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Design, Home staging, show Homes, and declutter in the Yorkshire area.
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When clutter is more than excessive - do you know whether it is OCD? |
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Obsessive-compulsive
disorder Nearly
everyone, what ever their age, has occasionally experienced brief runs
of repetitive thoughts, urges, or impulses (like having to check the
door is locked several times or having doubts that they have washed
their hands thoroughly enough after handling something dirty). Usually,
these can be dispelled easily and so cause little discomfort. For some
people, however, these kinds of worries really take a hold, and they
find that they get stuck in cycles of doing something over and over
again, like washing their hands, counting up to a certain number, or
checking something several times to be sure they've done it right. When
these kinds of behaviours become a persistent problem and interfere with
the person's life, it is known as obsessive-compulsive disorder (or OCD,
for short). Article
with thanks to Sally Burningham, Paul Salkovskis, Victoria Bream and
updated by Dr Isobel Heyman
OCD
is a form of anxiety disorder, which can vary from very mild to severe,
and can take many different and novel forms. It can affect children,
teenagers and adults. Some people are bothered by upsetting thoughts
that they can't get rid of no matter how hard they try; other people
feel compelled to wash or to check things, even though logically they
know there is no need. When people are troubled by their obsessional
problems they can experience very high levels of anxiety and distress,
and can find the problem takes up a lot of their time and attention. It
can interfere with a child's ability to go to school, play with their
friends, and interfere with almost every aspect of their life. In adults
it can disrupt a person's ability to work, their personal relationships
and even lead to people becoming housebound. People
often try and conceal this distressing condition from others because
they are ashamed or imagine that they are the only one to experience
such strange and upsetting feelings. But it is far more common than most
people realise. It has been estimated that as many as two to three
people in a hundred (2-3%) are likely to experience obsessive-compulsive
disorder at some point in their life. It
is important to seek help at an early stage if you are affected by
obsessive-compulsive disorder, before it begins to dominate your life.
See your GP or contact one of the organisations listed in help and info below. What are obsessions and compulsions? Obsessions,
in the context of mental health, are recurrent persistent, intrusive,
unwanted thoughts, images or ideas that cause anxiety and are
unacceptable to the person (for example, a child fearing that their
mother will be in a car accident). People
know that these are their own thoughts (rather than hallucinations) but
they also know that the thoughts are senseless and that they are
worrying about them too much. However, they feel compelled to get rid of
the thought, usually by doing some kind of compulsion. The
kinds of obsession that people may experience include:
The
thoughts, or obsessions, described above are usually accompanied by
'compulsions'. These may take the form of overt behaviours (such as
washing or checking) or mental acts (such as mentally repeating words or
phrases or checking things). These behaviours are carried out according
to certain strict rules to try and control the anxiety and distress
caused by the obsessions. Sometimes
the compulsion may appear to be connected to the obsession, as when fear
of contamination gives rise to endless scrubbing of surfaces each time
they are touched, for example. At other times there may appear to be
little connection. However, all such behaviours are aimed at reducing
the obsessional fears. Although
compulsions may temporarily relieve feelings of anxiety, they also make
the urge to perform yet another compulsion stronger each time. Over time
this worsens the problem. Common
forms of compulsive behaviour include:
OCD
can affect people of all ages. It may start in childhood or develop
later. Some people may have several obsessions or compulsions or their
obsessions or compulsions may change over time. There is a very small
tendency for obsessive-compulsive disorder to run in families. However,
most people who have OCD do not have children who go on to develop it. We
do not know what causes obsessive-compulsive disorder although a number
of explanations have been put forward. There are almost certainly
several contributory factors. Predisposing factors may be genetic, may
be related to brain chemical such as serotonin, or may be related to
psychological factors and life stresses. Recent
research has revealed a great deal about the psychological factors that
maintain the disorder, which in turn has led to effective psychological
treatment. Whilst
everyone may experience intrusive thoughts at times, the issue is how
much significance the person gives to that thought – what having the
thought means to them. For example, a person who doesn't have an
obsessional problem may experience a thought about harm coming to
themselves or someone they love, and they are able to stand back from
this and see it as 'just a thought'. However, people with obsessional
