MindSG
Explore our suite of self-care tools and resources to help you better understand and manage your mental health.
Understanding
obsessive-compulsive
disorder
Young adulthood is the
stage of our lives where we find ourselves with increased independence and new
responsibilities such as being in a new school environment or having entered the
workforce. It is a stage where we would also perhaps find ourselves in relationships
and with increased financial responsibilities. All these changes can contribute to
increased stress.
Some of us may start having irrational thoughts and
fears (obsessions) and develop behaviours such as repeating words or numbers to cope
with the stress that comes from those thoughts
(compulsions). These obsessions and compulsions can be so immense that
they affect our day-to-day activities.
Fortunately, these obsessions and
compulsions can be managed.
What is obsessive-compulsive disorder?
Obsessive-compulsive disorder (OCD) is one of the
top three most common mental health
disorders.
Obsessions cause distress and anxiety to the
person. These obsessions typically intrude into our
thoughts and actions. It affects about 1 in every 15
Singaporeans aged 18 to 34 in their
lifetime.
Common misconceptions:
Learn more
about OCD here
Learn more
about OCD here
Perfectionism vs OCD
There is a difference between being a perfectionist and having
OCD. While we may sometimes find a need to keep the floors sparkly clean or have our
knickknacks arranged in a certain manner, that does not necessarily mean that we
have OCD.
With OCD, our quality of life decreases dramatically as we
become consumed in carrying out compulsive behaviours and rituals.
Signs and symptoms
Obsessions Obsessions
Obsessions are repeated, persistent, unwanted ideas, thoughts, images, or impulses that are experienced involuntarily at some time. They typically intrude into our thoughts and actions.
Common obsessions include:
Common obsessions include:
Fear of hurting someone.
Need for symmetry and exactness.
Irrational fears of contamination from dirt or germs.
Distressing religious thoughts.
Examples of
these kinds of thoughts include obscenities related to religious
figures or making ourselves excessively accountable for breaking
religious codes of conduct.
Distressing sexually intrusive thoughts. This includes
sexual thoughts about friends, family, children, or
animals.
These thoughts are unwanted, intrusive and cause
extreme anxiety and distress. They do not bring pleasure to the
person.
Compulsions Compulsions
Compulsions can be behavioural (actions) or mental (thoughts). They are repetitive actions that are often carried out in a special pattern or according to specific rules. Compulsions are usually performed to try and prevent an obsessive fear from happening, to reduce the anxiety the obsessive thought creates, or to make things feel “just right”.
Common compulsions include:
Common compulsions include:
Excessive checking
Excessive cleaning and washing
Continuously thinking
the same
thought
Mentally repeating words or numbers a certain number of times
These symptoms may not actually mean OCD as they may also be present in people with other medical and neurological conditions, such as:
Tourette’s syndrome
which is characterised by sudden, repetitive, rapid, and unwanted movements or vocal sounds
Autism spectrum disorder
where one experiences
difficulties with social interaction and communication
Epilepsy
which causes seizures or unusual sensations and behaviours
Brain injury
caused by head traumas
The signs and symptoms can be managed with early treatment.
Diagnosis
To diagnose OCD, a healthcare professional would conduct a detailed
clinical interview in which he/she would ask about the individual’s past medical
and psychiatric history, family history, current symptoms, and the impact on
his/her functioning.
With
the patient’s consent, the healthcare professional may also request to speak
with a family member to gather more information. A standardised questionnaire
may be administered to assess for the presence and severity of OCD. A physical
examination and some blood tests may also be done.
Treatment
A combination of medication and cognitive behavioural therapy
(a form of therapy to identify and change unhealthy behaviour) has been found to be
effective in significantly reducing the symptoms of OCD.
The treatment
may not result in a cure, but it can help keep symptoms under control so that they
don’t rule over our daily life. Depending on the severity of OCD, some may need
long-term, ongoing, or more intensive treatment.
