Mental Health Awareness: A beginner's guide to obsessive-compulsive disorder (OCD)

In this article, we will provide you with a beginner's guide to the mental health condition called obsessive-compulsive disorder, also known more commonly as OCD. We will answer a number of questions about the condition, including what it is, how common it is, and what conditions it is similar to. As well as these questions, we will also touch on topics surrounding OCD, including misconceptions and stigma of the condition, signs and symptoms, the impact it has on someone with the condition, and how you can get help if you or someone you know is struggling. 

What is the definition of obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder is a mental health condition that is characterised by a pattern of thoughts and behaviours. According to the NHS, there are three main elements of OCD, these are:

• Obsession: Unwanted, intrusive and distressing thoughts, images or urges entering your mind

• Compulsion: Repetitive behaviours or thoughts that someone feels compelled to perform as a response to anxiety and distress

• Emotion: Feelings of upset, intense anxiety or distress

VIDEO: Obsessive-Compulsive Disorder Explained

Mind, the mental health charity provides a helpful explanation of obsessive-compulsive disorder (OCD) in the video below:

How prevalent is OCD in the UK?

In the UK, around 1 in every 50 people suffer from OCD at some point in their lives. This is an equal split of men and women. In context, this will equate to around 1 million people in the UK. Examples of well-known people who suffer from OCD include David Beckham, Charles Darwin, Florence Nightingale and Cameron Diaz (Blenkiron, Timms & Kennedy, 2022).

Is OCD the same as general anxiety?

Whilst OCD and general anxiety share similarities in terms of their symptoms, they are individual conditions that have unique characteristics. OCD involves repetitive thoughts and behaviours that stem from often irrational concerns. It often includes ritualistic behaviours that are used as a coping mechanism for anxiety. Generally, OCD does not have physical symptoms, however, in some cases, it can. People with OCD often recognise that their behaviour is problematic and irrational but still feel compelled to act on it.

With general anxiety, there are less ritualistic behaviours. General anxiety typically has at least three physical symptoms. The most common physical symptoms include nervousness, rapid heart rate or breathing, trembling, sweating, or difficulty concentrating. Anxiety can also be characterised by repeatedly going over situations in your head or worrying and overthinking (Catchings & Rice, 2022).

Which health conditions is OCD the main symptom of?

OCD is not typically known as a symptom. OCD is a standalone condition that affects people in specific ways. Despite this, OCD can sometimes be related to other mental health conditions including anxiety disorders, depression, tics, or in some cases substance abuse, according to the Mayo Clinic.

Misconceptions & Stigma

What are common misconceptions of obsessive-compulsive disorder?

According to The Recovery Village there are 7 myths that are the most common misconceptions people have about OCD. These misconceptions include:

• Everyone with OCD is neat and organised: Some people may be neat and organised, however, this is not the case for every person who has OCD.

• OCD is all about cleanliness: Some people may experience cleanliness rituals, however, OCD spans wider than this.

• People with OCD are uptight: OCD is not a personality trait and goes beyond being fussy or a perfectionist.

• People with OCD just need to relax: OCD is complex and cannot simply be solved by relaxing. It is not just a case of being stressed or anxious.

• OCD is obvious: Not all people with OCD have visible compulsions.

• OCD is caused by a troubled childhood: Childhood experiences can influence mental health conditions, however, OCD is not solely caused by childhood.

• OCD isn’t treatable: OCD is a treatable condition through talking therapies or medications.

Signs & Symptoms

What are the physical symptoms of OCD?

Physical symptoms are not as common with OCD as they are with other mental health conditions. However, some people may experience physical sensations when they have OCD. The most common physical sensations include (Taft & Marais, 2022):

• Hyperawareness of bodily functions

• A feeling of something being dirty or contaminated

• Disturbances with senses

• Itching or needing to scratch yourself

• Hallucinations

• Physical sensations in the groin

What are the psychological symptoms of OCD?

The psychological symptoms of OCD cover a range of cognitive and emotional experiences that impact someone’s thoughts, feelings and behaviours, according to SANE, the most common psychological symptoms of OCD are:

• Difficulty with new situations

• Rigidity and perfectionism

• Attention to details that don’t matter

• Feelings of guilt

• Anxiety and tension

• Sensitivity to criticism

• Suppressed emotions

• Having internal debates and arguments with yourself

What behavioural changes can there be with OCD?

Behavioural changes associated with OCD often manifest compulsive actions that are performed to alleviate distress. Some of the most common behavioural changes that people with OCD exhibit include (NHS, 2023):

• Cleaning and hand washing

• Checking doors, windows, appliances etc

• Counting of objects, steps etc

• Ordering and arranging items

• Hoarding

• Seeking assurance

• Repeating words or phrases in your head

• Avoiding places, objects or situations

Which environmental influences can cause OCD?

