So what is OCD?

The layman’s view of Obsessive Compulsive Disorder is either someone who is a bit anal of cleaning and tidying their house, or someone who washes their hands a lot. For sufferers of this condition it’s something completely different.

OCD is an anxiety disorder which can express itself in behaviours that can include constant cleaning, frequent checking that the gas is off, that the doors are locked, counting and regularly washing hands. These actions are actually relieving the individual from great stress. Uncontrollable and unescapable, horrible thoughts will constantly be plaguing the minds of those suffering from OCD. Often these thoughts are something catastrophic and the only way they can prevent this awful thing from happening to them or their loved ones is to perform their routines. By completing their routines they believe they’re protecting others and even for a brief moment that anxiety that comes with those thoughts is taken away. Usually, this doesn’t last that long.

There are 2 parts to OCD – Obsessions & Compulsions.

Obsession are the repetitive thoughts that invade the mind. They’re not just extreme worries, but are products of that individual’s mind and they often try to supress them.

Compulsions are the responses to these thoughts, rituals, routines, mental acts (like counting) that relieve the stress or even prevent the disaster they’re worried about from happening.

Like many other mental health issues, sufferers of OCD need understanding. For them their arguments for doing what they’re doing are perfectly logical, to them they make sense and other people’s arguments for not performing those actions (like not taking their shoes off in their house) is just as alien to the sufferer as the action is to those who don’t have OCD.

OCD can be both mentally and physcially exhausting. Those suffering have to contantly mentally fight against the intruding negative thoughts and trying not to conduct their compulsions, whilst physically having to do them, some of which in extreme cases can take hours. This can make things even worse, as a tired mind is more susceptible to negative thoughts, and weaker so more prone to giving in.

OCD doesn’t mean that someone is constantly cleaning or washing or counting or checking. There is a spectrum of severity with this disorder just as there is for all mental health issues. Several people can live relatively normal lives, by trying to avoid the situation that would cause those negative thoughts in the first place. Eg – if someone becomes anxious about the dirt and germs that can spread from shoes that they’ve picked up in the street, and that this may cause terrible illness, then one way they can avoid this is not to permit people to where their outside shoes inside. This obviously requires a lot of understanding and willingness to help from those they share the house with.

What causes OCD?

There are currently 3 theories as to what causes OCD:

1) Psychodynamic Theory

2) Cognitive-Behavioural Theory

3) Biomedical Theory

Here we will look at 2) & 3)

The Cognitive-Behavioural Theory suggests that everyone gets obsessive thoughts at times, but have the ability to distract themselves easily from this , but those with OCD do not have the same ability. They also will find the intruding thoughts make them anxious and this reduces their strength to ignore the thoughts. Temporary relief is obtained by a certain pattern of behaviour and this becomes a compulsive ritual. Despite bringing relief these rituals also proudcue a stronger tendency to carry them out. The reduction in anxiety acts as a reinforcer.

The Biomedical Theory has at its core that OCD is an illness of the brain concluded from evidence from neurological signs, brain scans, drug effects and the primitive content of obsessions and compulsions. Brain scans, for example, show that there is high activity in the ‘cortical-striatal-thalamic circuit’ (made up of the caudate nucleus, the orbito-frontal cortex and the cingulate cortex). This is the area of the brain that is responsible for filtering out irrelevant information and perseveration of behaviour. They also argue that the focus of OCD tends to be very restricted – mainly on germs and violence, showing itself as washing and checking. Their argument goes back to evolution where these two things were important and have stayed in our brains, but have just gone too far in those with OCD.

How is OCD treated?

Each of the models that try to explain OCD have their own tratment

The pscyhodynamic theory has psychoanalytic therapy where they try and help the patient understand the underflying conflict by releasing their repressions.

The behavioural model has 3 techniques it tries to use – response prevention, flooding and modelling. These can help with the compulsions, but don’t tend to help with the invading thoughts.

The biomedical model uses drugs to help such as Clomipramine, which is an antidepressant which acts as a serotonin reuptake inhibitor. It helps obsessions fade and compulsions are more easily resisted. However, all drugs have various side-effects and don’t work on everyone.

So far there is no cure for OCD, though a combination of the above treatments do help. What is important that if you know someone who suffers from OCD is to be informed of what they are going through, what their trigger points are and be patient. It can be difficult to live with them, their compulsive behaviour can be annoying, but it is also annoying and exhausting for them. Getting annoyed or angry can just increase stress levels and make it worse for all concerned. Reassure them that you understand and ask them how you can helpl

Subjects we’re afraid to talk about.

