OCD: why some people suffer with it, is it on the rise and can it be treated? A Priory expert answers
- Inquiries about private mental health treatment for OCD have more than doubled in the last year
- Priory expert says there are a range of treatments that can help, including CBT and medication
- OCD is said to affect up to 12 people in every 1,000 at a time
Based on current estimates, there are around three quarters of a million people living with OCD in the UK at any one time – and inquiries to the Priory for private mental health treatment for Obsessive Compulsive Disorder have more than doubled in the last year.
So what exactly is it, and why does it occur?
Dr Paul McLaren, consultant psychiatrist at Priory’s London Wellbeing Centres and its hospital in Hayes Grove, Kent, says: “OCD is an anxiety disorder that causes individuals to experience a variety of symptoms that typically fall into one of two categories: ‘obsessions’ and ‘compulsions’.
“Obsessions are persistent and irrational thoughts or urges, and compulsions refer to physical or mental acts that individuals feel compelled to perform.
“Some only experience one type of symptom, whilst others experience both. These irrational thoughts and behaviours can become extremely time-consuming and seem impossible to control. An example could be if someone has an intrusive thought of being contaminated by germs, so they may repetitively wash their hands in response. However, this is not the only form of OCD; common ‘presentations’ not only include contamination worries but double-checking and hoarding behaviour, as well as ruminations and intrusive thoughts and images. These can be overwhelming.”
There is no definitive reason why someone should develop OCD, he says, “but a range of factors - or combination of factors - include neurobiological, genetic, or specific events that trigger the disorder in a specific individual at a particular point in time”.
The most effective and commonly used treatment is cognitive behavioural therapy (CBT), which helps the sufferer develop alternative perspectives; getting the right help and support is vital to the success of treatment, he says.
“Some experts use the Yale-Brown Obsessive Compulsive Scale (YBOCS) – a symptom checklist and severity rating scale. It is the most widely used severity rating scale for OCD and is considered a gold standard instrument to measure severity.”
Treatments that can help
“There are a range,” says Dr McLaren. “There is also medication to complement the therapeutic element of treatment. OCD has the potential to become increasingly worse over time and can have a big impact on all areas of your life, as well as the lives of those who are closest to you. The aim of CBT is to address the negative thought patterns that form the basis of your OCD, examine why they have developed in the first place, before challenging you to view situations in healthier ways.
“CBT for OCD consists of exposure and response prevention (ERP), which means confronting your fears, learning to tolerate anxiety, and avoid using compulsive behaviours. CBT has been found to result in long-lasting benefits and also aims to provide you with effective coping strategies. The most useful medications in the treatment of OCD are selective serotonin reuptake inhibitors (SSRIs), which are a form of antidepressant medication. Eye movement desensitization and re-processing (EMDR) is a therapy method used to treat OCD and a variety of mental health conditions including trauma, addiction and anxiety as well as other emotional conditions.”
Five ways to deal with OCD:
- If you suffer from unwanted intrusive thoughts, help is out there
Speak to a professional who can offer guidance regarding your difficulties, and suggest the best treatment. Treatment for OCD can be very effective - treatment is not about eliminating anxiety, but learning to tolerate it, whilst being able to engage with your day-to-day life - Remember that you are not alone
OCD is a common anxiety disorder. In fact, a large part of the population may have had some OCD traits at some point in their lives. Don't let it prevent you from talking to people and getting help. There are online forums, and support groups that take place regularly - Read about Obsessive Compulsive Disorder (OCD)
There is a lot of information available online regarding OCD, including testimonies from people with OCD and how they have dealt with it. This can help you to put your difficulties in perspective, offer context, and offer you more understanding - Accept that OCD can be a problem and may be interfering in your life
The first step of any change is coming to terms with what is required and why a change is needed. When suffering with OCD, people may employ a number of behaviours or rituals called safety behaviours. These behaviours may be helpful in the short-term as they can help you to avoid experiencing uncomfortable feelings, but in the long-term they may be perpetuating your difficulties - Understand the treatment of OCD
Read extensively about what you can and need to do to reduce your OCD. There is plenty of literature out there regarding the treatment of OCD and a number of knowledgeable therapists and consultants who can guide you, step by step, towards overcoming your difficulties. Priory offers online video therapy which can be helpful if you prefer to access support remotely
Acceptance
“Changing a difficult situation isn't always possible. So, accept what you cannot change and focus on the things you do have control over - such as regularly connecting with colleagues over video conferencing or online meetings.
Use music
“Put on headphones to listen to music can have many benefits, such as helping you relax and focus on something away from work and the outside world. Turn off rolling news and social media platforms such as Twitter, and just check in once a day. Stretch your legs and take a walk, even just to the garden, the kitchen or another room in your house before returning to your desk. Moving around and changing your environment, even slightly, can clear your mind and re-energise you.”
Coping with panic
Dr Donna Grant, consultant psychiatrist at Priory Hospital Chelmsford, offers some tips to help cope with panic at this time:
“Observe your thoughts and tell yourself that your mind is reacting to these thoughts and anxiety. These feelings are
normal - it's just the body's alarm system doing its job when it doesn't need to.
