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Obsessive Compulsive
Disorder

Obsessive compulsive disorder (OCD) is an anxiety disorder. If you live with OCD, you will usually have obsessive thoughts and compulsive behaviours. These can be time-consuming, distressing and interfering in your day-to-day life.

General symptoms of OCD

OCD usually involves both obsessions and compulsions, although in rare cases, one may be present without the other.

Obsessions

Obsessions are defined as recurrent and persistent thoughts, impulses or images that the person feels unable to control or prevent. Obsessions are usually experienced as senseless, disturbing and intrusive, and patients try to ignore or suppress them. Anxiety, fear, disgust or doubt often accompany the obsessions.

• Worrying excessively about dirt or germs and that you may become contaminated or contaminate others
• Imagining you have harmed yourself or others; having doubts about safety issues (such as whether you have turned off the stove)
• Fearing something terrible will happen or that you will do something terrible
• Preoccupations with symmetry, or a need to have things “just so”
• Intrusive sexual thoughts
• Intrusive violent or repulsive images
• Excessive religious or moral doubt or guilt; intrusive blasphemous images
• Excessive doubting or indecision: “should I – shouldn’t I?”
• A need to tell, ask or confess 

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Compulsions

Compulsions are things you think about or do repeatedly to relieve the anxiety from your obsessive thoughts. You might also hear these being called ‘compulsive behaviours’. When you carry out a compulsion, your relief usually doesn’t last long. This makes your original obsession stronger. You may then feel you need to carry out your compulsion again to feel better. 

• checking things repeatedly - for example, whether an appliance has been switched off,
• washing or cleaning things excessively,
• carrying something out in a particular order, in a repeated pattern or a certain number of times, and
• counting to a particular number, or going through a standard sequence of numbers, repeatedly.

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Contamination

Some people who live with OCD have a fear of contamination. This means you might constantly feel the need to make sure that something is clean and free from germs or dirt. This is a compulsion. Your obsessive thought is usually that any contamination will harm yourself or a loved one. 

• shaking someone’s hand,
• using public toilets or shared toilets,
• touching door handles,
• using plates, glasses or cutlery in a public place,
• using public telephones,
• visiting hospitals or GP surgeries,
• visiting someone else’s house, and
• touching shared objects. Such as remote controls, computer keyboards or money.

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Checking

This is a compulsion where you will feel the need to check something repeatedly. You might be worried that something, or someone, might be harmed if you don’t check something. Common checking

• that a light is switched off,
• that an appliance is turned off. Such as a cooker, an iron, a tap or a lamp,
• that a window is closed or a door is locked,
• health conditions and symptoms online,
• that you have your wallet, purse, phone or keys on you, and
• re-reading something to check you have taken in all the information.

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Hoarding

Hoarding is where you find it difficult to get rid of items in your home even when space is becoming limited. Or when most people would see the items as not being useful. You may find that you buy, collect and store items even when you don’t need them. :

• fear that you, or someone else, will be harmed if you throw something away,
• feeling an object may come in useful at a later point, or
• because you are emotionally attached to the item.

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Treatment and Help

To begin with you can:

See your GP 

You should make an appointment to talk with your GP if you are worried about your symptoms. Or if it's causing problems in your day to day life.  

Your GP will look at different things when deciding on your treatment such as the following:

• Your diagnosis and symptoms.

• What options you have tried already.

• Your goals and preferences.

• Any other conditions you have.

Your GP might think your symptoms are severe. They might refer you to a specialist mental health team in your area or to the nearest community day clinic that has mental health facilities. 

Getting talking therapy

You can access talking therapy by:

• Getting a private therapist/psychologist or a community therapist that if you do not have a medical aid or insurance. 

Medication

Medication often plays a prominent role in the treatment of OCD and is particularly helpful for patients who also have depression or who are bothered by obsessions but do not perform compulsive rituals that can be modified by behavior therapy.

A class of drugs called Selective Serotonin Re-uptake Inhibitors (SSRIs) has been helpful in reducing OCD symptoms. Changes in serotonin levels are believed to be associated with OCD. These drugs treat the obsessions and compulsions , reduce anxiety and treat depression.

Behaviour Therapy

Medication and behaviour therapy often compliment each other. While medication alters the brain’s serotonin level, behavior therapy helps the patient learn to resist the compulsions and obsessions. Research has shown that over a period of time, behavior therapy can also change brain chemistry.

Behaviour therapy teaches an individual how to confront his or her fears and reduce anxiety without performing the rituals. Gradually, the person exposes himself or herself to situations that cause anxiety, but refrains from performing the rituals that relieve the anxiety.

You and your doctor or healthcare team should agree on a treatment plan that works best for you.

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