This blog will tackle some topics we’re afraid to talk about, give you facts and figures, dispell some myths and hopefully help you accept them as something that is okay to talk about.

So far we’ve briefly covered; mental health specifically depression and schizophrenia and domestic violence. What would you like next?

Refuge & Women’s Aid are two orgnaisations trying to encourage women to talk about domestic violence, and to get out of the situation. It’s okay to talk, it’s good to talk; but people need to LISTEN and ACT accordingly.

It’s still important to talk. About 50% of women in the UK say they don’t know anyone who suffers from domestic violence, but with 300,000 cases reported in England and Wales during 2009 (a figure which would probably quadruple if all cases were reported) – is this a case of denial, of people not knowing how to talk, of them not having anyone to turn to?

1/3 of local authorities in the UK provide no help for victims of domestic violence – this plainly isn’t good enough. It’s time we changed this.

Refuge (the national charity for women and children suffering from domestic violence) have been working tirelessly to help improve the situation throughout the world. With the assitance of Hollywood star Reese Witherspoon they are calling for better services for women suffering from domestic abuse as part of the United Nations Development Fund for Women (UNIFEM).

Watch Reese speak here

If you can do nothing else, how about buying one of Avon’s Empowerment necklaces at just £3 (with all UK proceeds going to Refuge and UNIFEM).

Thank you.

Thank you!

For those who have seen Ruby Wax on TV it’s only natural to think of her as a brash, outgoing, happy, lively individual. Mention the word depression in the same sentance as her and I’m sure many people will be surprised she is the 1 in 4 that suffers from it. Depression isn’t selective. Anyone can have it.

Ruby really hit the nail on the head as she compared depression to diabetes. In both one of your organs is sick and is lacking in a chemical. People with diabetes aren’t embarassed to admit they need to take insulin and someone who has to take antidepressants shouldn’t be embarrased to admit this either.

She went on to say that attitudes have changed, the very fact that she was on the TV this morning talking about it proved this. A few years ago, this would never have happened. She admitted that she would never talk about it, for fear of being sacked. This is terrible. No one should have to cover up any illness, mental health included.

Ruby Wax is currently doing a tour and at the end of the show they have a talkback event where people stay behind and everyone talks about their depression. She delighted in saying how many people in the audience recognised the stories she was telling and how people actually felt relieved and good about talking to other members of the audience. If it works in this scenario, it should work elsewhere. It also proves, that people need to talk about it.

We’ve come along way, but as the stats show, 1 in 4 people suffer from depression. This means it’s highly likely that someone you know is suffering – and probably in silence too. The stigma is fading, but only gradually. We can all do something about this – we need to do something. It’s so important to talk about problems if you have them, if you haven’t, then it’s just as important to listen to those who do, or to talk to them in the first instance to show it’s okay to talk.

Find out more about Ruby Wax’s tour at www.rubywaxlosingit.com

Hands up those of you who have managed to talk about something you find difficult this week. A big pat on the back if you have, and if you haven’t, don’t worry – maybe this week?

I’m really keen to get people to talk openly about mental health issues and I was pleased to hear on breakfast television the other morning someone doing just that. It’s great when mental health gets time on a TV show, though normally it’s only a couple of minutes and then they move onto cooking or the competition. It’s brilliant when someone is brave enough to go on and talk about their problems as it shows people suffering that they’re not alone. Sometimes I feel what works even better is when a public figure speaks out. A lot of people believe that celebrities are perfect individuals who have no problems, but are perfect. By speaking out, it shows other people mental illness can, and does, happen to anyone.

This week, one of the nation’s most well loved actresses from Coronation Street stepped up and talked about her severe depression. I didn’t see the full programme myself, but have seen clips on the internet. It was a good discussion, but once again far too short. I do, however, hope that people sitting at home watching this, thinking or knowing they are suffering similarly with depression, might be encouraged seeing someone so well known to get help themselves. She was certainly hoping so too. One word of warning though. Her depression was severe and as such she had to undergo ECT (electro-convulsive shock therapy). This treatment has a history and has often been portrayed as being barbaric. It’s now done under general anaesthetic and only in extreme cases, and not regularly as it once was. So, please do not feel worried or scared that if you go for help for depression then you will have to undergo this too. There’s a lot more the doctors will work with you on first. Don’t be put off by the mention of this therapy; because even if you do have it, it’s regulated and has shown to have some success.

Here’s a quick guide to Depression:

Depression is one of the most common forms of mental distress. Often occurring with anxiety it appears in about 10% of the population, and arises on its own in about 3%.

What is it?

