OBSEIVE COMPULSIVE DISORDER

It'scommon for people with anxiety or depression to lose control of their negative thoughts, so it's hardly unsurprising that there other kinds of thought that can go out of control.
Similarly, many of us have our little rituals, often for the good reason that routine helps to prevent forgetfulness. But sometimes the rituals will take on a life of their own - always locking doors in a certain order, or serving food in a certain way.
For some people - about two per cent of people in the UK - this can intensify, and their lives are ruled by constant worry over small things and the need to perform endless rituals.
What are the symptoms?
It can be useful to look separately at obsessions and then compulsions. With obsessions, the symptoms include bursts of:
words
ideas
indecision
images
doubts
The person experiencing them recognises that these thought patterns come from within their own mind and wants to stop them, but is unable to. The obsessions can be of a quite distressing nature - sexual, violent or blasphemous - and in conflict with the person's own moral beliefs.
Compulsions are often the actions resulting from the obsession, and one of the few ways that the person can deal with the thoughts.
Failure to complete the compulsion often results in severe anxiety or panic - but continuing to try to live with the rituals often leads to depression. Many people live with the OCD for years before seeking treatment. The kind of compulsions that people experience are:
rituals - doing things in a certain order or a set number of times
cleaning
checking tasks that have already been completed
needing cutlery or furniture, and so on, to be arranged in a certain way
These compulsions can take many forms, and this list covers only the most common ones.
What can I do to help myself?
As the problem often starts with thinking, and these thoughts often provoke anxiety, these are good places to start in addressing the problem. Monitoring your thoughts and practising relaxation can be a useful lead into dealing with obsessions and compulsions.
Having developed relaxation skills, and identified where the problem thoughts occur and how strong they are, it may be worth attempting slowly to desensitise yourself.
To do this, start by imagining a problem situation where you don't carry out the compulsive behaviour. Rate the anxiety that you experience, and then try to use relaxation techniques to deal with it.
Keep practising this until your anxiety is properly under control when you imagine not carrying out your compulsion.
The next step is to try this in the actual situation - maybe by carrying out a ritual one less time, or waiting 30 seconds before carrying out the compulsion. Again, try using relaxation techniques to control the anxiety.
For many people, a slow steady progression from here allows them eventually to achieve mastery over the problem.
Before attempting this, it's worth getting a good self-help manual, or try using the tools on our thought and mood monitoring page.
If you find yourself unable to deal with the problem on your own, you're one of many - and there's now quite a lot that professionals can do to help.
What professional help is available?
Since the 1990s, the outcomes for people with obsessions and compulsions have improved immensely. There are currently two approaches to the problem, often used in combination.
The first is cognitive behavioural therapy, and the exercises described in What can I do to help myself? are taken from this approach. Some people with OCD may need to see a professional face-to-face for coaching, support and encouragement. They may also need to have treatment for the anxiety or depression that can build up when obsessions go untreated.
The second approach is to give medication, often in the form of one of the newer antidepressants that acts on a chemical in the brain called serotonin. It's thought that this chemical may play a part in obsessions and compulsions, as well as in depression.

Keep it Hypnotic

David