What is Obsessive Compulsive Disorder (OCD)?

Obsessive Compulsive Disorder can affect people in many different ways. Not all people experience the same symptoms or the same degree of intensity of symptoms, although all people who suffer from OCD experience obsessions and/or compulsions. Obsessions are intrusive, unwanted and often disturbing thoughts that the person cannot control. Persistent fears of contamination, that they are to blame for something or an overwhelming need to do things perfectly are common. Time after time, the individual will experience a distressing and anxiety- provoking thought, such as, "have I left the iron on?", "have I injured somebody else?" or "do I have something physically wrong with me?"

Compulsions are repetitive, distressing and purposeful physical behaviours, which relate to the obsessive thoughts. Examples of compulsive behaviours include:

• repeatedly washing hands due to the rear of contamination
• constant checking  (doors or windows have been locked, gas turned off etc)
• avoidance of certain objects and situations (holes in the road, cracks or lines in pavement)
• the need to repeatedly count something (pavement cracks, stairs etc)
• hoarding things due to a fear of throwing them away (newspapers etc)

All of these compulsive behaviours are ways for the person to try to reduce their feelings of anxiety. This repetitive behaviour can interfere with a person's life to the extent that the individual cannot leave home or function at school or at work because of the many hours spent performing these rituals.

What are the causes?

The exact causes of OCD are not fully understood. There are, however, a number of possible theories which suggest that it could be genetic, a result of the effects of interaction between behaviour and the environment, beliefs and attitudes or even chemical changes in the brain, usually related to the brain chemical serotonin.  OCD may be triggered initially by some stressful, anxiety-producing event in a person's life. For example, a person who became very ill might develop a phobia about germs, an obsession about cleanliness, and a compulsion to wash hands hundreds of times a day.

What help is available?

Although there is currently no one theory that can explain precisely all causes of this disorder, there are a number of very effective treatments and therapies for OCD.  It was once considered to be an extremely rare disorder that was largely untreatable. But when studies revealed that OCD was much more common than believed, the disorder began attracting much more attention from researchers. Consequently, breakthroughs in treatment of OCD have occurred and OCD is now a major focus of research in the mental health area.

Research has shown that behaviour therapy is an effective treatment for most types of OCD. It involves experiencing the fearful situations that trigger the obsession (exposure) and taking steps to prevent the compulsive behaviours or rituals (response prevention). This type of therapy is a step-by-step structured technique tailored by therapists to suit individual clients. Essentially behaviour therapy is about 'unlearning' disruptive behavioural patterns

Cognitive Behaviour Therapy (CBT): CBT challenges the person's thought patterns and behaviour. Cognitive behavioural therapists focus their treatment on assisting the person to modify the thoughts causing their unwanted behaviour. In the case of OCD, cognitive behaviour therapy can prepare the ground for the use of behaviour therapy and can also help to prevent any future return of the symptoms after the treatment has finished.

Psychotherapy: This is a form of 'talking' therapy. It can help the individual to understand and cope with their feelings and the difficulties they experience directly as a result of the disorder.

Support Groups: Support groups provide support, friendship, education, understanding and information for the individual with this disorder and to their friends and family. Presently in NSW alone there are support groups for people living with OCD in both the Sydney metropolitan area and regional NSW. There are support groups run through the Mental Health association NSW. Click here to link through to the support groups page.

Pharmacotherapy: Anti-depressant drugs, which specifically affect a neurotransmitter in the brain called serotonin, are the most useful of pharmacological interventions. These drugs are not addictive substances and work on correcting chemical imbalances within the brain. This is thought to reduce patterns of compulsive behaviour. Unfortunately, medications are not equally effective for all sufferers.

Therapeutic Axis provides counselling in Sydney and psychotherapy in Sydney for persons who may be affected by Obsessive Compulsive Disorder - O.C.D.

What can I do to help myself?

• educate family and friends about the condition, as this may help them to understand what you are experiencing
• support groups may also be helpful in offering you support and the chance to find out how other people have coped
• relaxation, meditation, physical exercise, regular sleep, and a balanced diet are helpful for all anxiety disorders
• keeping a diary may help you to identify those stressful situations that help to trigger compulsive reactions, which may assist therapy goals and keep track of changes and improvements.

Families and Friends

• • learn as much as you can about the disorder, its causes, and its treatment.  This will help you to understand the distress that can be caused by OCD
  • you may feel ‘entangled’ with the person’s behaviours and rituals and inadvertently become involved in helping the person to continue these.  If this is a concern, speak to the person treating your relative (if you have your relative’s permission) or seek family therapy, rather than suddenly withdrawing your support or participation in the rituals
  • avoid negative comments or criticism of the person or telling them to ‘just stop’ the behaviour.  The person with OCD is likely to feel negatively towards themselves already and this will only reinforce these feelings.
  • encourage the person to persevere with treatment and/or medication
  • if the person with OCD is a child or adolescent, work with their school to ensure they receive the support and assistance they may need.

Further Reading

Obsessive-Compulsive Disorder: Help for Children and Adolescents by Mitzi Waltz, O'Reilly Media, Incorporated, 2000, ISBN: 1565927583

Obsessive Compulsive Disorder: A Guide, by John H Greist, Madison Institute of Medicine, 1997, ISBN: 1890802034

Freedom from Obsessive Compulsive Disorder by Jonathan Grayson, Penguin Group (USA) Incorporated 2004 ISBN:042519955X

The Mental Health information Service sells these books:

• Learning to Live with OCD by the Association of Relatives and Friends of the Mentally Ill (ARAFMI)
• The Secret Problem by Neil Phillips (ShrinkRap Press)

For more information on OCD support groups in Sydney go to info@mentalhealth.asn.au 1300 794 991