfying one does not have to constantly cope with OCD. Severe OCD can make it impossible to work regularly, to take part in family life – or even to get on with your family. In particular, they may become upset if you try to involve them in your rituals
How will OCD affect my life?
One will usually be aware that these thoughts or actions are unreasonable. It is common to feel guilty, disgusted, depressed or embarrassed about it. The repetititve behaviours can be very time consuming, often getting in the way of normal work and family life. One could develop depression due to the emotional strain of dealing with obsessions. It can upset one's family life.
What could happen without help or treatment?
Many people with OCD are reluctant to report their symptoms to a doctor because they feel ashamed and embarrassed about their condition. It is also not unusual for a person with OCD to go to great lengths to disguise their symptoms from friends or family. However, if one has OCD it is important to remember that there is nothing to feel ashamed or embarrassed about. Like diabetes or asthma, OCD is a chronic health condition, and it is not one's fault that one have developed it.
Many people with mild OCD improve without treatment. In the rest, if left untreated, the symptoms of OCD may not improve and, in some cases, they will get worse. With treatment, a lot of people will achieve a complete cure. Even if a complete cure is not achievable, treatment can reduce the severity of a person's symptoms and help them to achieve a good quality of life
What causes OCD?
The exact cause of obsessive compulsive disorder (OCD) is unknown.
- Sometimes it runs in the family.
- Stressful life events bring it on in some cases.
- Sometimes it is brought on by life changes requiring taking of more responsibility like birth of a child or a new job.
- There could be an imbalance of a particular chemical in the brain.
What treatment is available for the problem?
Psychological therapy: This will be usually delivered by a psychologist or a psychiatrist. This therapy will focus on reducing the distress caused by the thoughts and preventing oneself from doing the repetitive behaviours.
Medication: The doctor can also prescribe a type of antidepressant medication which can help to reduce the distressing thoughts and repetititve behaviours.
How can family and friends help
As family or a friend, one may feel frustrated and confused by the symptoms of OCD, but one can help a lot by accepting your partner’s, friend’s or relative’s feelings and understanding that this is their way of coping. Negative comments or criticism tend to make OCD worse; a calm, supportive family can help improve the outcome of treatment.
~ Tanushri Sharma, Psychologist Antarman Centre for Psychosocial Wellbeing.
~ by Dr Ravindra Agrawal Not so ethical conversation…the unanswered quest
~ by Dr Saumitra Nemlekar Young people and mental health in a changing world.
~ by Dr Ravindra Agrawal Recently I have taken to filing the slips of paper on which I write down