Obsessive-Compulsive Disorder (OCD) is a serious anxiety-related condition that affects as many as three in a hundred people – from young children to older adults - regardless of gender and social or cultural background.
It is listed amongst the top most debilitating illnesses by the World Health Organisation, in terms of loss of income and decreased quality of life.
In the UK, Obsessive Compulsive Disorder is thought to affect 2-3% of the population.
Many sufferers go undiagnosed for many years.
This is partially because of a lack of understanding of the condition, and partially because of the intense feelings of embarrassment, guilt and sometimes even shame associated with what is often called the ‘secret illness’.
OCD can take many forms, but, in general, sufferers experience repetitive, intrusive and unwelcome thoughts, images, impulses and doubts which they find hard to ignore.
These thoughts form the obsessional part of ‘Obsessive-Compulsive’ and they usually (but not always) cause the person to perform repetitive compulsions in a vain attempt to relieve themselves of the obsessions and neutralise the fear.
The illness can have a totally devastating effect on work, social life and personal relationships.
What are the common symptoms of OCD?
Common obsessions include:
contamination and germs
causing harm to oneself or to others
upsetting sexual, violent or blasphemous thoughts, the ordering or arrangement of objects
worries about throwing things away
Sufferers try to fight these thoughts with mental or physical rituals, the compulsions, which involve repeatedly performing actions such as washing, cleaning, checking, counting, hoarding or partaking in endless rumination.
Avoidance of feared situations is also common; however, this often results in further worrying and preoccupation with the obsessional thoughts.
Most sufferers know that their thoughts and behaviour are irrational and senseless, but feel incapable of stopping them.
This has a significant impact on their confidence and self-esteem and as a result, their careers, relationships and lifestyles.
To sufferers and non-sufferers alike, thoughts and fears related to OCD can seem profoundly shocking.
It must be stressed, however, that they are just thoughts – not fantasies or impulses which will be acted upon.
What does 'Compulsive' mean?
Compulsions or compulsive acts can be defined as repetitious, purposeful actions in which the individual feels compelled to engage according to their own rules or in a stereotyped manner.
Typically, the individual experiences a sense of resistance to the act but this is overridden by the strong, subjective drive to perform the action.
Most often the principal aim behind the compulsive act is to generate temporary relief from the anxiety caused by a preceding ‘obsession’.
Compulsions can be overt or covert.
Overt compulsions typically include checking, washing, hoarding or a symmetry of certain motor actions.
Covert compulsions, or ‘cognitive compulsions’, as they are sometimes referred to, are mental actions performed, as opposed to physical actions.
substitution of distressing mental images or ideas with neutralising alternatives
Practical examples would be a sufferer who feels compelled to silently repeat a string of words over and over on experiencing a negative or violent thought or the need of a sufferer to transpose negative words or images which may intrude into consciousness with positive ones e.g. feeling compelled to mentally substitute the word ‘hell’ that pops up, either as a thought or as a mental visual image, with the word ‘well’.
Another obsession considered to be part of the ‘OCD spectrum’ is the inability to discard useless or worn out possessions, commonly referred to as ‘hoarding’.
More recent research suggests that hoarding may be different to other forms of Obsessive-Compulsive Disorder, and that standard OCD treatments may not necessarily address.
Who is affected by OCD?
To some degree OCD-type symptoms are probably experienced at one time or another by most people, especially in times of stress.
It would also be fair to say that most individuals, at some stage in their lives, have come into contact with the phenomenon of obsessional or intrusive thinking and/or succumbed to the seemingly nonsensical need to perform an odd, and often unrelated, behaviour pattern in order to avert a real or imagined danger (e.g. touching a certain item of furniture before going to bed in order to ‘ward off’ a nightmare, or checking several times that the doors and windows are locked before leaving the house when going on holiday).
However, the key difference which segregates these little ‘quirks’ from the disorder is when the distressing and unwanted experience of obsessions and/or compulsions impacts, to a significant level, upon a person’s everyday functioning – this represents a principal component in the clinical diagnosis of Obsessive-Compulsive Disorder.
The incidence of OCD can be traced historically, cross-culturally and across a broad social spectrum and does not appear to restrict itself to any specific group of individuals.
On the contrary, increased availability of information shows numerous examples of OCD, and its occurrence in the lives of various well-known figures.
For example, the eminent evolutionist Charles Darwin suffered from it, as did the nineteenth century pioneer of nursing and reformer of hospital sanitation methods, Florence Nightingale.
More currently, Academy Award-winning writer, actor and director Billy Bob Thornton, actress Jessica Alba and football stars Paul Gascoigne and David Beckham have all candidly discussed their battle with the disorder.
Perhaps most famous of all was the twentieth century billionaire aviator and entrepreneur Howard Hughes (“The Aviator”) who, in spite of his immeasurable financial wealth, spent his final days both mentally and physically incarcerated by his own contamination terrors and elaborate cleaning rituals .
OCD and Gender
OCD affects males as frequently as it does females, and on average begins to affect people in late adolescence for men and early twenties for women.
However, it may take individuals 10-15 years or even longer to seek professional help.
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