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Obsessive compulsive disorder (OCD)

Obsessive compulsive disorder, often just called OCD, is a mental health condition in which a person has repetitive, obsessive thoughts and exhibits compulsive behaviour.

A person with OCD may have recurring, sometimes distressing, thoughts and fears they cannot control.

This causes anxiety and nervousness leading to the person feeling the need to carry out rituals or routines to try to stop the obsessive thoughts or make them go away.

OCD is thought to affect around 12 in 1,000 people in the UK. However, firm statistics are not available as many people with OCD feel too embarrassed to seek help for their condition.

What are the symptoms of OCD?

The symptoms of OCD, which are the obsessions and compulsions, may vary. Common obsessions include:

  • Fear of dirt or contamination by germs.
  • Fear of causing harm to another.
  • Fear of making a mistake.
  • Fear of being embarrassed or behaving in a socially unacceptable manner.
  • Fear of thinking evil or sinful thoughts.
  • Need for order, symmetry, or exactness.
  • Excessive doubt and the need for constant reassurance.

Common compulsions include:

  • Repeatedly bathing, showering, or washing hands.
  • Refusing to shake hands or touch doorknobs.
  • Repeatedly checking things, such as locks or cookers.
  • Constant counting, mentally or aloud, while performing routine tasks.
  • Constantly arranging things in a certain way.
  • Eating foods in a specific order.
  • Being stuck on words, images or thoughts, usually disturbing, that won't go away and can interfere with sleep.
  • Repeating specific words, phrases, or prayers.
  • Needing to perform tasks a certain number of times.
  • Collecting or hoarding items with no apparent value.

What causes OCD?

Although the exact cause of OCD is not fully understood, studies have shown that a combination of biological and environmental factors may be involved.

Biological factors: The brain is a very complex structure. It contains billions of nerve cells -- called neurons -- that must communicate and work together for the body to function normally. The neurons communicate via electrical signals. Special chemicals, called neurotransmitters, help move these electrical messages from neuron to neuron. Research has found a link between low levels of one neurotransmitter -- called serotonin -- and the development of OCD. In addition, there is evidence that a serotonin imbalance may be passed on from parents to children. This means the tendency to develop OCD may be inherited.

In addition, certain areas of the brain appear to be affected by the serotonin imbalance that leads to OCD. This problem seems to involve the pathways of the brain that link the area of the brain that deals with judgement and planning, and the area of the brain that filters messages involving body movements.

Studies also have found a link between a certain type of infection caused by the Streptococcus bacteria and OCD. This infection, if recurrent and untreated, may lead to the development of OCD and other disorders in children.

Environmental factors: There are environmental stressors that can trigger OCD in people with a tendency toward developing the condition. Certain environmental factors may also cause a worsening of symptoms. These factors include:

  • Abuse
  • Changes in living situation
  • Illness
  • Death of a loved one
  • Work- or school-related changes or problems
  • Relationship concerns
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