Understanding
obsessive-compulsive
disorder
As teens, we face unique stressors such as changes due to puberty and new school environments. It’s natural to feel stressed and overwhelmed over the things happening in our lives.
However, some of us may start having unpleasant and repeated thoughts and fears (obsessions) or develop behaviours such as repeating words or numbers to reduce the stress that comes from those thoughts (compulsions).
Don’t be quick to dismiss these thoughts and behaviours especially if they are persistent, distressing and interfere with our day-to-day functioning. These may be symptoms of Obsessive-compulsive disorder (OCD).
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 28 Singaporeans aged 18 to 24 years old 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
Symptoms vary from person to person but there are some signs that can help us identify OCD amongst other disorders.
Making a point to learn about the symptoms of OCD will help us in the journey towards recovery.
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.
Frightening religious thoughts.
Examples of these kinds of thoughts include offensive things related to religious figures or making ourselves responsible to an unreasonable extent for breaking religious codes of conduct.
Fear of saying certain things, having lucky/unlucky numbers, or the fear of losing things.
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
Re-reading or rewriting
Counting, tapping,
repeating of certain words
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
As teens, our OCD symptoms can easily go undetected as we may find it hard to express our intrusive thoughts or understand that our actions do not make sense. This can result in a delay in seeking diagnoses and treatment. However, it is important to seek help as early as possible, as tackling OCD early can lead to better treatment outcomes.
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
At times, OCD can feel like it’s interfering with the way we live our lives. But it’s important to remember that having OCD is no fault of ours. And we can certainly learn how to manage it.
A combination of medication and cognitive behavioural therapy (a form of therapy to identify and change unhealthy behaviours) 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 bring 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. Common medication prescribed are a class of drugs called Selective Serotonin Reuptake Inhibitors (SSRIs).
SSRIs work by increasing the levels of serotonin (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 judgment 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 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, the person eventually gets used to not engaging in the repetitive behaviour (a process called “habituation”). In addition, it is also useful in teaching alternative ways of coping with our anxiety and stress. The combination of medication and CBT often increases the chance of achieving the intended results.
When living with OCD, we also need to be patient with ourselves because the recovery process takes time. Managing OCD requires commitment and dedication, just as with anything that we’re striving to improve, be it an art piece, music, or levelling up in our favourite game.
Once we learn how to control and manage the OCD symptoms, we can get back to concentrating on our studies, friends and family, hobbies, sports – whatever matters most to us. Remember that we have the power to keep OCD under control, with the help of those around us and healthcare professionals.
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. 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.
Mental health services
Belle, Beyond the Label helpbot, is an interactive platform for users to find mental health resources and services in a private and convenient manner. If you or anyone you know is overwhelmed with stress or anxiety, you may find the help you need via Belle.
Get access to Belle
You may also visit here for more mental health resources or download the list of community mental health services including your nearest GP here.