Living with obsessive-compulsive disorder: symptoms, treatments and challenges
Obsessive-compulsive disorder (OCD) has gained attention in recent years, but casual references in TV shows and headlines only skim the surface. With the help of Specialist Mental Health Nurse Adviser Glenys Jackson and Medical Coordinator Ariel Arcaute, we provide an expert perspective on what it’s really like to live with OCD.
We see it in news headlines and on popular shows like Girls1, and we’re generally learning more thanks to initiatives like OCD Awareness Week, but OCD is still a condition that’s prey to misunderstandings.
Glenys Jackson (Specialist Mental Health Nurse Adviser at Bupa UK) and Ariel Arcaute (Medical Coordinator, Medical Service Team at Bupa Global Latin America) give us the lowdown on what OCD really means for those suffering from it.
The difference between worries and obsessions
The depiction of OCD on television and films doesn’t necessarily reflect reality: occasionally worrying about whether you’ve left the oven on or paid a bill is completely natural, as is getting caught up in patterns of negative thoughts now and then. There’s more to OCD than wanting your house to be clean or liking things to be ‘a certain way’.
While people can be fussy or particular, this doesn’t mean that they have OCD. In fact, OCD is thought to affect up to three in 100 adults and two in 100 children and teens2, and there are two features that characterise this condition:
- Obsessions: Unwanted thoughts, images or urges that repeatedly enter your mind.
- Compulsions: Repetitive behaviours or mental acts that you feel compelled to do.
These thoughts or repetitive behaviours make it hard to think about anything else and can interfere with quality of life.
Not everyone experiences OCD the same way
The symptoms of OCD can vary widely. Not all sufferers are obsessed with cleanliness and hand-washing, for example. Instead, people might struggle with a fear of harm, aggressive or sexual obsessions, or an excessive need for things to be symmetrical.
Compulsions differ from person to person and can range from checking a locked door multiple times to hoarding or feeling the need to repeat certain mantras or prayers. The main thing to remember is there’s no ‘one size fits all’ when it comes to OCD.
OCD: Not a term to use lightly
While the recent spotlight on OCD is promoting acceptance and understanding, it can cause challenges for sufferers by making light of what is a potentially serious condition. People regularly make throwaway remarks, such as “He’s so OCD about doing the dishes” or “She’s a bit OCD about the budget.”
Comments like these might appear harmless, but for people dealing with a whole range of distressing symptoms, using the term OCD as shorthand for anything that sounds bizarre or excessive can undermine their experience.
“This can have a negative impact on the severity of the actual condition and possibly increase the stigma surrounding it,” Glenys says. “It can also reduce the understanding of the real symptoms which can be so debilitating.”
Keep rogue thoughts under control
When you’re facing obsessive thoughts or compulsions, it can be hard to see them for what they are. But with practice and help, it can become easier to identify when your thinking is disordered, and you can learn methods for dealing with them.
This might include actively exposing yourself to troubling thoughts and deliberately breaking rituals. It might sound difficult, but it can help you to acknowledge that thoughts and compulsions don’t have power over you3.
Cognitive Behavioural Therapy (CBT) is the therapeutic approach found to be most effective in tackling OCD4. It helps you to examine in detail how you think about certain situations in your life, how you behave in response to those thoughts, and how your thoughts and behaviours make you feel. The premise is that your thoughts, behaviours and emotions are inextricably linked, so by changing one of these elements, you may be able to ‘break’ overall unwanted patterns. CBT aims to give you the understanding and tools to carry on working towards recovery by yourself.
OCD UK has some great information about CBT and the Bupa CBT guide offers insight into what form the treatment might take and how it can help. In the UK, you can often have some CBT sessions on the NHS if you are referred by a GP.
How to be there for someone with OCD
It can be hard to patiently and consistently support someone who is suffering from an anxiety disorder. Friends and family often feel like they’re stuck on the outside, unable to ‘fix’ their loved ones, or even to understand what they’re going through. “It is very complicated to live with an OCD patient,” Ariel says. To help, read up on different types of OCD.
Mind.org5,has some useful advice for friends and family, to help you understand the condition. It also provides tips on how to accommodate compulsions without accidentally normalising them in a way that can actually make it harder for someone to work towards recovery. Helping someone with their compulsions isn’t the best choice in the long term, even if it might to reduce anxiety in the short term.
It’s important to remember that OCD is no one’s fault, and you should try to tackle the management of it as a team. Try to think of the disorder as being external to the sufferer, so you can draw a line between the challenges of dealing with the behaviours, and the actual person who is suffering from it.
Be aware that many OCD sufferers are often also dealing with other anxiety issues like depression, eating disorders, general anxiety or social phobias, and these problems might compound one another.
It’s also important to know when to seek help. Ariel explains that as a loved one, if you feel that the medical situation is getting serious, or you are not sure how to help or indeed, to cope, it’s time to reach out to a specialist.