Obsessive compulsive disorder (OCD) is a common mental health issue that is thought to affect around 12 in every 1,000 people living in the UK. That means there are approximately three quarters of a million people currently living with the disorder.

What is OCD?

The NHS describes the condition as follows:

“Obsessive compulsive disorder (OCD) is a common mental health condition in which a person has obsessive thoughts and compulsive behaviours.

It affects men, women and children, and can develop at any age. Some people develop the condition early, often around puberty, but it typically develops during early adulthood.

OCD can be distressing and significantly interfere with your life, but treatment can help you keep it under control.”

What are the symptoms of OCD?

OCD is typically characterised by frequent obsessive thoughts and compulsive behaviours.

These are described by the NHS as follows:

“An obsession is an unwanted and unpleasant thought, image or urge that repeatedly enters your mind, causing feelings of anxiety, disgust or unease.

A compulsion is a repetitive behaviour or mental act that you feel you need to carry out to try to temporarily relieve the unpleasant feelings brought on by the obsessive thought.”

What are the types of OCD?

There are thought to be infinite forms of OCD, which can range from a compulsive need to wash your hands to more serious symptoms.

Generally speaking, OCD will present itself in one of five main categories, although there can also be some crossover between these.

The five main categories are:

• Checking
• Contamination/mental contamination
• Symmetry and ordering
• Ruminations/intrusive thoughts
• Hoarding

You can find out more about each of these categories by visiting OCD UK’s website.

What is Pure O?

Pure O, or ‘purely obsessional’, is not a medically listed term. It typically refers to a form of OCD that is wrongly thought to have no external symptoms, and only presents itself as distressing and intrusive thoughts.

OCD UK have the following passage on their website:

“Like any person suffering from OCD, a person with ‘Pure O’ will have compulsions, some will manifest as unseen mental rituals, but importantly there will nearly always be physical outward compulsions too, making the term ‘Pure O’ imprecise…

‘Pure O’ is like any other form of OCD, it will involve both obsessions and compulsions, and treatment approaches would be no different. A person doesn’t need a ‘Pure O’ specialist, ‘Pure O’ would be treated using standard traditional treatment methods, the same that are used for every other type of OCD.”

Pure O is the central theme of the Channel 4’s show, Pure, which follows 24-year-old Marnie (Charly Clive), who is bombarded by intrusive thoughts of an extremely sexual nature. The comedy drama is based on Rose Cartwright’s memoir.

What is it like living with OCD?

Here, Lucy Donoghue shares her experience of living with OCD.

There was a clear passage to the door on my right and I knew that I could get out of the room, quickly.

But I couldn’t leave. I was chairing a meeting for one of the most important initiatives of my career, surrounded by people with very busy diaries. The meeting had to happen then, and I had to be there.

The pressure and internal chatter in my head was maddening. One half of my brain was urging me to get up and leave, to check, on the premise that I had done something truly awful. The other side was fighting back, reassuring me that no, I hadn’t done anything that could harm another person, and reminding me that I needed to be professional and not embarrass myself.

All of this raged on in my mind as I tried to lead the conversation with my colleagues.

By the end of the meeting, I was exhausted but able to recognise that I’d had a ‘good day’. I hadn’t fled the room, but stayed in my seat. It felt like a small victory against Obsessive Compulsive Disorder (OCD).  

This is a description of just one of many episodes that I’ve had over years of living with intrusive thoughts and compulsive checking.

According to OCD Action, 1-2% of the population are living with OCD, with a relatively even split across gender (although research suggests women are more likely to have contamination obsessions and cleaning-focused compulsions, while men are more likely to experience OCD earlier in life). People with OCD suffer intrusive and upsetting thoughts (obsessions), causing anxiety that can be temporarily quietened by performing certain rituals (compulsions). And then the cycle begins again… 

I first realised I was living with OCD 20 years ago, and it took me a further eight years to ask for professional help. This delay in seeking and receiving support is not unusual. Staying silent is sometimes preferable to the possibility of the people you love viewing you in a different, negative way.

My obsessions centre around the potential harm that I could cause to others: my family, my friends, sometimes complete strangers on the street. The intrusive thoughts in my head range from starting fires, to causing car accidents, murder and other possibilities that I find hard to write, even now. 

Before eventually seeking help, I believed that underneath my self-constructed façade of a normal woman, I was capable of causing great hurt and damage (which, to my knowledge, I have never done). I was ashamed of the person I believed I really was, and fought hard to hide the compulsive checking I carried out to offset my deep-seated ‘evil’. I had to consistently ensure I had eliminated any possibility of hurting others, by checking appliances, doors, and at one point my email outbox, which I was obsessed with reading and re-reading in the belief that I had written hideous messages to others. Only after all of this checking could I could rest, temporarily, knowing that I hadn’t put anyone else in danger’s way.

Secrecy around OCD was important to me. I didn’t want anyone to know what was happening, although my husband, Paul, was aware from early in our relationship. He was supportive, checking out possible ‘dangers’ for me and offering reassurance. However, this only made my OCD worse, as I became dependent upon another pair of eyes. The checking could be frustrating for Paul as I asked him time and time again to reassure me, to end my rising panic. Occasionally this caused arguments.

I realised that I couldn’t cope with OCD anymore shortly after my 30th birthday. Paul was working abroad, my dad had been diagnosed with cancer, my job was extremely busy and everything felt out of control. I know now that loss of control and stress are major triggering factors for me.

My OCD ramped up a gear. I saw danger and possible harm everywhere in my flat. I checked the water, gas and electricity appliances, ensuring that they were switched off, counting up to 30, 60, 90, 120. I repeated the checking pattern over and over again. With no-one to reassure me, these rituals could last as long as they needed to, meaning OCD was now stealing around four hours of my day, mainly in the mornings and evenings when I was alone. 

Exhausted and unable to sleep one night, I finally admitted to myself that I needed help. I researched local therapists through a site called the Counselling Directory and found someone suitable. Two days later, we started our sessions and I began to fight back against OCD, firstly by speaking openly and honestly. Saying your worst thoughts out loud and having a professional empathise and want to explore them with you, rather than reject you, changes everything. You feel heard, and you start to have hope. 

Since then, I’ve had talking therapy and CBT, and I currently take an antidepressant, which quiets the noise of OCD right down. I recently made major changes to my lifestyle, too. I realised I couldn’t work in London or in a highly stressful environment, especially one where I couldn’t be honest about OCD for fear of being seen as less than capable. I left my job and applied for a role working for Happiful magazine and Counselling Directory - the site where I first found help.

When I met the team, they asked me how I knew about the Directory and I told them everything. Saying ‘I have OCD’ in an interview was liberating, and having a job where I know I can always be honest with my colleagues about mental health is priceless. I feel a deep sense of gratitude for that every day.

I would be lying if I said that my OCD no longer exists - it does - but now it’s a faint murmur, rather than a brain-filling bellow. I keep it at a distance and continue to have counselling at points when I need to. 

Talking to a professional was truly the best thing I could ever have done for myself.

If you are living with OCD, please remember that you are not alone. OCD is treatable and you can learn to manage it. Visit your GP or OCD Action for more information. You can also find local therapists on Counselling Directory. 

This feature was originally published in October 2018

Images: Channel 4, Unsplash