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Betsi Cadwaladr University Health Board

North Wales Child and Adolescent Mental Health Service



Obsessive Compulsive Disorder (OCD)

What is Obsessive-Compulsive Disorder (OCD)?

The word ‘obsessive’ is used commonly. This can mean different things to different people. Obsessive Compulsive Disorder (OCD) is a type of anxiety disorder. In this condition, the person suffers from obsessions and / or compulsions that affect their everyday life, like going to school on time, finishing homework or being out with friends.

What are the symptoms?

An obsession is a thought, image or urge that keeps coming into your mind even though you may not want it to. An obsession can be annoying, unpleasant or distressing and you may want it to go away. An example of an obsession is the thought that your hands are dirty even though they are not. Different people have different obsessions.

Here are some examples:

Having an obsession often leads to anxiety or feeling uncomfortable and you may then have the urge to ‘put it right’. This is where compulsions come in.

Compulsions are things you feel you need to do usually to control your ‘obsessions’, even though you may not want to. You might even try to stop doing them, but this might not be possible.

Often, a compulsion means doing something again and again, as a ‘ritual’. By doing the compulsion you feel you can prevent or reduce your anxiety about what you fear may happen if you don’t do it. For example, turning the light on and off 20 times because you worry something bad may happen if you don’t.

Different people have different compulsions. Some examples include:

Individuals who have these problems often try to avoid any situation that might set off obsessive thoughts (e.g. not using hands to open doors). When obsessions and compulsions take up a lot of your time, interfere with your life and cause you distress, it becomes obsessive-compulsive disorder (OCD).

Who does OCD affect?

OCD is common and can affect people of all ages irrespective of their class, religion or gender.

What causes OCD?

We do not know the cause of OCD for certain. However, research suggests that OCD may be due to an imbalance of a brain chemical called ‘serotonin’.  It is likely that there may be someone in your family who has similar disorder (OCD) or have tics (jerky movements).

Sometimes the symptoms seem to start after a specific type of infection (cough and cold). It can also occur after a difficult time in your life like having an accident.

How is it treated?

There are psychological treatments and medications available to treat OCD.

One of the helpful psychological or talking treatments for OCD is cognitive behavioural therapy (CBT) that includes exposure and response prevention (ERP).  CBT is a psychological approach that is effective in treating young people with OCD.

In OCD people often think that by avoiding a certain situation or doing the ritual / compulsion helps to keep the worry (obsession) away or come true.  However, this does not help the worry to go away.  In the treatment for OCD, the therapist would help you to understand this reality and also teach you ways to face the worry rather than running away from it. Eventually this helps to get rid of your obsessions and compulsions.

In ERP the therapist helps you to face the things you fear and have been avoiding. They then help you to stop responding in your usual way (like not letting you wash hands when you worry it is dirty).  To help you fight OCD, you will be taught a wide range of skills to manage the anxiety that OCD creates. This helps you to learn strategies to control the OCD rather than it controlling you.

Sometimes the therapist may suggest someone in your family be involved during the therapy.

When OCD is severe or you struggle to do the psychological treatment, you may need medication. This is usually given to help whilst trying the CBT. Medication can help you get the most out of the psychological treatment.

How can I get help?

It is important to seek help early and remember that having OCD does not mean you are ‘mad’ and ‘losing control’.

If you are worried about yourself, you should talk to someone you trust such as your parents, carers or a teacher.  A lot of adults with OCD never got any help for their problems when younger, and now wish they had.

Your GP or school nurse can give you advice and help you get specialist help from the Child and Adolescent Mental Health Service (CAMHS), who will talk to you regarding the difficulties you are experiencing.

It can be hard or embarrassing to discuss details of your obsessions or compulsions, but giving as much detail as possible will help the therapist or psychiatrist give you the right treatment.  If your life has become severely affected by OCD, you may also need help from other professionals for example, teachers to help you get back to ordinary life at school or college.

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