Obsessive compulsive disorder (OCD): symptoms, diagnosis and treatment

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This page was clinically reviewed by Dr Anne Perry (MBBS, MRCPsych), Consultant Psychiatrist at Priory Hospital Ticehurst House, in January 2022.

What is OCD?

Obsessive compulsive disorder (OCD) is a serious mental health condition that causes people to experience a variety of symptoms that typically fall into one of two categories: ‘obsessions’ and/or ‘compulsions’.

Obsessions are characterised by persistent and irrational thoughts or urges, and compulsions refer to physical or mental acts that people feel compelled to perform. Some people who develop OCD only experience one type of symptom, whilst others can experience both obsessions and compulsions. These irrational thoughts and behaviours can become extremely time consuming and can seem impossible to stop or control.

Symptoms of OCD

Sometimes, the signs of OCD are not always obvious. You may find yourself taking a step back from socialising, starting to become more conscious of cleanliness, or losing concentration, without realising that you could be suffering from OCD. If these symptoms are left to develop, they could become more serious and start to develop into obsessions or compulsions.

OCD obsessions include:

  • Overwhelming fear of germs or contamination
  • Recurring involuntary thoughts that you might say something inappropriate or harm another person
  • Constant worry that you forgot to lock a door or turn off an appliance
  • Experiencing intrusive sexual thoughts or constantly questioning your sexuality
  • Fearing that something bad will happen if you throw anything away, or a fear of losing things you might need
  • Worrying that you have a serious disease, despite medical reassurances
  • An obsession with order and symmetry, and being highly superstitious in relation to certain numbers, arrangements or colours
  • An obsession with causing accident, injury, harm, danger or misfortune to yourself and others

OCD compulsions include:

  • Repeating ritualistic actions a set number of times or for a certain amount of time. For example, turning a light switch on and off
  • Washing your hands or bathing multiple times each day, regardless of need
  • Only touching certain objects with a tissue or avoiding objects that may be contaminated
  • Continually counting or repeating certain words over and over again
  • Repeatedly seeking reassurance from other people
  • Excessive praying or other religious rituals
  • Hoarding or collecting items that you don’t need or use

The most common form of OCD is related to hygiene and contamination. This form of obsession causes the sufferer to develop an intense and irrational fear of germs, dirt and disease, resulting in them compulsively washing themselves or objects more than usual, only touching things with a tissue, and avoiding items that may be contaminated.

For someone struggling with an OCD, intrusive thoughts can also be a symptom. Intrusive thoughts are unwanted thoughts and feelings towards a range of different scenarios. They can cause extreme worry, followed by compulsions, which can be mental or physical.

We can all experience intrusive thoughts from time to time - they tend to quickly appear and disappear, and leave no lasting impression. But for someone with OCD, they can linger and occur time and time again, leading to a great deal of stress and anxiety.

Examples of intrusive thoughts include:

  • Violence – thoughts about harming themselves or others
  • Religion – thoughts that are against their religious beliefs
  • Relationships – thoughts about the strength of their relationship
  • Sex – thoughts about sexuality or sexual harm

For anyone who's having intrusive thoughts, it's important to remember that these thoughts are normal. Everyone experiences them.

However, if they're frequent, overwhelming and you find yourself carrying out compulsions in an attempt to cope, you may need professional support.

Diagnosis for OCD

The diagnosis process for OCD starts with a conversation with your GP or another medical professional. They'll be able to ask you some simple screening questions provided by the National Institute for Health and Care Excellence (NICE) to assess your current situation and discuss the need for further referral. These questions might include:

  • Do you wash or clean a lot?
  • Do you check things a lot?
  • Is there any thought that keeps bothering you that you would like to get rid of but cannot?
  • Do your daily activities take a long time to finish?
  • Are you concerned about putting things in a special order or are you very upset by mess?
  • Do these problems trouble you?

During your assessment, you'll also be asked about physical symptoms you may be experiencing, such as:

  • Dermatological symptoms (from excessive washing)
  • General stress (for example, from losing a job as a result of repeated lateness)
  • Avoidance (hiding sharp objects, not touching common surfaces like door handles, avoiding being left alone with children)

Depending on your responses, a more formal diagnostic interview may be conducted to understand your symptoms better and learn how OCD is affecting your life. Some OCD symptoms are easily observed and reported, but others can be extremely difficult to pick up on without probing, especially where the rituals are covert or stigmatising.

How is OCD treated?

Treatment for OCD is often offered as outpatient therapy, meaning you and a team of specialists work together during weekly therapy sessions. Depending on your symptoms and how they affect your life, residential inpatient treatment is also an option. This means you live at a mental health treatment centre and have access to care and support more often.

Whether you’re treated as an outpatient or inpatient, the same OCD treatment methods will be used, and these include different types of therapy and medication to control your compulsions.

Cognitive behavioural therapy (CBT) for OCD

CBT is a highly effective therapeutic method that's used worldwide to treat a range of mental health conditions, including OCD. CBT is based on the principle that OCD develops and is intensified as a result of a series of dysfunctional, deeply ingrained thought processes that cause people to evaluate and respond to situations in unhealthy ways.

