Category Archives: Health

OCD Action: Cleaning Up Misconceptions

Image by Jez Nicholson (flickr) used under Creative Commons license

My interest in Obsessive Compulsive Disorder (OCD) is rooted in personal experience. For the purpose of spreading awareness however, I’m playing uninformed. To begin my conversation with Olivia Bamber, Media and Communications officer and helpline coordinator of OCD Action, I asked if OCD was simply a quirk.

“Definitely not. It’s a disorder…and I think that’s the bit that people forget. Everybody has quirks, obsessions, compulsions or rituals.” We’ve all heard someone flippantly describe themselves as ‘a bit OCD’. How is a distinction made? “The way that is characterised as being a disorder is when it has an impact on your life.”

Is everyone who has OCD clean and organised? Absolutely not. For a lot of people, Olivia explains, there are no “obsessions to do with contamination or organisation”. The themes for them are far more taboo. “They could have intrusive thoughts about causing harm or coming to harm, or sexual or religious thoughts, that sort of thing.” Consequently, these worries are rarely discussed. Even for those whose OCD is closer to media stereotypes, symptoms can be distressing.

Do people know they’re being irrational? “I think a lot of people know that, deep down, their obsessions and compulsions aren’t logical. They still can’t stop doing it, because there’s that niggling doubt all the time. OCD is often referred to as the ‘doubting disorder’. I think that niggling doubt just makes people continue to do those compulsions. So I think, generally, people do realise what they’re doing is irrational – but that doesn’t mean people can stop doing it.”

Are the things they’re doing to deal with anxiety always obvious? “No. Compulsions can be mental or physical. They might be things you can see like washing, tapping or saying phrases out loud. They could also be mental compulsions that might be things like avoiding certain situations, they could be things like asking for reassurance, so they might not seem so obvious. It could be repeating certain mantras or phrases inside your head, so definitely, there are compulsions that you can’t see as well.”

Some people with OCD have debilitating obsessions about being a murderer or rapist. Does this make them dangerous? “Absolutely not. They’re just intrusive thoughts and do not characterise what a person actually wants to think or feel.” In a survey of 293 students, 42% of females and 50% of males had experienced intrusive thoughts about hurting a family member. Intrusive thoughts are uncontrollable, and as Olivia observes, “everybody in the world gets them. It doesn’t, in any way, reflect on someone’s personality or character.” Arguably, people with these types of obsessions are more concerned with morality than anyone else. However, “pushing an intrusive thought away doesn’t help.”

What treatment helps a person to recover? “The therapy for OCD would generally try and gradually teach you to confront the thought rather than try and push it away. Because actually, often by pushing the thought away you can make it stronger. And Cognitive Behavioural Therapy (CBT), which is actually the therapy for OCD, would encourage you to allow that thought to come, and sit with that anxiety and actually let that anxiety go down on it’s own.” CBT, Olivia explains, “uses an element of ERP (Exposure Response Prevention) which is basically where you expose yourself to the trigger or the thought and you very gradually reduce doing the compulsion.” Some people also find that antidepressant medications (Specific Serotonin Re-uptake Inhibitors, or SSRIs) make the condition more manageable; especially during the often challenging therapy process.

What causes OCD? As a charity we generally don’t talk about the cause. There is actually no known cause. There’s a lot of research being done into OCD and a lot of research into why people develop it.” Studies have found that people with first-degree relatives who have OCD are at a higher risk for developing it themselves. This suggests a genetic predisposition towards the disorder. There also seems to be a link between certain structural abnormalities in the brain and OCD. Trauma is also thought to increase the likelihood of having OCD. Sometimes, however, there’s no apparent reason. “I genuinely have heard of people with OCD who have gone to sleep with no obsessions and have woken up with loads. So there is no known cause but, actually, knowing the cause doesn’t help. The therapy is very practical and we don’t find that that’s particularly helpful.”

I’m sure OCD Action is also a help to people. When I invite Olivia to tell me more about the charity her face lights up. I can tell you a lot about OCD Action, I’ll be here for ages!” she laughs. “We are a national charity that supports anyone affected by OCD or related disorders. When I say ‘anyone’ that means the person with the condition and family and friends. By ‘related disorders’, I mean things like BDD (Body Dismorphic Disorder) and hoarding or habit disorders, as we cover a big, wide range of things. What we do is we offer support and information to those people. So we have lots of support services like the helpline, our advocacy service, a big network of independent support groups and our youth service. We also offer loads and loads of information through our website.”


