Obsessive-compulsive disorders: Symptoms & Diagnostics

Breaking free of restrictive thoughts

It is common for us all to washes our hands, keep our house tidy and clean, and close the door behind us as we leave a room. But if you find yourself with an overwhelming need to complete these and other similar tasks repeatedly then you may be affected by an Obsessive-Compulsive Disorder. (Frequently referred to as OCD and formerly known as Obsessive Neurosis).

There are many ways in which an Obsessive-Compulsive Disorder (OCD) can develop to the point you feel anxious and low in mood. Perhaps you feel that something bad is going to happen unless you count to a certain number. You may seek reassurance from your friends, family or partner multiple times during the day to check that simple things you are doing are ‘OK’. Some of these behaviours do not impact on your life too greatly although cause you some distress. However, if the need to count to a number, several times and it increasingly starts to interfere with you being able to get to work or focus on your work; or the constant need for reassurance about things that seem insignificant to others harm your relationship with others; then you may have an OCD. If this stops you doing things, it is restricting you. If any of these things sound like you - you may benefit from our therapies.

What are Obsessive-Compulsive Disorders?

Obsessive-Compulsive Disorder (OCD) is the experience of obsessions, leading to compulsions. Obsessions are unwanted repeated and intrusive thoughts, urges, or worries that cause distress. The presence of these obsessions leads to compulsions, which are repeated actions or activities carried out with the aim of reducing the anxiety caused by the obsessions.

Obsessive-Compulsive Disorders (OCD) can have an extreme effect on your life. Without treatment, you can be left feeling alone, distressed and overpowered by your obsessions and compulsions. It may be that the frequency and repetitive nature of your OCD interferes with you carrying out simple tasks.

There are similarities for people who experience Obsessive-Compulsive Disorder (OCD) and people who are compelled to carry out rituals. They are not however the same. Many of us have rituals, for instance how we carry out our morning personal care routines may be described as a ritual which we do automatically in the same order every day. Or a ritual may be religious and something you carry out as part of worship. For instance, prayer practices can be a ritual. For someone with OCD a ritual may develop as a result of a perception or fear or something bad happening. It may start as a simple routine such as checking your front door is locked before you go to bed and develop into having to check the door because you are worried about an intruder getting in. This may develop into you obsessing about the possibility of an intruder and lead you to check the front door over and over again, maybe a ritual develops where you check the door is locked, rap three times on the bannister before going up the stairs and you count the steps as you climb them. If this gets to the point that you then feel compelled to go back and recheck and carry out this ritual over and over again. We want to help you regain your confidence and quality of life. You can speak to us without fear of judgement and with comfort in the knowledge that our therapies have helped hundreds of people.

Obsessive-compulsive disorder symptoms

Compulsions are repetitive actions or activities that you do to reduce the anxiety caused by the obsessions. Often these behaviours can be time-consuming and obstruct the functionality of day-to-day life. These compulsions can be physical actions, mental rituals or involve a specific number. Sometimes people rationally know that it does not make ‘sense’ to carry out the compulsion but feel scared to ignore it. Some examples of compulsions are:

Rituals: arranging objects in a specific way, frequently washing your hands, body or surroundings, and touching things in a particular order or at a certain time.
Checking: ensuring repeatedly that all doors and windows are locked, checking your body for signs of response to thoughts or for contamination.
Correcting thoughts: for example, counting to a certain number, repeating a word, name or phrase, drawing out a certain shape, or replacing an intrusive thought with a different image.
Reassurance: for example, repetitively asking people if everything is alright.

Causes of Obsessive-Compulsive Disorder: How do compulsions occur?

There is no one exact cause of OCD, but the below factors are suggested to contribute to the development of OCD:

A lack of the brain chemical Serotonin
Genetic predisposition shown in family history of anxiety disorders
Brain activation abnormalities
Experience of trauma, including abuse, neglect and bullying
Recent key or stressful life event
Compulsions can be learnt from parents or carers
High personal standards
Neat and meticulous personality
Anxious temperament
Perceived high level of responsibility

Causes of Obsessive-Compulsive Disorder: How do obsessions occur?

