OCD - Obsessive Compulsive Disorder

OCD is often described as a vicious cycle.

It starts with the obsessive thought, this causes anxiety, leading to a compulsive action, only providing temporary relief.

And the cycle is repeated. 

Breaking the cycle helps to treat OCD.

See the next section for ways to break the cycle, such as:

• Anxiety management.
• Thought challenging.
• Delaying compulsions.

Therapy can also help (such as exposure/response prevention with a CAMHS worker).

_{Understanding OCD and Anxiety} 

With OCD, anxiety often comes from upsetting or unwanted thoughts (obsessional thoughts). These thoughts can feel very real and scary, but they are just thoughts, not facts, and not actions. These thoughts can often feel out of character and they often don’t reflect someone’s true beliefs or intentions.

_{Recognising Triggers} 

Try to notice what sets off your obsessive thoughts. Once you know your triggers, you can use strategies to help manage the anxiety. When your anxiety goes down, the urge to do a compulsive behaviour often goes down too.

Here are some strategies to help with anxiety:

Relaxation 

You can do meditation, mindfulness, or deep breathing. There are many free apps that can help with this: 

Smiling Mind, Calm, Self-help for Anxiety Management (SAM)

• Take a deep breath. Breathe in slowly through your nose and hold the air in your lungs. When you are ready to release the air, put your lips together and pretend that you are blowing through a straw.
• Stop and listen. Spend a few minutes just listening to the sounds around you. What sounds do you hear? Are they loud or soft? Pay special attention to interesting sounds you have never noticed before.
• Imagine your favourite place. Think of a place where you feel calm, comfortable and happy. It may be a beach, a forest, your bedroom, or somewhere else. Imagine what this place looks and sounds like and imagine how good you feel when you are there.

Self-soothe box 

You can fill up a self-soothe box with items that help you manage anxiety. This can include fidget toys, photos, scented oils, positive quotes, toys, colouring sheets (e.g. mandalas). You can find out how to make a self-soothe box. 

Write a happy ending 

When feeling worried, it is common to imagine the worst-case scenario. Try writing a positive ending.

Activities 

Some things that can also help you to feel calmer:

Exercise.

Listen to your favourite music.

Practice a hobby.

Write in a journal. 

Talk to friends.

Thought Challenging

There are strategies you can use to help you to challenge anxious thoughts: 

• Think about it. When you feel worried, you probably imagine that bad things happen/things go wrong. Think about what really tends to happen.
• Fact or opinion. Sometimes we tend to interpret thoughts as if they are facts. You can challenge your anxious thoughts by asking ‘Is it an opinion or a fact?’ Look for concrete evidence.
• What is your interpretation? Feelings are not based on events but how we interpret, or understand them. You might assume that an event is bad or threatening and this makes you anxious. You might help your anxiety if you take the time to consider whether the assumptions you make are correct, or whether events are less worrying than they first seem.

Thought defusion

This is a tool that helps you step back from your thoughts. Instead of getting caught up in them, you learn to see them as just passing mental events, not something you have to act on.

• What does my thought mean? Sometimes we give too much meaning to a thought, especially if it’s upsetting. One way to reduce your anxiety around your OCD thoughts is to view thoughts as passing, without any real meaning like clouds in the sky that float by.
• Is the thought the same as an action? No. Having a thought doesn’t mean you’ll act on it, or that it reflects who you are. Knowing this can help reduce the anxiety that comes with OCD thoughts.

Delaying the compulsive behaviour

Doing a compulsive behaviour might make you feel better for a moment, but it doesn’t last. The obsessive thoughts will come back, causing anxiety, which will lead to the compulsive act to remove the anxiety.

Delaying the compulsive act for as long as you can will expose you to the anxiety for a longer time. It's a proven way to help your anxiety reduce over time.