What is it?
Obsessive-compulsive disorder or OCD is made up of two different parts:
Obsessions are unwanted thoughts, ideas or urges that are distressing. They may seem very strange or have to do with things you wouldn't normally think about doing. You can't control obsessions and they cause a lot of anxiety or 'bad feelings'.
Examples of common obsessions include:
- concerns about cleanliness or infection (worries about dirt, germs or becoming ill)
- bad things happening (someone attacking you; causing a fire or flood)
- unwanted "bad" or "inappropriate" thoughts (unwanted thoughts about sex; fear of killing oneself; sacrilegious thoughts)
- concerns about identity or morality (am I a good enough person; is what I'm doing wrong?)
- feeling something is "just not right" (a need for things to be perfect, look a certain way or be in a certain order)
Compulsions are things you keep doing to lessen feelings of distress or to prevent something bad from happening. But, these behaviours or mental acts only work for a short time so you need to keep repeating them and they start to interfere with daily life. For example, if a child or youth has obsessions about getting very sick, they might stay away from sick people and ask their parents again and again if they will be okay. Compulsions take up a lot of time and affect the way you live.
Examples of common compulsions include:
- staying away from things that are scary (knives, public toilets, things that trigger an obsession)
- repeated behaviours (hand washing, arranging items, checking, erasing and rewriting)
- mental acts (telling yourself you'll be okay, counting, praying)
- causing others to act in certain ways (to keep telling you everything is okay, wash your hands, stay out of your room)
Children and youth with OCD may have trouble controlling their emotions and become extremely angry. They may not see that their obsessions or compulsions are unreasonable or causing them problems.
How do I know?
Everyone has unwanted or unplanned thoughts at times. We may wander if the food has gone bad or think "maybe I'll jump off this bridge". Lots of people also have particular ways in which they like to do things or feel things need to be done (routines, superstitious habits). But people with OCD often experience their obsessions and compulsions as very distressing. They struggle to move on from their thoughts, behaviours, and experiences, and they have trouble enjoying life as a result.
For example, the disorder can take up a lot of their time and interfere with the way they function:
- socially (avoid friends; quit sports; rejected by peers)
- at school or at work (stay home; struggle to concentrate; work takes much longer)
- with family (fighting; stress; the amount of time and money others spend trying to help)
- personally (feeling down and sick of being distressed; not able to enjoy hobbies)
What can go along with OCD?
People with OCD frequently also have other mental health challenges, like:
- an anxiety disorder
- a depressive disorder
- a tic disorder (more often in males with childhood onset OCD)
- attention-deficit/hyperactivity disorder (ADHD)
When OCD is untreated, it can cause many challenges. For example, children may stop socializing with friends or become less engaged in school. Adults may have problems with personal and work relationships. Some adults with untreated OCD have trouble managing the demands of adult life on their own and rely more on family.
What can be done?
There are two main treatments that can be helpful for individuals with OCD. These treatments do not cure OCD, but they do help to manage and reduce the symptoms and to improve quality of life. These treatments may also be used along with other therapies or medications in some cases (another disorder, side effects, etc.). The most common and effective types of treatment for obsessive compulsive disorder are:
1. Exposure and Response Prevention (ERP)
ERP is a type of Cognitive-behavioural Therapy (CBT). It helps those with OCD gradually face their fear or distress while resisting their compulsions. ERP works very well for most people and had long lasting benefits. That is why it is considered the first line treatment for OCD. Treatment may be done on your own (self-help books), one to one with a therapist or in group settings. It is usually helpful to involve family members in treatment.
2. Serotonin Reuptake Inhibitors (SRIs)
SRIs are a type of medication that helps to reduce the intensity of OCD symptoms. It is recommended that SRIs be used along with ERP when an individual has severe symptoms.
What are other disorders related to OCD?
The following disorders share certain characteristics or patterns with OCD. They are seen as part of an obsessive-compulsive range or spectrum.
Body dysmorphic disorder: An over concern with a real or imagined defect or flaw in your appearance and a constant focus on it or trying to fix it. The child or youth might constantly compare their appearance to others or spend too much time looking in the mirror or grooming. Others cannot see the defect or think it is a minor flaw.
Excoriation (skin-picking) disorder: Picking at skin that causes an injury or lesion in spite of repeated attempts to decrease or stop.
Hording disorder: Serious problems with collecting or not getting rid of possessions regardless of their real value. The individual is very upset with the idea of parting with possessions.
Trichotillomania (hair-pulling disorder): Pulling out hair causing hair loss in spite of repeated attempts to decrease or stop.
Where to from here?
Talk to your doctor and get help from a mental health professional by:
- Getting a mental health assessment and support through your local Child and Youth Mental Health team (through a walk-in intake clinic in your community).
- contacting a private psychologist or counsellor.
For additional information about options for support and treatment in BC, visit our interactive ‘Ask Kelty Mental Health’ tool, where you can type in the questions you have about accessing services and supports.