Therefore, the aim of CBT is to address the negative thought patterns that form the basis of your OCD, examine why they've developed in the first place, before challenging you to view situations in healthier ways. The OCD CBT programme at Priory aims to reduce anxiety and prevent patients from engaging in the harmful rituals that are characteristic of OCD.

Exposure and response prevention (ERP) treatment for OCD

ERP is a therapeutic technique that encourages you to gradually face your fears until you learn to tolerate and overcome the anxiety they cause. The process of ERP teaches you to simply let your obsessive thoughts and anxiety wash over you, instead of becoming distressed and needing to ‘put them right’ or ‘neutralise’ them with a compulsion.

Exposure requires you to repeatedly test your fears and expectations, learning to tolerate the anxiety without performing your rituals (response prevention).

 What does this mean?

  • Learning to give up control
  • Resisting your compulsions
  • Repeatedly tolerating the discomfort that occurs
  • Planning out exposures and behavioural experiments so that you can test out whether your irrational theories actually match the results

Through consistent exposures, you'll gradually find it easier to face up to your fear and cope with anxiety. You'll then be able to generalise what is learnt through exposures in other areas of your life. Despite an increase in short-term anxiety and distress, these tend to gradually decrease over time.

Eye movement desensitisation and reprocessing (EMDR) for OCD

EMDR is a therapy method used to treat a variety of mental health conditions including trauma, addiction and anxiety as well as other emotional conditions.

EMDR allows a person to process an emotional experience they have had difficulty talking about. Experience has shown that following EMDR treatment, the person can develop the ability to talk about their trauma more freely, and in a way that may have proved difficult in the past.

Medication for OCD

Medication can also be used to treat OCD. It's usually prescribed alongside CBT, in order to complement the therapeutic side of treatment. Medication can reduce anxiety, minimise the risk of relapse following treatment, as well as act as an additional buffer against OCD. The most useful medications in the treatment of OCD are selective serotonin reuptake inhibitors (SSRIs), which are a form of antidepressant medication. SSRIs are non-addictive and their effects can be seen after several weeks. It's important to take a full course of SSRI treatment, which is usually a year or more.

Treating OCD at Priory

At Priory, we understand that the symptoms of OCD can be distressing and confusing. As such, our world class team of specialist psychiatrists, psychologists, therapists and other mental health professionals are committed to providing tailored OCD treatment at our hospitals and wellbeing centres. We're dedicated to enabling you to address the causes and underlying triggers for your irrational thoughts and behaviours, improve your symptoms and regain control of your life.

In addition, Priory’s national network of specialist UK hospitals and wellbeing centres mean that we can offer you the specialist mental health support you need in a location that is convenient for you, and in a way that's flexible around your work and other commitments.

OCD and related conditions

Unfortunately, OCD can have quite an impact on your mental health and wellbeing. As well as experiencing symptoms of OCD, the condition can also induce other mental health conditions such as:

  • Anxiety
  • Depression
  • Sleep disorders
  • Paranoia

Alongside these, you may also experience problems with socialising, self-esteem, appetite changes, and self-medicating with drugs and alcohol. OCD and guilt are often linked too, as you can feel guilty for your obsessions, compulsions and changing mental health. Not everyone will experience these challenges at the same time as OCD, but they can be explored further during an OCD diagnosis assessment.

OCD treatment FAQs

How effective is OCD treatment?

The treatment you receive for OCD will vary depending on the type of OCD you're struggling with and how intense your symptoms are, but many effective treatments exist today.

Statistics show 50% of people who receive treatment for their OCD symptoms found that their condition improved.

How much does OCD treatment cost?

The cost of OCD treatment depends on the kind of treatment you need and the intensity of your treatment.

For mild symptoms, you may only need outpatient treatment, which can include day sessions and/or weekly therapist sessions. For more severe symptoms, you may need inpatient treatment, where you become a resident of a mental health treatment centre and participate in different therapies and mindfulness activities each day.

Does OCD get worse with age?

For some people, their symptoms can get worse as they get older, but for others, symptoms can stay the same.

There are lots of factors that can impact OCD, such as your home environment, school, and even your social life. These will all play a role in determining if your OCD will worsen. The age at which you get help for OCD will also impact whether your condition gets worse, stays the same, or improves.

What are some examples of OCD?

Depending on the type of OCD you're struggling with, your symptoms may differ.

However, some common traits include:

  • Repeatedly checking plug sockets to make sure they're switched off
  • Constantly washing your hands
  • Counting
  • Reordering and reorganising regularly
  • Checking doors and windows are locked
  • Needing regular reassurance

Can OCD come back after treatment?

There is no cure for OCD, but with treatment, it will become much more manageable.

As long as you continue to practise coping techniques that a therapist has taught you, and take any medication you've been prescribed, your OCD should be manageable and allow you to live a normal life.

Private medical insurance

We are a registered and approved provider for all of the UK's leading private medical insurers. All of the services we offer at Priory can be funded through private medical insurance. This includes:

  • Mental health treatment
  • Addiction treatment
  • Eating disorder treatment

All clients will have access to our highly skilled and accredited clinicians, many of whom are published experts in their fields of treatment. Whatever your requirements, we're committed to working with you to get your life back on track.

Registered and approved provider

We are a registered and approved provider for all of the UK's leading private medical insurers.

Obsessive compulsive disorder (OCD) treatment near me

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