10 Things You Need to Know About OCD

My name is Rose Cartwright. I’m a writer based in London. When I was 15-years-old I started experiencing intrusive thoughts about paedophilia. As I got older I started to have constant doubts about whether I was gay or straight. It took me many years to figure out that I had OCD, and many more to find effective therapy. Here’s a list of things I wish I’d known when I started my OCD journey. (Please note, I have had no medical training. Always seek the advice of an expert when researching OCD.)

1. No thought is too weird for OCD.

If you’ve got OCD, you may be sat there thinking ‘I’m the only person in the world who’s ever thought these things.’ But you’re not. Obsessions come in all shapes in sizes: doubts about whether or not your want to commit incest; doubts about whether you want to murder someone; doubts about whether you’re capable of child abuse; doubts about whether you want to set people on fire; doubts about whether you’re actually alive; doubts about whether you’ve got aids; doubts about whether you’re the devil, and so on. OCD specialists have heard them all, so don’t be afraid to articulate them.

2. OCD can get better.

This is the good news. The great news! Where you’re in the grip of the condition it can feel like you’ll never get out of it, but it can get better. I know people who used to be utterly debilitated by their OCD – it sabotaged their jobs and their relationships. These same people are now completely OCD-free.

3. ERP is the only therapy recommended by experts.

The main barrier to getting better is finding the right therapy, as many practitioners aren’t OCD specialists. Experts agree that ERP (exposure and response prevention) is the only effective therapy. It’s a type of CBT (cognitive behavioural therapy) which exposes you to the source of your obsessions and habituates you to the anxiety they provoke. I had years of ineffective treatment before ERP changed my life quickly and dramatically.

4. Watch out for the wrong kind of CBT.

The fact that ERP is a form of CBT can be confusing when you’re searching for treatment. It lead me to assume that all types of CBT are effective in treating obsessive compulsive disorder, but that’s not the case and the wrong kind can actually be very destructive. If you’re being offered CBT that doesn’t include ERP, find alternative treatment.*

5. Compulsions make obsessions worse.

Whatever compulsions you’re enacting to alleviate your anxiety in the short term, will only make your obsessions worse in the long term. OCD is a vicious cycle. But as you progress through therapy you’ll gradually break this vicious cycle by learning to tolerate anxiety without acting out compulsions. If this doesn’t make sense to you, it’s something a good therapist will help you to understand.

6. Medication can help, but it’s not essential.

Many people with OCD find medication incredibly helpful and experts seem to agree that the right drug teamed with ERP is highly effective. That said, therapy alone can work very well, too, and many people recover without taking any medication.

7. Be cautious whose advice you buy.

Non-experts (hello!) don’t always know what they’re talking about. Parents, friends, colleagues, lovers, journalists and even doctors might not necessarily be versed in the most effective OCD treatments. Please listen to what the professionals on this website say and be careful whose advice you buy. When there are so many unspecialised therapists out there, a little scepticism goes a long way.

8. Talking can be good. Too much talking can be bad.

Opening up about OCD to loved ones and the wider world can be very therapeutic. But talking about symptoms can easily become obsessive in itself, especially on social media. I often see people in forums ‘confessing’ their thoughts or telling others that they’d never act out their obsessions. This kind of reassurance will feel good in the short term, but it’s destructive in the long term. Support from your peers is a wonderful thing, but make sure they’re not unknowingly colluding in your compulsive behaviour.

9. There might be an upside to having OCD.

Many experts have observed that people with OCD often possess a range of positive character traits, such as inquisitiveness, creativity and empathy. I like that idea: the brain which gives you misery is the same brain which can give you great joy.

10. OCD might never go away.

As I’ve already said, OCD can get better, but 100% recovery isn’t guaranteed. Realistically, people may still experience some symptoms after they’ve completed successful therapy – I know I do. That might sound scary if you’re in the grip of severe OCD right now, but trust me, it is possible to live very happily with the condition when you know how to manage it. Once I accepted that obsessive thoughts might be part of my life forever, they were ironically robbed of their power.

It's important to understand the different types of Cognitive Behavioral Therapy (CBT). Ultimately, it is recommended that you only choose Exposure Response Prevention (ERP) Therapy to treat OCD.

And for a very impactful read, pick up "Pure".