You can contact OCDAction‘s support services by calling 08453906232, emailing, or by using their contact form

For more information about the charity, email or check out their website

OCDAction are also on Facebook and Twitter

Depression as a Continuum

Medicine often functions by dichotomizing: ill or healthy, good or bad, normal or abnormal. In doing so, it allows those making decisions to feel that particular courses of action are correct.  It is rare that things are so clear-cut, yet medical discourse commonly frames them as if they were. In fact, this is often the only option. 

A pertinent analogy may be the difference between passing and failing an exam. A student with a 42% isn’t much more knowledgeable than one with a 39%, yet one passes while the other is marked as a failure. An extra percentage may affect the way a student sees themselves or the way in which future employers judge their worth. Does this make them a different person? Someone who is more or less intelligent, or even more hardworking? Not necessarily. Yet, the cut off must be placed somewhere. Clearly someone who gets 98% in every exam has done better and probably tried harder than one who receives 12%, but this is an ‘obvious’ case. As outliers, they are easily definable. It is those who are ‘normal’ – those who fall in the middle – who have the most to gain or lose.

In the case of physical health, these differentiations between what is normal and abnormal clearly carry their own costs, but I suggest that this argument is particularly crucial in the case of mental health – in no small part as a result of the way mental illnesses are viewed.

depression 2What do you imagine when you think of depression? Public perceptions appear to be changing. More celebrities are ‘coming out’ about their own experiences with depression. It is almost fashionable – as long as one is rich and successful, and has gotten better.

A study published in 2014, conducted in Australia, suggested that stigma towards those with mental illness may be divided into two main categories: ‘weak-not-sick’ and ‘dangerous/unpredictable’. That is, people with mental health problems are viewed either as malingerers or as a threat to society. Certainly, there are individuals who pose a risk to others at times and there are individuals who choose to exaggerate symptoms in order to gain material benefits, such as time off work. However, these people are the minority. These views could also be applied to physical illnesses, yet this appears to be a less common phenomenon. A recent study conducted in Italy found that 75% of those surveyed believed that people with depression should avoid talking about their illness, and 52% thought primary care physicians were too busy to treat patients with depression, presumably because they are dealing with ‘more important’ physical illnesses.

In addition to social stigma, there may be costs to admitting to depression in other contexts, particularly the workplace. There is a significant economic burden due to loss of productivity as a result of depression. A study looking at attitudes towards depression in association with time taken off work in seven European countries showed that the attitudes of managers affected the amount of time employees took off, and whether they felt able to disclose their diagnosis.

Developed by Drs. Robert L. Spitzer, Janet B.W. Williams, Kurt Kroenke and colleagues, with an educational grant from Pfizer Inc.

The questionnaire used to help doctors diagnose depression and grade its severity contains a range of symptoms that must be familiar to many people. For example: Over the last two weeks how often have you been bothered by feeling tired or having little energy? By feeling bad about yourself, that you are a failure, or have let yourself or your family down? Treatments, such as talking therapies or antidepressants, rather than active monitoring are advised based on criteria including symptom duration, the impact of symptoms on a patient’s life, a previous history of depression, and a lack of social support. Thus, it is immediately evident that the difference between a diagnosis of mild or moderate depression depends on some rather subjective reporting of symptoms by a patient.

Is it possible to view depression not as a dichotomy, but as a spectrum? There has been increasing interest among researchers in viewing depression on a continuum. For instance, a 2010 article in the British Journal of Psychiatry reported that:

Symptoms that do not meet the threshold for depression produce significant decrements in health and the experience of them is not qualitatively different from an illness which would meet the diagnostic criteria.

Further, a 2014 study found that there was an association between a belief in a continuum of symptoms in mental health and a positive attitude towards those with mental illness.

So, if you notice any of the symptoms of depression in yourself or in someone close to you, it would be helpful to view these feelings not as abnormal, but in a more accepting way. Mental health is not as simple as ill or healthy. If you have lost interest in the things you normally enjoy, have negative feelings about yourself, or experience any ‘somatic’ symptoms, including a loss or gain of appetite, a change in sleep pattern, or excessive tiredness, then it may be worth seeking medical advice.

It is estimated that between 8-12% of the UK population experiences depression each year. Talking therapies and antidepressants can help, and using them should not be viewed as a sign of weakness. Additionally, the Mental Health Foundation has useful information on other approaches to treatment on its website. A diagnosis of depression need not be feared or avoided. In short, symptoms of depression are very common, and there is often a fine line between the diagnosis of a depressive illness with subsequent treatment and a lack of diagnosis. People should be treated with equal sympathy and respect regardless of what side of the line they fall on.