People living with OCD can be compared to a driver who is constantly checking and rechecking their rearview mirror, even though they know they've already checked it several times. Just as the driver may be anxious about missing something important on the road, those with OCD may feel compelled to repeat certain behaviours or thoughts to avoid perceived harm or anxiety. Despite the awareness that these actions may not be necessary, they feel compelled to continue them.
OCD can be very challenging for those who suffer from it. OCD is a mental health disorder characterised by persistent, intrusive thoughts or obsessions and repetitive behaviours or compulsions to reduce anxiety. People with OCD may feel like they are trapped in a cycle of repetitive behaviours and thoughts that they cannot escape from. They may also experience feelings of guilt or shame due to their ideas and behaviours, which can be distressing and impact their quality of life.
Intrusive thoughts or "obsessions" are unwanted, distressing and recurrent thoughts or mental images that may include violent or sexual content, fear or doubt. Research suggests that intrusive thoughts are everyday experiences for everyone, shared among the general population and do not necessarily indicate a mental health problem.
A study published in the Journal of Obsessive-Compulsive and Related Disorders found that about 90% of participants reported experiencing intrusive thoughts at some point. Intrusive thoughts can vary in content and severity. Research has identified different intrusive thoughts including harm-related, sexual, contamination and religious/blasphemous thoughts. A study published in the Journal of Anxiety Disorders found that harm-related thoughts were the most common type of intrusive thought among college students.
However, intrusive thoughts do not necessarily reflect reality or hold any significance to most people. Individuals with OCD differ from those without in their interpretation of intrusive thoughts. While non-OCD individuals may view such thoughts as random and bizarre, those with OCD often misinterpret them and fear that they signify something terrible, leading to significant discomfort and anxiety.
For example, a mother may have an intrusive thought about throwing her baby out the window. Someone without OCD will view the thought as random and fleeting. However, someone with OCD may fear that this intrusive thought means they are capable of such an act and spend significant energy avoiding it or performing rituals to prevent harm.
It is important to note that having intrusive thoughts does not mean an individual will act on them. In fact, research suggests that those with OCD are statistically less likely to act on their fears than others. Individuals with OCD exhibit a strong sense of caring and kindness despite their intrusive thoughts.
The most common obsessions experienced by people with OCD include fear of contamination, fear of harming oneself or others, fear of losing control of oneself, fear of making mistakes, and fear of imagining or thinking unpopular or disturbing thoughts. Common compulsions include washing or cleaning, counting, ordering and arranging objects, repeating certain words or phrases, checking, praying, or repeating actions imposed by oneself or others.
People with OCD may avoid certain activities, places, or objects to limit their exposure to the things that trigger their obsessions. Alternatively, they may engage in rituals or compulsions to gain a sense of control over their irrational thoughts. People with OCD may also struggle to recognise their own distress. Sufferers often feel ashamed of their obsessions and compulsions. They may keep their symptoms private, so it is essential to understand that OCD is not simply a bad habit and needs to be treated as a mental health condition.
Attempts to avoid or neutralise intrusive thoughts through rituals or avoidance ultimately exacerbate OCD symptoms. Treatment involves:
Developing awareness of intrusive thoughts and compulsions.
Collaboratively developing a list of avoided situations and a fear ladder.
Gradually exposing oneself to such situations while reducing ritual responses.
Treatment for OCD often includes psychological therapies, such as cognitive-behavioral therapy (CBT), exposure and response prevention (ERP) and acceptance and commitment therapy (ACT).
CBT for OCD typically involves two main components: exposure and response prevention (ERP) and mindfulness.
Exposure and response prevention (ERP) is a behavioural technique in which the patient is gradually exposed to the feared situation or object while being prevented from carrying out the compulsive behaviour that typically follows the obsessive thought. This is done in a gradual and controlled manner, with the client learning to tolerate the anxiety and discomfort that arise as a result of not engaging in the compulsive behaviour. Over time, the client's anxiety decreases, and they learn to tolerate it without engaging in compulsive behaviour.
Mindfulness involves identifying and observing intrusive thoughts and beliefs about obsessions and compulsions. Sufferers are guided towards recognising and detaching from the thoughts and beliefs that underlie obsessions and compulsions and developing more realistic ways of thinking about fears.
The combination of ERP and mindfulness is believed to be effective in treating OCD by helping sufferers to tolerate anxiety and uncertainty, develop a more mindful approach to their beliefs and fears, and break the cycle of obsessions and compulsions that can interfere with daily life.
OCD can be debilitating, making it difficult for those suffering from it to perform daily activities and live their life to the fullest. While it can be a challenge to manage, there are ways to cope with and manage obsessive-compulsive disorder (OCD) on a daily basis.
Relaxation techniques such as deep breathing, progressive muscle relaxation and mindfulness meditation can help reduce OCD anxiety. These techniques help to reduce stress, which can, in turn, help to reduce the intensity of compulsions and obsessions.
Eating a balanced diet, exercising regularly, getting enough sleep and taking breaks throughout the day can help reduce the anxiety of OCD.
Finally, it is essential to remember that it is okay to reach out and ask for help. Finding a supportive network of friends, family members, or mental health professionals can be a great way to find support. Online resources and support groups such as OCDUK can help and advise people with OCD.
Although living with OCD can be challenging, finding ways to cope with and manage it daily is possible. Through relaxation techniques, cognitive behavioural therapy, self-care and seeking out support, it is possible to control the effects of OCD and create a happier life.
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