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OBSESSIVE COMPULSIVE DISORDER (OCD)
WHAT IS OBSESSIVE COMPULSIVE DISORDER (OCD)?
Obsessive Compulsive Disorder is an anxiety which affects
2-3% of the population - more than 450,000 Australians. OCD
usually begins in late childhood or early adolescence. People
with OCD are besieged by intrusive and unwanted thoughts, images
or impulses (obsessions), and are compelled to perform tortuous
behavioural and mental rituals (compulsions). Obsessions and
compulsions are distressing, exhausting and time-consuming, and
cause significant interference in the sufferer's family and
social relationships, daily routines, and their capacity to
fulfil their goals in employment and education.
Sufferers are typically aware of the irrationality of their
behaviours and obsessive thoughts. They are not able to control
the obsessions or effectively limit their intrusiveness.
Compulsions mostly develop into highly complex rituals which
cause endless frustration and anxiety for the sufferer.
Sufferers are often acutely embarrassed about their symptoms
and may keep them a secret for many years, at times even from
close friend and family. Those affected can live in their own
private hell for years, while outwardly seeming to cope with and
lead a relatively normal life. However, this seemingly normality
is only maintained at great cost in time, energy, stress and
The severity of the disorder is often compounded by
depression, and other anxiety conditions, including social and
simple phobias, panic disorder, separation anxiety and
WHAT ARE THE SYMPTOMS OF OCD?
The most common obsessions involve thoughts and fears of
contamination, and harm to self and others. Other obsessions
include thoughts, images and impulses associated with symmetry
and orderliness, illness, religious or moral issues, sexual
concerns, and needs to save, collect and remember things. These
obsessions can very from time to time both in nature and
severity. Obsessions do not depend on logic, and produce feelings
from annoyance and discomfort to acute distress, disgust and
The most common compulsions are washing, cleaning and
checking. Other compulsions include hoarding, repeating routine
activities and actions, touching and tapping, applying rigid
rules and patterns to the placement of objects, needing to
constantly ask or confess, and a range of mental compulsions such
as counting and repeating words. The compulsions generally are
excessive and ritualised behaviours, involving constant
For example, a sufferer may spend 2-3 hours every day in the
shower, and several more hours handwashing, or washing clothes,
food and household items. Their anxiety may not only be that they
are dirty themselves, but that they may infect others,
contaminate foodstuffs and so forth. They may know that further
washing is unnecessary, but they cannot stop the feeling of
needing to wash and re-wash. Similarly, compulsions to check may
involve repeatedly checking light and power switches to ensure
that they are off, or checking locks to ensure they are secure,
despite knowing that they had just checked them.
WHAT CAUSES OCD?
There are several theories about the causes of OCD. One
theory views compulsions as learned behaviours, which become
repetitive and habitual when they are associated with relief from
anxiety. Another theory indicated that OCD may have a genetic
cause - that there is vulnerability to OCD in certain families.
During the past twenty years, another theory has been developed
which suggests that OCD may be caused by chemical, structural and
functional abnormalities in the brain. Extensive research has
supported the idea that an imbalance in the chemical in the brain
called serotonin is associated with OCD. It is most likely that
the development of each person's OCD is the result of several
interacting causes, and is affected by stressful life events,
hormonal changes and personality traits.
HOW IS OCD TREATED?
During the past ten years, OCD has been recognised as the
fourth most common psychiatric disorder after phobias, substance
abuse and major depression. It has been the subject of an
explosion of interest and intense investigation by clinicians and
researchers, and subsequently treatment options are becoming more
precise and effective.
It has been found effective to use a combination of treatment
techniques, depending on the symptoms and severity of the
disorder. These includes:
Cognitive Behaviour Therapy
This type of therapy involves exposure of the sufferer to the
situations and objects which trigger their obsessions and then
prevention of the compulsive rituals. It includes ways of helping
the sufferer to identify the ideas and beliefs associated with
OCD, and ways to modify them. Achieving success with cognitive
behaviour therapy requires an experienced and skilled clinician,
and a client who is motivated to putting in the time and effort
required - continual and daily practice.
Some medications, especially those which affect the serotonin
system, can help the disorder. These can only prescribed by a
practitioner. You will not get physically dependent on these
tablets but some sufferers may develop side effects and need to
be carefully supervised. Side effects may include nausea,
headaches, dried mouth, blurred vision, dizziness and feeling
sleepy. These effects often dissipate after the first few weeks
of treatment. If you are concerned about side effects which are
severe or last a long time, go back and see your doctor. A change
in dosage or type of medication may resolve the problem. To be
effective, medicines need to be taken for an adequate amount of
time and at the right dosage level. Responses to the medicine
usually take several weeks, and improvements may continue during
the following months of treatment. When stopping the treatment
the dose should be reduced slowly. In some people, stopping
suddenly may cause symptoms such as dizziness, sleep problems,
feeling anxious or feeling sick.
Talking to a trained therapist can be helpful in
understanding symptoms, feelings and difficulties with the
For some sufferers, when getting treatment started, or when
they are severely affected, a period of treatment in hospital can
be helpful. This may involve from a few days to a few weeks for
assessment and treatment.
Support Groups and Education
Support groups provide an environment in which sufferers and
their families can meet in comfort and safety, and give and
receive support. The groups also provide the opportunity to learn
more about the disorder and self-help and coping strategies, and
to develop social networks.
Obsessive Compulsive & Anxiety Disorders Foundation of
The OCADF aims to promote the emotional, mental and social
well-being of sufferers and carers, and reduce the impact of OCD
on their lives. The OCADF provides a range of support and
educational services to people with OCD and other anxiety
disorders, and their families and carers. These services include
support groups, information kits, telephone counselling and
referral advice, newsletters and educational seminars. The
Foundation also provides educational resources to professionals
and mental health care agencies.
For information, counselling, support and referral advice,
OCD & Anxiety Helpline: 03 9576 2477 Monday - Friday 10.00am
or write to: OCADF, PO Box 358, Mt Waverly, Victoria, 3149
NSW OCD Support Group
Telephone 1800 626 055
SA OCD Support Group
Telephone 08 231 1588
or contact your State's Mental Health Association.
East Valley Division General Practice, Victoria,
Level 1, Pathology Building, Repatriation Campus, A&RMC,
Heidelberg West VIC 3081. .. map
Phone: 03 9496 4333, Fax: 03 9496 4349, Email: email@example.com,
Please note: NEVDGP does not provide
an on-line consultation