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Obsessive Compulsive Disorder (OCD) is a psychiatric disorder resulting in intense anxiety & often the need to perform endless rituals.˜Obsessions are recurrent, persistent, uncontrollable thoughts, impulses & images.
What causes obsessive-compulsive disorder remains unknown but common theories include biological factors, brain abnormalities, serotonin levels and adverse life events.
Biological factors – OCD may be inherited and the genes responsible may affect brain development. Although no specific genes have been linked to the condition, a person is four times more likely to suffer with OCD if another family member has the disorder.
Brain abnormalities – Someone with OCD has an abnormality in the part of the brain known as the basal ganglia. This part of the brain is responsible for the fight or flight reflex and if OCD develops it is thought that the individual believes they are constantly under threat. Compulsive behaviour develops as a coping strategy to help shake the anxiety and fear.
Serotonin levels – Serotonin is a chemical in the brain that transmits messages from one brain cell to another. Why this contributes to OCD is unclear but serotonin re-uptake inhibitors (anti-depressants) have been used to help treat the symptoms.
Life events – Traumatic or adverse life events such as divorce or bereavement may trigger the onset of OCD in people who are predisposed to the condition through biological or psychological tendencies.
Someone with obsessive-compulsive disorder will suffer a pattern of thoughts and behaviour that has four main steps: obsession, anxiety, compulsion and relief (temporary).
Obsession is characterised by an overwhelming obsessive fear of something such as a fear of a break-in to the home. This obsessive fear triggers distress and intense anxiety leading to compulsive behaviour to reduce the anxiety e.g. checking door locks more than once before leaving the home. This behaviour brings temporary relief until the anxiety returns and the cycle begins again.
Obsessive thoughts common to OCD sufferers include:
fear of being harmed or causing harm to others
fear of infection or disease
the need for order
fear of offending others or being considered sexually deviant
fear of catastrophic mistakes (leaving the gas on resulting in a house fire or leaving doors unlocked resulting in burglary)
Compulsive behaviours common to OCD sufferers include:
repeatedly checking doors are locked
frequently cleaning and washing
rituals (such as closing cupboard doors two or three times before walking away)
hoarding objects with little value
These behaviours are sometimes logical to the person. For example, if someone fears disease then repeatedly washing the hands will help prevent it. In some cases there is no connection and the behaviour appears to be superstitious with the individual believing they have the control to prevent the obsession from occurring.
OCD sufferers are usually aware that their behaviour is irrational but are unable to stop their actions.
Someone with OCD will go to great lengths to hide their symptoms and as such will be reluctant to seek treatment because of feeling ashamed or embarrassed. It is important for friends and family not to accommodate or 'play along' with obsessive behaviours as this will only reinforce the condition. Confronting the behaviour and suggesting medical attention is the best course of action.
In the first instance you should visit your GP who will carry out an initial screening to assess if you do have OCD. They will question you on your everyday behaviours and thoughts. If the GP suggests OCD then a further assessment will be required by a mental health professional. This will involve more detailed questioning to identify how much of your daily life is affected by obsessive thoughts and behaviour.
At this point, the severity of your OCD will be determined. OCD severity is classified as either:
Mild functional impairment – obsessive thoughts and behaviours that occupy one hour of the day
Moderate functional impairment – thoughts and behaviours occupying two hours per day, or
Severe functional impairment – more than three hours per day