What do you do if you think you have OCD? Well, the first thing is OCD has some typical symptoms, and you need to look at whether you have those symptoms. So OCD really consists of the O which is obsessions and the C which is compulsions.

What are compulsions?

So let’s talk about the C. So the compulsions are really behaviours. And typical behaviours would be washing your hands repeatedly because you’re frightened that they’re not clean, going back into the house and checking that the lights are turned off, even though deep down, you know they’re turned off. So that checking behaviour is a compulsion driven by anxiety. Another type of compulsion would be ensuring that the locks are actually locked in your house. Even though you know that the locks are locked, you’ll go back and check. So compulsions have this checking element to it, and repeated checking. Even though you know it’s irrational, even though you know that that checking behaviour is due to your fear that something is happening, you do it. And those sort of compulsions are for some people part of the disorder. But not everyone has compulsions.

What are obsessions?

The other element is obsessions. Obsessions are thoughts. So these are repeated irrational thoughts that occur on a regular basis. And these thoughts can be very unpleasant. They can be thoughts that are of a sexual or religious nature or a harmful nature that you actually almost feel like they’re not your own thoughts. These thoughts are intrusive and repetitive.

What should I do if I have compulsions or obsessions?

So some people have a preponderance of obsessions. Some people have a preponderance of compulsions. Some people have this combination of obsessions and compulsions. So what do you do? So let’s say you’ve worked out that you have these obsessions, you have these compulsions, and you think you might have OCD. Well, the first thing to do obviously, is to get assessed, to get an expert who understands the disorder to actually make a diagnosis. And in our healthcare world, that’s either via psychologist or via your GP. Once you’ve been diagnosed and been assessed, and let’s say the diagnosis is OCD, then there’s a variety of treatment approaches, which can be broadly divided into psychological approaches to treatment and medical or medicine approaches to treatment, or in some people, a combination of both. The good news is it’s a treatable condition. In highly motivated individuals, the psychological treatment can be very successful, but most often it’s a combination of medical and psychological treatment, particularly in people who have moderate to severe OCD.

Dr Matthew Cullen, Psychiatrist, St Vincent’s Hospital, Sydney

Last Reviewed: 17/09/2020

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