problems become very upset about what the thought might mean. They may
think that it is immoral to ignore the thought, or that simply having
the thought makes them responsible for harm that might come to
themselves or other people. They therefore feel compelled to act to
prevent any harm from happening or to prevent themselves from being
responsible for bad things happening. One
way they do this is to try very hard to suppress the thought which
bothers them – unfortunately this makes it occur more (tell yourself
not to think of a giraffe and you will probably find that an image of a
giraffe keeps popping into your mind). The
compulsions listed above are designed to neutralise the thoughts, or
obsessions. The bottom line is that people with obsessional problems are
trying too hard to keep the thoughts out or to make sure that things are
done properly or to be kept clean, and so on. The harder they try, the
more difficult it gets and the more upset and anxious they get – a
very unpleasant vicious circle. There
are effective treatments for OCD and it is important that the disorder
is diagnosed as soon as possible and people access the correct
treatments. The National Institute for Health and Clinical Excellence
(NICE) has recently produced guidelines for the assessment and treatment
of people with OCD. The
two effective treatments for OCD are cognitive behaviour therapy and
specific medication. Everyone with OCD should be offered CBT and ideally
this should be the first treatment in children. People may also benfit
from medication. The
extent to which people are affected by OCD varies a great deal. Some
people are only mildly affected and recover over time, often as their
circumstances change. However, for those more severely affected it is a
very distressing and disabling condition that – if untreated – may
persist throughout their lives, although its course may be up and down
and there may be periods of remission. The
most effective treatment for OCD is cognitive behaviour therapy (CBT).
CBT is a short-term, structured, problem-focussed and goal-directed form
of therapy. It helps the person get a full understanding of how the
problem works, introduces new ways of looking at it, and teaches the
person the necessary skills to understand and overcome their problem. It
aims to enable the person to become their own therapist when therapy
ends. The NICE guideline emphasises that the CBT technique which has
been shown to work best in OCD is a technique called 'exposure and
response prevention'. This involves the person with OCD working
collaboratively with their therapist to learn how to resist the urge to
carry out compulsions, while facing up to the anxiety this produces.
This is done in small steps so it is not too difficult. The target of
treatment is not to get rid of the obsessional thoughts (after all,
everyone gets them) but to get rid of the distress attached to the
thoughts that arises due to the beliefs attached to them, and to reduce
or eliminate the associated rituals. Your
GP can refer you for CBT. This form of treatment is always provided by
qualified professionals such as clinical psychologists, psychiatrists,
nurses, counsellors or social workers. There are a number of approaches
that a therapist might use with you to tackle your obsessive-compulsive
disorder. CBT
focuses very much on problems in the present rather than looking at the
past. Each session usually lasts about an hour and you are likely to be
offered 8-12 weekly sessions, although it could be more or less. You
will also be given tasks to work on at home. For more information you
might like to look at our
cognitive
behaviour therapy feature. Medication Certain
antidepressant drugs can be useful in treating obsessive compulsive
disorder; these are drugs which act on the serotonin system. These
include the specific serotonin reuptake inhibitors (SSRIs) such as
fluoxetine (Prozac). They are also useful in treating depression which is so often associated with
this disorder. High doses may be required and relapse is common if the
drug treatment is stopped. Treatment with medication is often more
effective if it is combined with cognitive behaviour therapy. Tips for friends and relatives Obsessions
and compulsions can be very time-consuming and seriously interfere with
someone's work, family life and other relationships. Often tasks that
once took several minutes can take several hours to complete and life
may become very restricted. Parents
of children with OCD have often become very caught up in their child's
rituals, and part of the treatment involves cutting back and eventually
stopping this involvement. Partners and friends can also find their
lives disrupted. They may find themselves becoming very involved in
compulsions and even going along with strange or inappropriate behaviour
in order to avoid upsetting the person further. However, trying to
placate the person in this way can reinforce their condition. If you
find yourself in this situation seek advice from an appropriate health
professional or organisation . Try
to persuade your child, friend or relative who has the condition to seek
help early
Organisations OCD
Action OCD-UK Anxiety
Care Websites KidsHealth:
Obsessive Compulsive Disorder Obsessive
Compulsive Disorder (OCD) in Children and Adolescents Website OCD
Information for Kids Under 10
Things
you need to know about OCD: Information for Young People
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