Obsessive compulsive disorder (OCD)

What is OCD?

OCD is when you have irrational thoughts called 'obsessions'. To try to deal with the anxiety caused by the obsession, you may perform repetitive actions called 'compulsions'. Some people only suffer from obsessions, and other people suffer from a mixture of obsessions and compulsions.

Who gets OCD?

One person in 50 people will develop OCD during their lives. It is equally common in men and women.

What are the symptoms?

You will be diagnosed with OCD if it has a negative effect on your everyday life. Some people have minor obsessions which would be considered part of their personality. Other people have the condition so severely they are not able to go to work, their relationships are affected and they can be virtually housebound.

What are the most common compulsive rituals?

Because your actions are a response to your obsessional fears, a compulsive ritual can take various forms. The most common responses are checking, cleaning and avoiding certain things.

For example:

checking if something is turned off
washing yourself or objects more than usual
only touching things with a tissue or avoiding items which may be contaminated

What causes OCD?

OCD usually develops in early childhood or puberty. OCD can often run in families, and it can be triggered by stressful situations, depression or puberty.

How can obsessions affect my life?

Obsessions affect normal thinking and can be very frightening and upsetting. These obsessive thoughts can take up hours of time and be overwhelming, making it difficult for you to break out of the thought pattern. Sometimes, you will ask people close to you for repeated reassurance about your obsessions.

Your obsessions are irrational and do not reflect your usual behaviour or values in any way.

Why do I perform compulsive rituals?

One way for you to deal with your obsessional fears is to take action, leading to compulsive rituals. This behaviour makes the thoughts 'safe' in your mind so temporarily reduces anxiety.

Will obsessions always make me perform compulsive rituals?

This type of obsessional fear doesn't always lead to compulsive rituals. Instead, it can lead to intense fear of an outcome rather than feeling the need to act in a certain way. The obsessions may be about violence, contamination, sexuality or accidental injury, such as being afraid you might harm others either by doing something or failing to do something.

How will compulsive rituals affect my life?

You may take hours to perform your compulsive ritual, causing a great deal of disturbance to your daily life. You often have to repeat these actions a set number of times, or for specific lengths of time, before you can stop. If the ritual is interrupted, you may have to start the whole ritual again as failure to complete an action can cause severe anxiety or panic.

What treatment is available for OCD?

Treatment often involves cognitive behaviour therapy (CBT) and medication. A structured programme tailored to your specific problem will be designed after a consultant psychiatrist and trained therapist have carried out an assessment.

How does psychiatric or behavioural therapy work?

The main parts of this programme are techniques known as exposure and response prevention. These techniques help you confront your fears and learn not to use compulsive behaviour. The programme will start by tackling your smaller fears then gradually building up, and will involve practising the tasks in your own home to reinforce the response prevention. It will help reduce your anxiety, which will then allow the rituals to stop.

Will I need residential treatment?

The treatment you receive depends on how serious your condition is. For example, you may be treated as an outpatient, day patient or inpatient. We will discuss with you whether you need to go into care.

How long will the treatment take?

The length of treatment varies from 10 outpatient sessions upwards, depending on how serious your condition is. You may need some follow-up sessions over several months to encourage you to continue to use the skills you learned in your treatment.

What medication is available?

There are some antidepressant medications that can be very useful in treating OCD. They reduce the obsessions and are useful when one of the symptoms of the condition is that you feel low. In severe cases, medication can make behavioural and psychological treatments more effective. They're not addictive and are safe to use over long periods of time. The medication used to treat OCD is normally of a higher dose and needs to be taken for longer than in depression, so a psychiatrist should supervise use.

Does treatment work?

You may find the treatment difficult as you will need to confront your obsessional fears and stop your compulsive responses to these. But the most important thing is to realise that help is available and effective in most cases. Therapists and other hospital staff are aware of your condition and will give as much support as possible. Carers and family members will be involved as appropriate, especially where you need support at home.

Self help

Self-help may be useful as the first stage of treatment or alongside other treatments. There are also many different self help books, leaflets and internet sites available, and you need to find the right one for you.

Self-help groups, like those supported by OCD Action, can be a useful support but they do not replace professional treatment. However, they can help sufferers and families understand that they are not alone, and offer valuable support and practical advice.

Contacting your GP is often the easiest way to get help and further treatment. He or she may offer you counselling or refer you to a specialist for further assessment. This may lead to outpatient treatment or, if more serious, day or inpatient treatment.

If you're worried about talking to your GP, consider writing down your concerns and questions. You can:

take a friend or family member with you;
see another doctor in the practice; or
join a new GP practice.

The type of professional support offered will depend on the services that are available in your area and the arrangements that our primary care trust (PCT) have with other health authorities or private providers. Treatment for OCD is also available privately through Priory.

Finding help

If you feel that you or a close relative are affected by obsessive compulsive disorder and would like help or more information, you can ask your GP or contact any of the following organisations:

OCD Action
0207 226 4000 (www.ocdaction.org.uk)

OCD UK
0870 126 9506 (www.ocduk.org)

NHS Direct (England and Wales)
0845 4647 (www.nhsdirect.nhs.uk)

NHS 24 (Scotland)
08454 242424 (www.nhs24.com)

Priory
0845 2 774 679 (www.priorygroup.com)

If you are interested in receiving treatment from us, your GP will be able to refer you.

If you or your relative have private medical insurance, your insurer will probably insist that your GP refers you to us.

To view a list of the Priory hospitals that can help with obsessive compulsive disorder (OCD) please click here.

Why should I choose Priory?

Our service

At Priory, our committed and professional staff provide the highest standards of care, understanding and service for everyone. This service brings hope and confidence, allowing our patients to take control of their lives within a safe and secure environment.

At Priory, our committed and professional staff provide the highest standards of care, understanding and service for everyone. This service brings hope and confidence, allowing our patients to take control of their lives within a safe and secure environment.

Expertise and innovation

As Europe's leading independent provider of specialist mental health, neuro-rehabilitation and special education services, we bring experience and an excellent reputation. Through our close links with the public and private sectors, we've developed the expertise and innovation to offer consistent and successful treatment. We admit patients 24 hours a day, seven days a week.

This document has been edited by Dr Catherine J Downie with the help of Plain English Campaign (www.plainenglish.co.uk)

For more information and advice on obsessive compulsive disorder please download our self-help leaflet by clicking here.