Medication has been
found to be an effective way to reduce OCD symptoms. A
common medication prescribed is a class of drugs called
Selective Serotonin Reuptake Inhibitors (SSRIs). SSRIs
work by increasing the serotonin levels (our body’s
chemical messengers that help stabilise our mood) in our
brain. This, in turn, helps to decrease OCD
symptoms.
Most people will have no or only
mild side effects. It will take a few weeks before one
sees an improvement in the symptoms. Medication may be
prescribed or recommended at the clinical judgement of
the healthcare professional.
CBT is a treatment
approach that helps us recognise negative or unhelpful
thoughts and behaviour patterns. It aims to help develop
alternative ways of thinking and behaving to reduce
psychological distress.
A specific form of
CBT used for clients is the Exposure and Response
Prevention therapy in which the individual is
deliberately exposed to the obsessional trigger, and
then prevented from engaging in the associated
repetitive behaviour.
With repeated and
prolonged exposure to triggers, habituation eventually
takes place. In addition, it is also useful to learn how
to cope with our anxiety and stress. The combination of
medication and CBT often increases the chances of
achieving the intended results.
Coping with OCD
Anyone can have a medical condition - some
people have allergies, others are asthmatic. It is important to understand that
these conditions don’t define who they are. Similarly, OCD doesn’t define a
person, and it doesn’t make them who they are.
To complement the
treatment for OCD, here are some coping strategies to help us through this period.
What people may think:
OCD is all about cleanliness
But did you know:
OCD manifests differently in different people. Common behaviours include counting, repeating certain movements, handwashing, arranging things in a specific way etc.These behaviours vary among individuals and can even change over the course of a person’s lifetime.
What people may think:
We’re all ‘a little OCD’
But did you know:
OCD is a complex and serious mental health condition that affects quality of life.It is a diagnosable condition and not a personality or character trait.
What people may think:
People with OCD just need to relax
But did you know:
OCD is a mental health condition, making people with OCD experience persistent and unpleasant thoughts that are difficult to dismiss — hence resulting in them feeling anxious and having difficulty relaxing.
Accept our thoughts without judgement
We may find that holding back our thoughts may have the opposite effect, and conversely, we may find ourselves thinking even more about them. Accept those thoughts as they come, without judgement.
Understand how OCD works
When engaging in the compulsions of OCD, we may find ourselves feeling less worried in the short term, making us think that these compulsions are useful and necessary.In doing this, we are unable to properly discover that these OCD fears/beliefs will not happen and that they will fade away with time even if we don't act on them. We can learn to cope with OCD by first understanding how it works, and give ourselves a chance not to give in to everything it tells us to do.
Recognise that OCD is not us and is separate from who we are
OCD tricks us into thinking that our fears are real and they need to be acted upon. For starters, know that OCD is separate from us and it is something that worms its way into our brain as if it belongs there.Recognising that it is separate from us makes the fight against OCD much easier!
Accept mistakes if they happen, and avoid being too harsh with ourselves over it
Remind ourselves that a single mistake does not make us a failure.In fact, mistakes are bound to happen because managing OCD is not a straightforward journey.Instead, accept the mistake and think about how we can minimise the chances of it happening in the future.
Practise relaxation techniques
These relaxation and guided imagery audio exercises may be helpful in
managing OCD.
Access them here:
Relaxation audio exercises
Mindfulness
Other strategies that can improve our mental well-being include making time for the things we enjoy or being in the company of people who bring us joy and laughter. Find out more details about these strategies and other helpful tips here.
Reaching out to others
When in need of support, reach out by talking to our close friends and family members.Unfortunately, some of those around us such as our parents may not have heard about OCD. Helping them understand about OCD can go a long way as they can be one of the best co-therapists in helping us manage OCD.Educate them on what OCD is and share what our experience with OCD has been like so far. Find out what assumptions they might have about OCD and try to address them. Remind them that having OCD and managing it is not an easy feat, and that their encouragement and support can be really helpful during this difficult period.Find out more about the obstacles of asking for help and other tips on how to reach out here.
