OCD

Question 1

What is OCD?

Answer 1

Obsessive compulsive disorder (OCD) is characterised by obsessions and compulsions.

Obsessions are unwanted and uncontrolled thoughts and intrusive images that the person finds it very difficult to ignore. Examples of this are an overwhelming fear of contamination with dirt or germs or violent or explicit images that keep appearing in their mind.

Compulsions are repetitive actions the person feels they must do, generating anxiety if they are not done. Often these compulsions are a way for the person to handle the obsessions. For example, checking that all electrical equipment is turned off to settle the anxiety of obsessing about the house burning down. This is a normal behaviour, but in OCD the person may check every plug in the house 10 times before being able to go to sleep or leave.

Question 2

OCD cycle?

Answer 2

There is a cycle in OCD: The obsessions lead to anxiety, which leads to the compulsive behaviour, which leads to a temporary improvement in the anxiety. Shortly after the temporary improvement in anxiety the obsession reappears, leading to further anxiety, further compulsive behaviour with a temporary relief. This cycle continues and each time gets more engrained in the person’s behaviour. Without doing the compulsions, the person feels they cannot get relief from their anxiety.

The obsessions and compulsions are present on a daily basis and are not something the person will enjoy or do willingly. They impact on other areas of life, such as their social life or other interests.

Question 3

OCD associations?

Answer 3

OCD is strongly related to other mental health issues:

Anxiety
Depression
Eating disorders
Autistic spectrum disorder
Phobias

Question 4

Management of OCD?

Answer 4

Mild OCD may be managed with education and self help resources.

More significant OCD may require:

Referral to CAMHS
Patient and carer education
Cognitive behavioural therapy
SSRIs medications (under the guidance of a CAMHS specialist)