Obsessive Compulsive Disorder, more commonly known as OCD, is a term often thrown around and jokingly applied to friends or family members who tend to be a little too precise or particular about certain things. Some people even equate peculiar behaviour with such a diagnosis. But what exactly is OCD and how does it differ from the little quirks we all display from time to time?Affecting about 2% to 3% of the population, OCD is an anxiety disorder that usually lasts for years, during which time patients’ symptoms may vary in severity and focus. People living with OCD experience obsessions and compulsions. “Obsessions are intrusive thoughts, images or impulses that are involuntary and produce anxiety,” explains Johannesburg clinical psychologist and OCD expert, Kevin Bolon. He defines compulsions as voluntary behaviours aimed at reducing the anxiety experienced – these may be observable or unobservable. For example, a person with obsessions about contamination may wash their hands repetitively; someone with obsessions about possible harm may check repeatedly. While washing and checking are easily recognised, many people have more abstract symptoms such as having to pray over and over to get rid of blasphemous thoughts or having to hoard excessively. In addition to obsessions and compulsions, people with OCD may show avoidance behaviours, for instance the person with contamination concerns may simply stay indoors, avoiding contact with the outside world at all costs. Others may take an extraordinarily long time to complete routine daily activities – this is a form of OCD known as obsessional slowness.Bolon says: “When differentiating OCD from individual eccentricities, it’s important to consider two aspects – time and impairment.” If a person spends over one hour per day performing rituals that reduce the anxiety caused by their obsessions and if these rituals result in significantly impaired functioning in their work/social life, etc. then it’s possible they may have OCD.Stephen* is 28 years old and has been living with this condition for years: “It feels like obsessions are big knots in your stomach that can only be released by a compulsion. The problems is, the more you give in to the rituals, the worse the obsessions get.”Most people with OCD have good insight into their symptoms; they know their concerns are excessive, even though they cannot help following through on compulsions to set their minds at ease. “I feel like a freak, so alone… and I know what I’m doing is weird, but I just can’t stop because of the doubt,” says Stephen.The distress and functional impairment people with OCD experience also increase the risk of depression.
Commonly beginning in childhood or adolescence, OCD affects both men and women of all ethnic groups. For women, another common age of onset is at the time of pregnancy or childbirth; hormonal interactions with brain chemicals are likely to play an important role in such cases. Certain genes appear to also contribute to OCD, while there’s increasing evidence that the cause of OCD lies in problems with the circuitry, structure and neurochemistry of the brain.
The optimum treatment of OCD is a combination of medication and Cognitive Behavioural Therapy (CBT). Drake says: “OCD was considered a chronically debilitating and treatment-resistant condition prior to the development of exposure and ritual prevention. This was a groundbreaking discovery that has since been developed and refined into what is commonly referred to as prolonged exposure and response prevention, as we know it today.”
To learn more about OCD or any other mental illness, contact SADAG between 8am and 8pm 7 days a week toll free on 0800 21 22 23 .
* Name has been changed.
(a direct transcript from SADAG)