Obsessive-Compulsive Disorder (OCD): factsheet for
young people
What is Obsessive-Compulsive Disorder (OCD)?
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:
- worrying about illness;
- fears about dirt and spreading disease;
- worrying about harm happening to you or
someone else;
- fearing that something ‘bad’ may happen;
- worrying about things being tidy.
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, 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:
- washing rituals
- checking rituals
- thinking certain thoughts
- touching rituals
- ordering/arranging things or lining things
up
- counting rituals.
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 a lot with your
life and cause you distress, it becomes obsessive-compulsive
disorder (OCD).
Who does OCD affect?
OCD can affect people of all ages, and usually
starts in childhood.
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’. There is a tendency for OCD to
run in families. There may also be people in the family who have
tics (jerky movements).
How can I get help?
If you are worried about yourself, you should
talk to someone you trust such as your parents or 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 good
advice. They will be able to get you specialist help, if it is
needed. They may suggest that you meet with a child psychologist or
a child psychiatrist or other mental health therapist. They will
talk with you in order to understand the difficulties you are
experiencing.
Young people with OCD often find it hard or
embarrassing to discuss the details of their obsessions or
compulsions. But giving as much detail as possible will help the
therapist or psychiatrist know how best to help you. If your life
has become severely affected by OCD, other professionals may need
to be involved too – for example, teachers may help you get back to
ordinary life at school or college.
Treatments for OCD
Young people with OCD often think that if they
do not avoid a certain situation or do not complete a ritual, the
obsessions will become reality. This is not likely to be the
case, but these young people feel unable to take the risk to find
out. Treatment will help you take that risk. Helpful
treatments include:
CBT with ERP for OCD
CBT is a psychological approach which can be
effective in treating young people with OCD. CBT works by helping
you to understand how the way that you think (your thoughts,
beliefs and assumptions), affects how you feel (your emotions) and
what you do (your behaviour).
What is Exposure with Response Prevention (ERP)?
For CBT to work for young people with
OCD, you will need to tolerate your obsessional thoughts without
completing any of the rituals that OCD makes you do. This will
include facing the things that you fear and that you have been
avoiding. The point of ERP is to help you learn that what you fear
will happen to you actually won’t.To help you fight OCD, you will
be taught a wide range of skills to manage the anxiety that OCD
creates.
Involving someone in your family in the
treatment as well can really help you and can give you extra
support.
Medication for OCD
Medication can be helpful in treating people
with OCD. For some young people, medication may be used with a
psychological therapy, Medication can help you get the most out of
the psychological treatment.
How will treatment help me?
- It will help you to learn strategies to
control the OCD rather than it controlling you.
- It will help you learn skills to manage your
obsessional thoughts and urges to complete rituals.
- It will give you the skills and distraction
techniques to help you manage your anxiety
You will not face difficult situations
alone. Treatment is carried out with the support of your
therapist. Your family will also get help to know how best to
support you in your treatment.
Recommended reading
Sources of further
information
OCD Action
Leading National charity for
people with OCD.
Dr I Heyman and Dr I Frampton
have developed patient and parent information
packages, new instruments for the assessment of OCD in
young people, and have developed a website especially for children
and adolescents with OCD.
Reference
NICE Guideline for OCD and
BDD
Series editor: Dr Mona Freeman
Editorial Board: Child and Family Public
Education Editorial Board.
Revised: December 2009; next due for review: December
2011.
© [2004] Royal College of
Psychiatrists. This leaflet may be downloaded, printed out,
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