Advice on ... OCD
Monday, June 1, 2009
OCD, or obsessive-compulsive disorder, is a serious anxiety-related illness that affects on average two or three out of every 100 young people in the population. Joanne Sharman explains what the condition is and where young people can turn to for help.
Q: What is obsessive-compulsive disorder?
OCD is a disorder characterised by unwanted, intrusive thoughts (obsessions) and rituals (compulsions) carried out to alleviate the anxiety these thoughts cause. OCD affects between two and three per cent of the population. This means that in a year group of 100 students, on average two or three students will suffer from the illness. OCD can be extremely debilitating, especially when it occurs in conjunction with other illnesses (such as depression). It is important that it is treated as soon as possible, as the sooner treatment commences the more likely it is that the OCD can be controlled and limited. All experts on the subject agree that it is possible to get the disorder under control to such a level that it no longer affects a person's life.
Q: How do you develop OCD?
No-one is really sure why people develop OCD, but it is believed to be caused by a combination of genetic and environmental factors. Having a parent with OCD can increase a young person's likelihood of developing the disorder, although some sufferers have no family history of the illness. There is also research that suggests OCD in young people can be brought on by the Streptococcus bacterium.
Q: How does OCD affect behaviour?
OCD causes a person to carry out rituals to try to reduce or dissipate the anxiety they feel as a result of their obsessions. Common obsessions with possible compulsions include a fear that their hands are contaminated, which leads to excessive, lengthy and ritualised handwashing, even to the point where the skin cracks and bleeds. Another fear is that they might harm a loved one, so they might avoid being around that person or repeatedly ask for reassurance that they are okay.
Some fear they might shout out inappropriate or offensive words in public and therefore avoid going outside or keep repeating "safe" words to neutralise the perceived threat. Others are obsessed with the idea of perfection, which can lead them to arrange all items on their desk exactly in line with, or at right angles to, each other. Or they fear they have left something important at home, which leads them to repeatedly check their bag.
These are just some of the common obsessions and compulsions, but there are an infinite number.
Q: What should a youth worker do if they suspect a young person has OCD?
Many young people with OCD are embarrassed or ashamed of their behaviour and feel their thoughts might make them a "bad" person. As a result, they may be reluctant to disclose them for fear of being labelled crazy or sick.
It is important for young people to feel they can trust someone with their thoughts and find someone to whom they can talk. It is also important that they do not feel pressurised into talking about it if they do not feel ready.
A way of broaching the subject is to give a general talk or presentation on OCD, thereby opening up the possibility that they may feel more able to talk about their own thoughts and feelings. The sooner OCD is identified and treatment begins, the easier it is to bring under control.
Young people with OCD may not feel able to talk to their parents about it, but they should be encouraged to speak with their GP. If they feel unable to do so, then a talk with a school nurse or counsellor can be useful. They can help the person approach their GP, and they can also support them at school.
Although awareness of OCD is slowly increasing, many GPs are still unsure of the best course of treatment. Cognitive-behavioural therapy (CBT) is the recommended treatment, but waiting lists can be quite long. If the OCD is severe or depression is also present, then young people might also be offered SSRI medication to help alleviate anxiety and reduce depression. Fluoxetine, more commonly known by the brand name Prozac, is the only SSRI drug recommended for use in under-18s. Other SSRIs have not been properly tested on young people.
- Joanne Sharman is an OCD sufferer and a volunteer for OCD-UK
MORE INFORMATION
- OCD-UK is the UK's leading charity for those affected by OCD
www.ocduk.org
- The charity also offers an online bulletin board where sufferers and loved ones can discuss OCD and how to tackle it
www.ocdforums.org
- OCD Youth website provides information about how the condition affects young lives and where to turn for help
www.ocdyouth.info