Environmental influences can potentially cause OCD, or at least add to the prevalence of it. Several factors, including stress, trauma, and even certain life events, may play a role in the onset or worsening of OCD symptoms (Klein & Pedersen, 2022).

The Impact of Obsessive-Compulsive Disorder

How can OCD impact on personal life?

Living with OCD can impact someone’s personal life. The mental health chairty Mind outlined the following ways that OCD could affect someone’s personal life:

• Disrupting daily life 

• Impacting on relationships including friendships and familial relationships

• Feelings of shame or loneliness

• Impact on self-esteem

• Heightened levels of anxiety and stress

How can OCD impact on physical health?

OCD can have physical effects that can sometimes slide under the radar. Compulsive behaviours such as handwashing, checking or counting can lead to physical discomfort or injuries. Frequent handwashing can cause skin irritation or dryness. Some self-soothing behaviours such as hair pulling or skin picking can also cause injuries. Coping with OCD can also cause fatigue and exhaustion due to being at heightened stress levels for extended periods (Washington, Fletcher & Smith, 2021). 

Seeking Help

When should you seek help for OCD?

Seeking help for OCD is crucial if you find that your obsessive thoughts and behaviours significantly impact your daily life and function, according to the NHS. 

Which professional services are available for OCD?

Thankfully there are a number of professional services available for people who are suffering from OCD. Organisations that offer services for supporting people with OCD include:

• OCD UK - A UK based charity designed to help people with OCD

• OCD Action - An OCD charity founded in 1994

• Mind - A well-known mental health charity providing support for a number of issues

• NHS - The NHS can provide talking therapies and in some cases medications for OCD

Can therapy and medication help OCD?

Yes, therapy and medication can both be effective treatments for obsessive-compulsive disorder (OCD). Cognitive-behavioural therapy (CBT) is the most commonly recommended type of therapy for OCD. In particular, exposure and response prevention (ERP) therapy, a specific form of CBT, is highly effective for OCD. ERP involves gradually exposing yourself to feared situations or thoughts (exposure) while refraining from engaging in compulsive behaviours (response prevention). Medication is not typically a frontline treatment for OCD, however, some cases require medicine as a treatment.

Combining therapy and medication can be particularly effective for managing OCD, especially for individuals with moderate to severe symptoms. This approach is often referred to as "combined treatment" or "multimodal treatment." For people with mild OCD, treatment or medication is either not necessary, or necessary for a short period of time (NHS, 2023).

Self-Help Strategies for Obsessive-Compulsive Disorder

Can self-help techniques help to treat OCD?

Yes, self-help techniques can be beneficial for managing OCD, according to the NHS. Some self help techniques that you can use to help you if you are struggling with OCD include:

• Educating yourself and building an understanding of your condition

• Self monitor your condition and note how/if it changes

• Practice mindfulness and relaxation techniques

• Gradually expose yourself to feared situations or triggers

• Conduct experiments with your own behaviour, ensuring that you understand parameters of your individual condition and how far to push yourself

• Adopt lifestyle changes such as regular exercise, adequate sleep, balanced nutrition and stress management

Can mindfulness and relaxation help with obsessive-compulsive disorder?

Yes, both mindfulness and relaxation techniques can help people with OCD. By practicing mindfulness and relaxation you can help to reduce your anxiety and stress levels which can contribute to your OCD severity. Mindfulness and relaxation can also increase awareness and emotional regulation, both of which can help with rationalisation and resisting compulsions (McGrath, 2020).

Can strong support from friends and family help with OCD?

Yes, having strong support from friends and family can be very beneficial for people with OCD. They can provide you with the emotional support you need to manage your condition, and can help provide you with validation and understanding you need to get over irrational fears and thoughts, according to the mental health charity Mind. Having a strong support system can also help to reduce the stigma surrounding the condition, as well as spreading awareness and understanding to people that may not know much about the condition.

Sources

• Mayo Clinic - Obsessive-Compulsive Disorder (OCD)

• NHS - Obsessive-Compulsive Disorder (OCD)

• Mind - About OCD (Obsessive-Compulsive Disorder)

• American Psychiatric Association - What Is Obsessive-Compulsive Disorder?

• OCD-UK

• WebMD - Obsessive-Compulsive Disorder (OCD)

• Healthline - Social Signs of Obsessive-Compulsive Disorder (OCD)

• NHS Inform - Obsessive-Compulsive Disorder (OCD) Self-Help Guide

• YoungMinds - OCD (Obsessive-Compulsive Disorder)

• Royal College of Psychiatrists - Obsessive-Compulsive Disorder (OCD)

• Medical News Today - Obsessive-Compulsive Disorder (OCD)

• Rethink Mental Illness - Obsessive-Compulsive Disorder (OCD)