Obsessions are unwanted thoughts, images, urges or worries that repeatedly appear in the mind. They are intrusive and not controlled and interfere with your thoughts. These obsessions can cause fear, discomfort, anxiety, and sometimes self-loathing . People sometimes feel that they cannot share their obsessions as they feel like they are wrong to experience. It is important to remember that obsessions do not reflect your personality. Some examples of obsessions are:

Fears of initiating or failing to stop harm: for example, worrying you have harmed someone by not being careful enough.
Intrusive thoughts, images and impulses: violent thoughts or images, religious or blasphemous thoughts, relationship intrusive thoughts that often appear as doubts about a relationship, sexually intrusive thoughts or images.
Fears of contamination: physical contamination (e.g. by germs) or mental con-tamination (e.g. ‘internal uncleanliness').
Associated with order or symmetry: for example you might have a fear that something bad will happen if everything isn't 'right'.

People may experience more than one of these types of obsession.

Diagnosis: How Obsessive-Compulsive Disorder is detected

In order to diagnose Obsessive-Compulsive Disorder (OCD), the compulsive actions or thoughts must have occurred on most days for at least two weeks. The compulsions must be experienced as tormenting or interfere with your normal daily activity.

Standardised interviews or questionnaires enable us to precisely determine the severity of your OCD. We are very sensitive in our diagnostic discussions and give you enough time and space to develop the necessary trust in us.

New perspectives for your everyday life

If you have obsessive and compulsive thoughts, which you perceive as excessive or absurd, lead to severe suffering and significantly impair your everyday life; you should seek professional support. Our experts assist you in developing individual coping strategies.

We provide a very comprehensive and holistic day programme for those people whose lives have been significantly impacted on by OCD. Our individualised programmes will be designed jointly to take into consideration your specific anxieties and the context of your current responsibilities and ability to free up time to attend for treatment. Our environment at Schoen Clinic Chelsea is modern and bright, we take pride in our new building and we have smaller groups that mean you get a more personalized approach. We also provide short term individual therapy with a focus on achieving specific, mutually agreed outcomes. Your programme is reviewed at an agreed minimum by you and the multidisciplinary team, encompassing the different professionals involved in their care. The team consists of consultant psychiatrists, psychotherapists/psychologists, family therapists and occupational therapists. They are at the centre of our approach, ensuring all the progress made across the programme is understood, built upon and applied. Our model provides consistency and continuity.

Our treatments for OCD

Obsessive-compulsive disorder treatment: Our treatment concept

Obsessive-compulsive disorder treatment: Our treatment concept

Developing strategies to reduce the obsessive thinking and compulsive actions can be taught alongside the use of medication and psychological therapies. Therapy is a personal experience which means that different people respond to different types or a combination. Our day programmes combine a range of therapies that can benefit you. As part of your programme you will also have one to one time with a therapist as well as key working sessions.

Behavioural therapeutic methods

Cognitive Behavior Therapy (CBT) is an evidence approach that helps you explore how your thoughts affect your behaviours and how those behaviours can reinforce your thoughts. In brief, the negative thoughts lead to unhelpful behaviours so changing this sequence can change both the behaviours and the thoughts to more helpful ones. Many therapies and wellbeing techniques are rooted in CBT.

Mindfulness-based treatment elements

Mindfulness and other relaxation and meditation techniques are taught and encouraged in out treatment programmes. To be able to focus on the ‘now’, not predicting the future, not thinking about the past. In being able to focus on the present and breathe slow, deep breaths; you can master the ability to shift your mind and increase your feelings of wellbeing.

Treatment needs

Outpatient treatment is usually sufficient if you are still able to cope well with every-day life. It often helps to perform behavioural exercises at home or in real-life situations while temporarily accompanied by a therapist. If this is not possible in the context of outpatient therapy, attening and participating in a day programme can be helpful. Here you can learn from the experiences of other patients in group therapies under the guidance of a therapist in order to achieve your own goals.

Medications

Medication can be a useful associated treatment option and some people find instant relief from symptoms and other it takes more time. Our Consultant Psychiatrists will prescribe and monitor medication that are clinically recommended for your symptoms. However, we believe that combining talking therapies and medication can make a positive impact on helping you on your recovery journey.

Obsessive-Compulsive Disorder: Our specialists

Our team of experts consists of consultant psychiatrists, clinical psychologists, therapists, and specialist nurses who work together as a multidisciplinary team for the benefit of every patient in the treatment of compulsive disorders.