Obsessive Compulsive Disorder (OCD) is an anxiety based mental health condition characterized by “recurrent obsessions or compulsions which are severe enough to be time consuming or result in a marked distress or significant impairment” (APA, 2013, p.235).
Often the obsessive and compulsive impairment occurs within the persons’ usual routine such as occupational, academic, social activities or relationship domains. The obsessions that people typically experience are recurring and distressing thoughts, images, or urges which are often felt to be beyond the control of the person. The thoughts, images or urges may at times provoke anxious feelings.
When someone is experiencing an obsession, the goal of the compulsion is considered to be to alleviate the anxiety which is caused by the mental obsession. Thus there is a strong relationship – and feedback loop – between the obsession and the compulsion. The ongoing nature of the feedback loop continues to strengthen the relationship between the obsession and the compulsion. Unfortunately, completing the compulsive behaviours may not always relieve the thoughts that drive the obsessive behaviour, rather the obsessive and compulsive behaviour is reinforced (and strengthened) as the individual will experience short-term relief of the anxiety, shame or doubt.
What are some common obsessions?
- Fear of contamination
- Fear of being harmed or harming others
- Unwanted sexual or violent thoughts
- Constantly doubting
- Unacceptable impulses
- Concerns about morality or offending God
What are some common compulsions?
- Repetitive behaviours
- Hand washing
- Mental acts which the person feels driven to perform in response to an obsession
- Repeating words silently
What causes OCD?
There are a number of suspected causes of OCD, which includes the following:
Research is ongoing to identify genes which may be related to OCD.
Biologically based OCD is thought to include an imbalance in serotonin levels.
- Personality development
- Environmental factors
This may occur when an individual is brought up in a home with an inordinate pre-occupation with cleanliness.
How common is OCD?
Obsessive Compulsive Disorder in adults has an estimated prevalence rate of 3% across a life time and approximately 2% in a 12 month period. Within Australia approximately three in every hundred people will develop OCD at some point in their lives which is estimated at greater than 450,000 Australians. Generally, OCD will develop during adolescence (approximately 14 years of age); it is quite uncommon for a person to develop OCD or OCD symptomology after the age of 35.
There are some differences between males and females in the development of OCD and the type of symptomology. It is reported that males have a greater tendency to experience an earlier onset with OCD developing in early childhood; females tend to experience symptomology around cleaning while males experience symptomology around symmetry and taboo thoughts.
It is quite common for individuals to experience other mental health conditions in-conjunction with OCD symptomology, for instance:
- Major depression
- Anxiety disorders
- Eating disorders
- Personality disorders
- Tics and stereotyped movements
- Other compulsive-like behaviours
What is therapy for OCD like?
When entering therapy for an anxiety disorder, including OCD, there are a number of factors which the therapist must address. Similar to any therapeutic treatment plan, therapy is always at this client’s preferred pace. One of the evidenced based interventions for OCD is Cognitive Behavioural Therapy (CBT); common elements of treatment include psychoeducation, cognitive interventions, behavioural interventions and also relapse prevention. There is also growing evidence to support the use of Acceptance and Commitment Therapy (ACT) in the treatment of OCD. Rather than engaging in exposure or cognitive or behavioural interventions, ACT treatment encourages the client to engage in a behavioural commitment exercise instead of the ritual or compulsion.
If you or someone that know may be experience difficulty with an anxiety disorder or OCD, then discussing with a medical or mental health professional may be of assistance.
Authors: Vision Psychology and Dr Amanda White
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorder (5th ed.). Arlington, VA: American Psychiatric Publishing
Beyond Blue https://www.beyondblue.org.au/
Heyman,?I.,?Mataix-Cols,?D.,?Fineberg,?NA.?(2006).?‘Clinical?review:?Obsessive-compulsive?disorder.’ British Medical Journal. 333 (7565):?424–29
Sookman, D. (2016;2015;). Specialized cognitive behavior therapy for obsessive compulsive disorder: An expert clinician guidebook. New York: Routledge
SANE Australia https://www.sane.org
Australian Psychological Association. Evidence Based Psychological Interventions. Sourced from: https://www.psychology.org.au/Assets/Files/Evidence-Based-Psychological-Interventions.pdf
Crino, R. (2014). Treatment guidance for common mental health disorders: Obsessive-compulsive disorder. In-Psych, 36. https://www.psychology.org.au/Content.aspx?ID=6212