Obsessive Compulsive Disorder
Obsessive-Compulsive Disorder (or OCD) is an anxiety-related mental health condition. It’s thought to affect around 750,000 people in the UK.
- Common mental health condition
- Can be obstructive and interfere with daily life
- Tends to develop in late adolescence or early adulthood
Our doctors are available to help if you think you may be experiencing signs of OCD, or if you are already undergoing treatment and are looking for a convenient way to renew your prescription.
Obsessive-compulsive disorder is a well-known but often misunderstood mental health condition. OCD UK estimates that around three quarters of a million people in Britain have the condition, and that its effects are likely have an impact on an extra quarter of a million. The condition can develop at any time in a person’s life, but the average age at which the symptoms tend to become disruptive are during a person’s later teenage years or early twenties.
There are two main aspects of obsessive-compulsive disorder: obsessions and compulsions.
Obsessions involve a negative thought, urge or feeling which will not go away. This can cause persistent feelings of stress or anxiety, and lead to compulsions. Compulsions are when a person feels compelled to perform a certain action, behaviour or ritual to try and stop or address the negative thought. This action or ritual might seem irrational to someone else. The relief that performing the behaviour provides might only be felt short-term.
It’s common, particularly for those who are not familiar with the condition, to conflate the term OCD with being meticulous. For example, someone who likes to keep a neat and tidy desk might be referred to (or even refer to themselves) as having ‘OCD-like’ tendencies.
OCD UK explains that most people at some stage in their lives may display behaviours that could be categorised as OCD-like, particularly during times of anxiety or stress. But what makes the condition a disorder is that a behaviour or ritual might stop a person from going about their normal day, and potentially have a disabling effect on them.
Many people may live with obsessive-compulsive disorder for a number of years before seeking help, either because they don’t realise they have OCD, or because they don’t know that therapies are available.
Diagnosis usually starts with a GP. Where appropriate, they may refer someone to a specialist, who can carry out an assessment of someone’s symptoms. This is usually done through a series of questions, and the person explaining the process behind their thoughts and feelings, and how it affects them.
There are several different ‘levels’ of OCD. Someone with mild functional impairment may benefit from low intensity (up to 10 hours) cognitive behavioural therapy, where a specialist helps the person to dissect their obsessive thoughts into smaller chunks, and gives them mental tools on how to manage these.
Someone with moderate or severe functional impairment will usually be offered a higher level of intensity of CBT (over 10 hours). Other people may also benefit from a combination of CBT and prescription medicine, in the form of SSRIs.
If you are concerned that you may be displaying signs of OCD, it’s advisable to speak to a doctor. Without treatment, the condition can become more severe, and addressing the problem at an earlier stage may make it easier to manage.
Our video consultation service enables you to speak to a doctor about OCD, whether you want to talk to someone about symptoms for the first time, or if you’ve been diagnosed and are already taking medication for the condition, and want to renew your prescription. All doctors we work with are registered with the General Medical Council in the UK. They can refer you to a specialist where appropriate, or issue a prescription, which can be fulfilled by our online pharmacy.
How does someone know they have OCD?
Obsessive-compulsive disorder has two main elements: persistent obsessive or negative thoughts, feelings or urges, and compulsions, where a person feels as though they have to perform an action or ritual to prevent or address the feelings caused by that obsessive thought.
It’s not always obvious to someone that they have OCD. Many people can go for several years without speaking to a doctor about it, or without being diagnosed. This is because the symptoms (persistent unwanted negative thoughts, and the compulsion to act to try and prevent them) may feel normal to them.
However, the symptoms of OCD often prevent or obstruct a person from going about their usual daily life. It can also sometimes impact on other people who are close to them; it’s possible that a loved one will notice the symptoms before the person affected does.
How is OCD diagnosed?
Getting help for OCD can start with a GP. They may refer you to a specialist to discuss your symptoms in more detail.
A mental health professional can make an assessment during a verbal consultation. This can take place in person, but in some cases it might be done over the phone. They’ll usually ask you to answer some questions such as:
- Is there any thought that keeps bothering you that you’d like to get rid of but can’t?
- Are you concerned about putting things in a special order or are you very upset by mess?
NICE has a framework to help professionals identify OCD, and the assessment will be based around these guidelines. It takes around an hour.
Does OCD require treatment?
People with OCD can benefit greatly from treatment.
Psychological therapy techniques are the first-line option. These include cognitive behavioural therapy (CBT) and, less commonly, exposure and response prevention (ERP).
These can vary in intensity level; for example, someone who has ‘mild functional impairment’ may be recommended low intensity CBT (up to 10 hours with a therapist). Someone with moderate or severe functional impairment may be offered more intensive therapy (more than 10 hours) or an SSRI medication, or a combination of the two.
What treatments are there for OCD?
Cognitive behavioural therapy involves speaking with a therapist, and focusing on the negative thoughts present at that time. The therapy helps the person to divide their negative thoughts into smaller, more manageable segments, and demonstrating to the person how to overcome them, with the ultimate aim of improving their outlook and mental well-being.
Exposure and response prevention therapy is an approach sometimes used as part of CBT, but the overarching principles are slightly different. This involves the person not addressing the obsessive thought by taking the corrective action - enabling the person to see, essentially, what happens if they don’t act on their compulsions.
When medication is used in the treatment of OCD, selective serotonin reuptake inhibitors, or SSRIs, are typically considered first. This includes drugs such as citalopram and paroxetine.
If one or more SSRIs have proven unsuccessful, a tricyclic antidepressant, such as clomipramine, may be recommended.
What should I do if I think I might have OCD?
Most people may, at some stage, display behaviours which seem similar to those found in OCD. It’s generally when these behaviours are persistent and prevent someone from functioning normally, or come about as a result of anxiety, that speaking to a doctor is recommended.
A GP will be able to discuss your symptoms with you and refer you to a specialist if they feel it is appropriate.
What treatments are there?
OCD is usually treated with cognitive behavioural therapy.
There are different levels of intensity in CBT; someone who is more mildly affected may be advised to have low intensity CBT, which is up to 10 hours. A person with moderate or severe symptoms will typically be offered a greater number of sessions (over 10 hours).
In some cases, a doctor may also suggest prescription treatment, namely an SSRI (such as citalopram or paroxetine) to be used in combination with CBT.
Are there side effects?
CBT is a talking therapy, and so there are no side effects as such. However, certain aspects of it, such as ERP, can be discomforting as it requires facing and ‘riding out’ anxieties.
Some side effects associated with SSRIs include tiredness and lethargy, changes in sleeping patterns and headache.
Can I consult a doctor about OCD online?
Yes. Our video doctor service enables you to consult a GP online about OCD, whether you’re already receiving treatment on the advice of a specialist and want to renew your prescription, or if you have concerns and want to discuss OCD with a doctor for the first time. Our doctors can issue prescriptions for treatment, or make a referral to a specialist where necessary. Click to proceed, and choose a suitable appointment slot for you to get started.