Obsessive-compulsive disorder (OCD) is an anxiety problem where the person becomes obsessed with certain thoughts, images or ideas and finds them hard to ignore (obsessions). This can lead to them feeling that they have to do certain things repeatedly to feel better (compulsions).

Most people worry, about something or other, all the time, and have routines and things they like to do in a particular way. It’s when the thoughts or actions start to affect a person’s everyday life that it’s considered to be OCD. Research suggests that around one per cent of children and young people suffer from OCD. So in a secondary school of 1000 students there may be 10 people with OCD.

What causes OCD and who can get it?

Nobody is born with OCD and everyone has some potential to become obsessive and ritualistic. OCD frequently responds to professional psychological help which wouldn’t be the case if it was genetic. Obsessional rituals seem to be a way of controlling feelings of anxiety and insecurity by trying to keep the world predictable and in order. Part of growing up is to learn to cope with change and some children don’t get the help they need to do this. This insecurity can emerge more strongly under the demands of a bigger and more frightening world that comes with teenage years and adulthood. OCD can also be triggered later in life by an upsetting event such as the death of someone close but usually OCD seems to come out of the blue. It can affect any sort of person from any social background.

Many young people have mild obsessions or compulsions, like not changing the route to school each day or getting dressed in a certain order, but these “symptoms” usually disappear when they get older..

What are the signs and symptoms of OCD?

There are lots of different types of OCD. For some people it’s the same worrying thoughts or images that keep coming into their head – the ‘obsessions’ which they feel they have to ‘cancel out’ in some way with other thoughts. Other people feel the need to do things in order to stop or alleviate the thoughts (compulsions or rituals). For example, you keep having thoughts that your hands are contaminated, so as a result you keep washing them.

Common obsessions and compulsions include:

• Feeling unclean or contaminated and being afraid of germs
• Wanting to keep washing your hands or other things
• Thinking something is bad is going to happen to you
• Thinking something bad is going to happen to someone you love
• Feeling that you might hurt someone – even though this is the last thing you want to do
• Thinking violent/sexual thoughts or that you will say something awful out loud
• Counting things endlessly in your head
• Checking things (like doors, taps and light switches) over and over again
• Putting things in a particular order and arranging objects
• Being scared about throwing things away

Lots of people have these thoughts from time to time, but if you have OCD they dominate your life. If you have OCD you may know that your obsessions are not based on facts but you are unable to stop them.

Often you can feel a bit better once you’ve carried out the ritual – but the feeling of relief doesn’t last long and often the thoughts continue and you have to start again.

How is OCD it normally diagnosed and treated?

Diagnosing OCD starts with a trip to your doctor. They can arrange for you to see someone to have an assessment. After the assessment it will be easier to decide on what sort of treatment is likely to help you.

OCD can be treated successfully and there are usually two types of treatment used. There are national guidelines for the treatment of OCD (NICE Guidelines). The first recommended treatment is cognitive behavioural therapy, known as CBT. When people do CBT they learn how thoughts, feelings and actions are connected. The most important part of CBT is learning how to stop carrying our compulsions even when it makes you feel anxious to do so. You practice doing this little by little so that it is not too difficult, learning a lot about anxiety as you do this. CBT has been found to be very helpful in treating OCD in adults and young people.

Specific medication can help as well, but it is recommended that everyone with OCD should also have the opportunity to do Cognitive Behavioural Therapy. A combination of medication and CBT is good for some people.

Can it be prevented?

It can be helpful to know that if you have thoughts popping into your head about harming people or bad things happening, it doesn’t mean you are going to do them, or that you are responsible for preventing harm from happening. So these thoughts don’t need to be cancelled out with other thoughts, or by checking, washing, counting or anything else.

When should I seek medical help?

OCD can affect your quality of life, stopping you doing the things you used to enjoy, and making day-to-day jobs take much longer than usual. If your thoughts are having an impact like this on your life, or your schoolwork is suffering, then it’s a good idea to get some help as soon as possible.

Looking forward

The good news about OCD is that it does respond well to treatment. Of course OCD may disappear of its own accord, but often it’s quicker or more likely to happen if you get proper treatment. From the research done so far it looks like it’s important to treat OCD as early as possible. Sometimes after treatment people may still have routines and certain ways of doing things, but these usually don’t have such an impact on everyday life.

For more help and information

There is a self help book based on CBT principles: Breaking Free from OCD: A CBT Guide for Young People and Their Families by Jo Derisley, Isobel Heyman, Sarah Robinson & Cynthia Turner. 2008 Jessica Kingsley Publishers. For more information about OCD visit www.ocduk.org or call 0845 120 3778. Visit www.ocdaction.org.uk, a charity set up for people with OCD. Or you can call 020 7226 4000. For information on anxiety disorders visit http://www.anxietyuk.org.uk, a charity set up to provide support and information about various anxiety disorders. Or try www.nopanic.org.uk. No Panic supports people who suffer panic attacks, phobias, OCD, general anxiety disorder and tranquilliser withdrawal. Their number is 0808 808 0545. Accredited and amended by Martin Seager CPsychol AFBPsS 12th April 2013