We all have periods in our life where we feel sad. Often times, there’s a reason, a failed job, a failed relationship, but it’s when someone feels sad for long lengths of time for apparently no reason, then it can be described as ‘depression’.

There are 4 sets of symptoms:

1) Mood / emotional – describe themselves as sad, blue, miserable, helpless, hopeless, unhappy, worthless, ashamed, guilty

2) Thought / cognitive – thinks of self in very negative light.

3) Motivational symptoms – difficult getting started, motivated

4) Physical – every biological and psychological joy that makes life worth living is eroded. Loss of appetite is common, weight loos, get difficult to sleep, leads to weakness and fatigue

A person doesn’t need to be suffering from all of the above to be diagnosed as ‘depressed’

Research shows there is a gender difference with depression with women twice as likely to be diagnosed as men. Depression, however, isn’t choosy with age – it hits all age brackets and is becoming more frequent in younger people.

So what causes depression?

There are many theories to why people develop depression. Here are a few and very simplified, possible reasons:

The Biological Argument

Some researchers show that depression is linked to the depletion of biogenic amines (substances known as that help transmit nerve impulse across gaps between nerve cells). There also seems to be a genetic link. First degree relatives of depression have between 2-5 times risk for depression.

The Psychodynamic Argument

Anger turned against the self, excessive dependence on others for self-esteem and helplessness at achieving one’s goals

The Cognitive (Thought) Argument

The Cognitive Triad – negative thoughts about self, about ongoing experience and future. Negative thoughts about self consist of the depressive’s believe he is defective, worthless and inadequate. Slow self-esteem derives from belief he is defective. When has unpleasant experiences, he attributes them to personal unworthiness. – often misinterprets small obstacles as impassable.

Treatments

Drugs

There are a variety of different types of medication you can take. These include tricyclic antidrepssants, MAO inhibitors (monoamine oxidase an enzyme) and SSRIs (Selective Serotonin Reuptake Inhibitors eg Prozac). It’s the latter type that is the most popular form that is prescribed. All of these drugs help to lift the mood by working on chemical messengers in the brain, however they do all have side effects and can take up to 4 weeks to start to take effect.

Psychological treatments include:

Problem-solving therapy – a few sessions to help you put your problems into manageable proportions and find strategies for coping with them.

Cognitive therapy attempts to correct this distorted thinking

Psychodynamic counselling – this examines past experiences and relationships and how they contribute to feelings in the present.

Electro Convulsive Shock Therapy (ECT)

This remains a controversial therapy and is only used in severe cases when patients haven’t responded to drugs. The patient is put under a general anaesthetic and an electrical current is passed through the brain to alleviate the depression.

You can also help yourself

Depression can feed itself. By knowing this, you can help overcome it. Negativity breads negativity. There is no quick fix for this, but there are ways to help.

Be aware of your thoughts, try and recognise patterns that emerge surrounding times of feeling depressed and, if you can, try and change activity, preferably something more constructive. By getting out of doing whatever was making you feel down will help break this cycle.

One of the things people suffering from depression feel less inclined to do is physical activity. This, however, is a great therapy – for the mind as well as the body. Just 20 minutes a day will help improve your mood. Activity such has walking, gardening, cycling and dancing can stimulate endorphins, which are chemicals in the brain which help you feel better

Try to avoid alcohol and tobacco as these can exacerbate depression. You also need to look after yourself by eating a healthy, balanced diet and make sure you care for you general appearance and treat yourself from time to time. It’s also a good idea to set yourself some goals – nothing too extreme because you could be setting yourself up to fail and getting more depressed, but something that does offer a little challenge. A sense of achievement can really help.

TALK

That’s what this blog’s all about – getting people to talk. Depression, like many mental illnesses are isolating, so a good way to help yourself is to meet with others and share experiences, by doing this you realise you’re not alone. This is also a great way to hear other people’s stories on how they have managed and how they are getting better.

Talking is also a way of helping a friend or relative who is suffering from depression. By the very nature of their illness people who suffer from this condition will withdraw and not seek help themselves. Try to avoid blaming them or being negative. A positive attitude that something can be done will be much more effective.

There are also other forms of depression:

• Bipolar

• Postnatal

• Season Affective Disorder

I hope to return to these later.

For further information and links to helpful resources visit www.mind.org.uk

There are 2 broad subjects that are very close to my heart that fall into this category; mental health and domestic violence. At least one of these issues will effect us or someone we know. Why, then, are we so reluctant to talk about them?

This blog will grasp this topics and discuss them, give you facts and figures, dispell some myths and hopefully help you accept them as something that is okay to talk about.