Talk therapy can help your OCD

A recurring sense of impending doom or fear that a dreaded event is about to happen can become an immense burden for people suffering from obsessive compulsive disorder (OCD).

The time-consuming and repetitive behaviours associated with this mental health condition may severely impact an individual’s work and/or social functioning, and disrupt family life.

Dr Gwen Tonyane, a psychiatrist practising at Netcare Akeso Crescent Clinic Randburg, says OCD is characterised by the presence of obsessions, compulsions or both.

“Obsessions are recurrent and persistent thoughts, urges or images that come to mind but are intrusive and unwanted, causing the person marked anxiety or distress,” she says.

“A person who suffers from OCD may try to self manage the intrusive thoughts by distracting themselves with another thought or action, or simply trying to ignore the intrusive thought to help ease the anxiety and distress caused, but this is often very difficult.”

Resistance to the thought often intensifies it.

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“Sometimes, the individual may create their own rigid rules that they feel must be followed to neutralise the thoughts and gain a sense of control over them. These compulsions take the form of repetitive behaviours or mental habits that a person with OCD feels driven to by the obsession.

“The person may feel a responsibility to perform these rituals, believing that this could prevent something dreadful from happening. The person’s response is, however, either excessive or in many cases not even rationally connected to the source of anxiety,” Tonyane explains.

For example, a person may have obsessive worry or an irrational premonition of a terrible event and may develop their own personal rituals, which they perform compulsively in the hope that this could somehow influence external events to prevent the anticipated disaster from happening.

“The sufferers of OCD usually have a strong desire to resist these compulsions, but eventually they comply – even though in many cases the person is aware that the thoughts are irrational and that their response is not rooted in reality. However, sometimes the person may not realise this,” she says.

The obsessions or compulsions of a person living with OCD tend to be time-consuming and cause impairment in the person’s functioning.

This could be in their personal management, at school or work, socially or in other important areas of their lives.

“One of the more common obsessions is that of contamination, where the person with OCD may be consumed by the fear or thoughts of contracting specific germs or bacteria, and this may go far beyond causing anxiety about the actual illness caused by the germs, potentially to the detriment of the person’s health,” Tonyane observes.

“Sometimes, the anxiety may be accompanied by obsessive shame or disgust at the thought of being contaminated. The response may even become life-threatening if the individual’s OCD leads them to avoid doctors’ consulting rooms and hospitals when they are medically unwell or need urgent medical care. In such cases, their fear of exposure to germs is out of proportion, placing them at greater risk.

“In other instances, a person may develop dermatological problems such as skin lesions due to excessive compulsive washing driven by the efforts to rid themselves of contamination. Some individuals with OCD try to impose their rules on their family members or bar them from doing certain things, which can lead to family conflict.

“Another common manifestation of OCD is pathological doubt which manifests in checking behaviour. For example, the person may check multiple times whether the doors and windows are locked, usually for a certain count, before they can feel secure or less anxious.

“If a person, for example, feels compelled to get out of bed multiple times every night to check on the same thing, this can rob them of essential sleeping time and could take a toll on their work or school performance.”

As with most mental health conditions, it is believed that both hereditary and environmental causes may contribute to OCD.

“There appears to be a stronger correlation when OCD presents in childhood. Traumatic events, such as physical and sexual abuse in childhood, may increase a person’s risk for OCD, and there are also some psychological theories on why some people may develop OCD.”

Symptoms typically start gradually, with men often presenting at around 19 years of age and women more commonly around 22.

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“Medical problems or psychosocial difficulties can often exacerbate the OCD symptoms and often individuals with OCD present to their doctors or psychologists with other mental health concerns, commonly depressive disorder, social phobia and tics.

“Fortunately, OCD can be successfully managed with both medication and psychotherapy, also known as talk therapy. In certain cases of OCD, the treating psychiatrist may also suggest other treatment options.

“Without professional treatment, OCD is usually a long-term condition, often with the person’s mental health status shifting back and forth. Some individuals have episodes where the symptoms intensify, while a minority have a deteriorating course with OCD.

“If you think you or a loved one may be struggling with any aspect of your mental health, it is advisable to see a psychiatrist or psychologist for a proper diagnosis and management plan,” Tonyane said.