OCD centres around two key parts, obsessions and compulsions. They’re closely linked but it can help to look at them individually to understand how they’re intertwined.
An overview of OCD
Obsessions relate to how you think or feel about something. And while it’s normal to have passing negative thoughts, with OCD it can feel like they’re stuck there. Even if you try not to think about it or focus on something else.
Compulsions are all about behaviours. People with OCD carry out certain actions or rituals to help them cope with or reduce the unwelcome thoughts or feelings they experience.
These might be physical actions – like arranging items in a particular way or checking a lock repeatedly until it feels ‘right’. Or they could be thought processes – such as counting up to a certain number or repeating a word or phrase in their head.
Living with OCD
The behaviours associated with OCD can make it an incredibly disruptive condition to live with. Time taken up by repeatedly checking, planning or arranging may get in the way of work and social plans. Obsessive thoughts can often be upsetting and hard to cope with too.
Many of us will have experienced intrusive and unwanted thoughts, but usually they come and go without us dwelling on them. For people with OCD, these thoughts become repetitive and very distressing. They may even feel like their friends and family may get hurt if they don’t carry out their compulsions, so it can be difficult to break the obsessive-compulsive cycle.
Misconceptions about OCD
As awareness of mental health conditions improves, people are starting to have more open conversations about their wellbeing. But sometimes misinformed assumptions can make it harder for people to talk about their experiences and seek help.
Let’s challenge some misconceptions you may have heard about OCD.
“OCD’s all about being tidy and clean or washing your hands all the time”
There’s a difference between liking to keep your home neat and being compelled to do something because of OCD. Compulsions can involve washing or cleaning things a certain way or a specific number of times. But this isn’t the only way they can present and not all behaviours are visible.
“Everyone’s a bit OCD”
Some of us are naturally more organised than others but being organised doesn’t mean you have OCD. Again, the key difference here is choice. We may choose to plan the week ahead in a calendar or list, but someone with OCD may feel something terrible will happen if they don’t schedule every single detail.
Saying things like “I’m a bit OCD” when you mean you’re very organised can make light of OCD. And it can mean people struggling with OCD feel like their symptoms aren’t being taken seriously.
“OCD isn’t that bad compared to other mental health conditions”
This assumption can present OCD as a personality quirk instead of a mental health issue. In reality, OCD can be incredibly disruptive and distressing for the person living with it. It can be associated with other mental health conditions.
Supporting someone with OCD
When you don’t have OCD, it can be hard to make sense of the actions of someone who does. But this doesn’t mean you can’t be there to help. Here are a few things you could do:
Read up on OCD
But remember everyone’s experiences are different, so make space to listen without judgement.
Look for signs
You might notice them checking things more frequently than usual, appearing distracted or reluctant to do certain things. If you learn to look for the signs, you can step in to offer support in the moment.
Don’t get frustrated
It’s hard to see someone you care about struggling, but it’s usually even more upsetting for them. Try to stay calm and be patient so they feel safe and know you’re there to help.
Give gentle encouragement
Avoid explaining why their feelings and actions aren’t logical – this can cause more distress. Instead, remind them of times when they’ve resisted their compulsions and nothing bad happened as a result. This can help to create a safe space for them to challenge or push back on their compulsions. Or try to divert their attention by suggesting an activity they enjoy.
Treatments and how they can help
If you think you might have OCD, a trip to your GP is a good first step. Your GP will ask about your symptoms and may recommend further treatment. For OCD it’s likely to be medication, therapy, or a combination of both.
Therapy for OCD
Cognitive behavioural therapy (CBT) is often recommended for OCD. It’s a type of talking therapy that looks at the way you think about things (cognitive) and the way you do things (behaviour). CBT can be a good way to open up a conversation around OCD as both revolve around thoughts and actions.
Another type of talking therapy used to treat OCD is exposure and response prevention (ERP). It works by:
- encouraging you to face up to your obsessions to help you accept or dismiss them, and
- gradually helping you to resist carrying out compulsive behaviours.
And it’s not necessarily a case of one or the other. CBT with ERP can be an option too, helping you tackle OCD from two complementary angles.
Medication for OCD
Some antidepressants can help improve OCD symptoms. Usually, you’ll be prescribed a type of antidepressant called an SSRI. This stands for selective serotonin reuptake inhibitor. Medication doesn’t suit everyone, but your GP will be able to talk through your options and any side effects to help you decide.