“Learn to control your breathing. People often hyperventilate during a panic attack. This means taking deeper breaths than normal which results in you feeling short of breath, causing a feeling of dizziness, disorientation and chest pains. By learning to slow your breathing down, you can help prevent the uncomfortable physical symptoms and stop the panic cycle. Try to get a slower and more stable breathing rhythm by breathing in for three seconds, holding your breath for two seconds, and then breathing out for three seconds. As you breathe, ensure that your stomach expands as you take each breath as this helps to ensure the breathing isn't shallow, which can add to the problem.
Learn to use positive coping statements
“When you are feeling anxious and panicky it can be helpful to have 'coping statements' which can be used to remind you that panic is not dangerous and isn't harmful.
Such statements could be:
- Panic is simply high levels of anxiety
- By remembering these symptoms are nothing more than anxiety, I can prevent further symptoms occurring
- My anxiety and panic will pass naturally given time. It doesn't last forever
Reminding yourself of these facts can help to prevent further panic cycles happening.
Keep a journal
Pamela Roberts, a Priory psychotherapist based at Priory’s Woking Hospital, adds that for those who might be self-isolating: “Ensure you are working in a well-ventilated room and following basic self-care, so healthy eating, sleep, lots of hydration, and try to keep to a routine. Set up a ‘buddy group’ with family or friends and regularly check in online or with Facetime.
“If you feel low, journaling can be a helpful way to unload emotions. Go with the flow. Tell yourself ‘what I am doing is enough’. Be good to yourself. If you have slept badly, accept you'll be in a low, more anxious mood. Your energy will be low. Try and relax and focus on positive things knowing that every effort is being made globally to bring this situation to a close, but it will take time. Being able to relax will help you through. When you're tense you tend to dwell on things and make them worse. If you are able, get into your garden and get daily doses of sunshine. Maybe look at some free online courses offered by the Open University. The mental health charity Mind has some very useful advice on self-isolating and your mental health. For support with grief, anxiety, or mental wellbeing, you can call or text an organisation like the Samaritans, or you can access therapy online with a trained therapist.”
Tapping
Priory expert Steve Clarke, a psychotherapist and hospital director at the Priory¹s Life Works Hospital in Woking, Surrey, explains EMT: ‘Emotional Freedom Technique (EFT) - Repetitive finger tapping can sometimes help to release negative emotions such as anxiety. It has been called a psychological version of acupuncture in that it involves making contact with a number of acupuncture points. The specific points to tap are the end-points of the major meridians (meridians are believed to be channels of subtle energy which flow through our body). So, whilst focusing on your negative emotion you tap on a meridian point (collarbone, under the arm and top of the head try to avoid the face at these times) three to seven times, repeating your negative thought in your head. After each emotion, take a deep breath and exhale. Continue this until you feel calmer and relieved. When you feel more relieved, repeat the technique whilst you tap through a positive round, repeating more uplifting phrases.”
Nourishment
Dr Bijlani says: “Make time for a nourishing lunch with adequate hydration. Food and drink can greatly affect your physical and mental health. Stop working at the usual time you would if you had travelled to your office and then try and fit in some social calls to friends or family before you prepare your evening meal. Avoid drinking too much alcohol or eating unhealthy foods out of boredom. Try and keep to boundaries such as only drinking alcoholic beverages in limited quantities at the weekend. Having to spend endless time each day in our homes with others under the lockdown situation is certainly going to affect our relationships with them, regardless of whether they are our loved family members or not. Emotions can be “infectious” and if those around us aren’t able to keep calm and cope well, we could end up getting stressed, fed up, irritable or low ourselves. It’s important for each of us, where we can, to take responsibility for our own health so that we can help keep up a reasonable level of optimism and engender a healthy environment in our homes which we share with others. Try and do some things together, such as sharing the preparation and eating of meals and daily walks together while also maintaining respectful boundaries and giving each other space apart for private time alone. Work as a healthy community. Try and be sensitive, flexible and forgiving without losing your own sense of self or identity. The best way to keep your mood swings under control is to look after yourself by keeping to your usual routine of sleep, diet, exercise and other activities. If you have been prescribed medication for your mental health, then take it as advised.”
About Priory and MEDIAN
Priory is the UK’s leading independent provider of mental health services. We treat more than 70 conditions, including depression, anxiety, addictions and eating disorders, as well as children’s mental health, across our nationwide network of sites. We also support autistic adults and adults with a learning disability, Prader-Willi Syndrome and brain injuries, as well as older people, within our specialist residential care and supported living facilities – helping as many people as possible to live their lives.
Priory is part of the MEDIAN Group, one of Europe’s leading providers of high quality mental health and rehabilitation services. The MEDIAN Group comprises 290 facilities with 5,000 beds caring for 28,000 people in the UK, 120 facilities with 20,000 beds caring for around 250,000 patients in Germany, and 15 facilities with 2,000 beds caring for 13,000 people in Spain, with more than 29,000 employees overall.