What is OCD?

Many mental health disorders are poorly understood and this is no different for OCD. OCD, or Obsessive Compulsive Disorder, is a mental illness that many people do not take seriously, their general lack of understanding about the condition leading to phrases such as ‘we’re all a little OCD’ or assuming that it simply means one is exceptionally tidy. The only way to combat such misunderstanding is to spread awareness about the facts of the condition. So what is OCD and how serious is it?

What is OCD? 

OCD is a mental illness that is characterised by a mixture of obsessions and compulsions. In order for a diagnosis to be made the cycle of obsessions and compulsions must be extreme enough that they consume a lot of the person’s daily activity and energy, and get in the way of the persons day-to-day living. Having a particular routine that you rigidly follow or particular ways of doing things doesn’t automatically make you OCD.

Obsessions

Obsessions are thoughts, images, and impulses that occur repeatedly and are unwanted and unbidden, and yet those suffering them find them near impossible to expel from their mind. Obsessions are usually accompanied by intense and uncomfortable feelings like fear, anxiety, disgust, doubt or an intense feeling that things have to be done in a certain way or something bad will happen either to them or someone they love. For those with OCD, the anxiety caused by their obsessions is so strong that it gets in the way of daily living and prevents them from doing things that they would otherwise want to.

Almost everyone has unpleasant or unwanted thoughts at some point, for example being worried that you forgot to lock your car or that you left the stove on when you left the house. For most however it’s easy to put those thoughts out of your mind and carry on with your day. Furthermore some people may have naturally obsessive personalities, but the difference is that for these people it does not usually prevent them from carrying out normal every day tasks.

Compulsions

Compulsions are the second part of OCD. These are repetitive behaviours or thoughts that a person uses with the intention of neutralising or counteracting obsessions so that they can relieve the anxiety that they cause. These can be anything from physical actions to mental rituals. The person usually realises that the compulsions are only a temporary solution, but without a better way to cope they rely on them to provide relief. In the same way as obsessions, not all ‘rituals’ or repetitive behaviours are considered compulsions. To ascertain whether it’s a habitual or comforting routine or the way in which people like to do things, or a compulsion, one has to look at the function that the action fulfils. Are they undertaken to provide relief to a very specific worry or obsession? Just as it is possible to have an obsessive personality without having OCD, many people may have a compulsive personality without having the illness.

Pure O

OCD doesn’t always present as clearly as this however. The term ‘Pure O’ stands for ‘purely obsessional’. This phrase is a little misleading as it implies that the person does not suffer from compulsions, however this is incorrect. ‘Pure O’ describes a type of OCD in which people experience disturbing or intrusive thoughts with no outward signs of compulsions, but will still experience mental compulsions. Because there are no outwards manifestations it can be hard to define what these compulsions are. They could be as simple as checking how you feel, such as are you still in love with your partner? It could be checking bodily sensations, how you feel about a thought, or repeating phrases or numbers in your head.

What causes OCD? 

No one knows for sure what causes OCD but experts suspect that there may be three potentially contributing factors: personality, biological factors and lived experience. Some research suggests that people with certain personality traits are more likely to have OCD, for example those who are naturally more obsessive. However as with all mental illnesses it is suspected that biological factors are at play as well. It has been seen that those with OCD have decreased levels of seratonin in their brains, though it is not certain whether this is a cause, or an affect of the illness. It has also been shown that one’s lived experience can impact the onset of OCD. If a person had a painful childhood, experienced trauma or bullying and learnt to use obsessions and compulsions as a way to cope with anxiety, it can continue to impact their later life. It has also been shown that it can become a learnt behaviour from one’s parents. If a parent displays similar issues often a child may pick it up from a young age.

There are a number of strategies that can help those with OCD. The most effective treatment usually involves a combination of both therapy / counselling, and medication. This is aimed at equipping the person with strategies to help them manage their obsessions, whilst the medication increases the level of seratonin in their brain. Combined these treatments allow the person to get their obsessions and compulsions more under control so that they have less of an impact on their daily lives.