November 28, 2021

I, Science

The science magazine of Imperial College

Even simple tasks like leaving the house can be arduous for OCD-sufferers. But misuse of the label can have negative effects, argues Chrissie Clark...


I sat there for the first time in my nurse training with tears in my eyes. Trying desperately to roll them back in before he noticed, I sniffled and slapped a wonky smile on my face again. I was watching him paint a picture of how it felt to have severe OCD. The paint was red and the circles were endless. Everything was 45 times… 45 times… 45 times…


She was leaving the house for work, certain that the hair straighteners were off.

Almost at the bus stop now.

She turns around and heads back.

I didn’t turn them off, shit the house is going to burn down, I haven’t got insurance, my flat mate will be so angry.

She’s back in the house now.

They are off.

Running back to her bus on her way out she Chubb locks the door; three times she tries to turn the key to make sure it is definitely turned. Then she pushes the door to make sure it’s shut.

Yep shut.

Step forward.

Oh wait.

Check again. But half way down the road.

I don’t think I shut the door.

Run back and check.

It’s shut. But did I turn my hair straighteners off? I did right?!


This vicious circle can be the start of something serious, life changing and difficult to escape. OCD affects thousands of people each year: old or young, professional or unemployed. Some people have to give up work because of it and some even end up hospitalised as a result. This incapacitating illness not only hinders mental limits but in its severest forms, it can disrupt work, hobbies and even simple chores like popping out to get some milk.

Forget the Hollywood images you see of controlling husbands lining up towels or the myths of housewives washing their hands. Terms like: “you’re so OCD” are thrown around too easily, stigmatising not just OCD sufferers but also those who show signs of anxiety that are conflated with the condition .

What are the facts?

Symptoms of OCD can vary from mild to severe; for some people it may dictate an hour of their day and for others it may take over their lives.

Patterns of OCD-influenced thoughts and behaviours usually fall into the following four steps: obsession; anxiety; compulsion; and temporary relief. When a person is constantly obsessing about something their mind can become overtaken with fears such as ‘your house burning down’ or ‘something bad is happening to someone you love’. Understandably these fears typically cause an intense feeling of anxiety and can cause severe distress. People with OCD may tend to develop a compulsive behaviour which they think helps to relieve the fear and the anxiety, such as checking the cooker is switched off or phoning loved ones several times a day to check their welfare. These compulsions tend to alleviate the anxiety, but the relief is only temporary.When the anxiety return so does the compulsive behaviour – and thus the cycle begins all over again.

What causes OCD?

There are several possible explanations for the cause of OCD. Some studies indicate that OCD may be hereditary or genetic. Yet others have shown through brain imaging that people who have a diagnosis of OCD demonstrate abnormalities in the brain, including increased activity and increased blood flow.

One larger school of thought (and one that is commonly accepted and treated with a class of drugs known as SSRI’s) is that people with OCD have an imbalance of serotonin, a neurotransmitter, in their brains.

How is OCD treated? 

At present, treatment of OCD is likely to involve Cognitive Behavioural Therapy, a talking therapy usually administered  by a clinical psychologist or a specialist nurse. This can last anywhere from six weeks to six months. The therapist will help the patient to distinguish thoughts from behaviours and set them tasks to complete each week in order to challenge these behaviours and break the patterns associated with them. The therapist will help to separate the different components of the problem at hand in order to encourage the patient to make sense of how these factors can be managed individually, rendering the situation less overwhelming.

What more can be done?

Like many mental health problems, OCD is not always recognisable to others and it is often a condition that sufferers feel unable to discuss.

There has been successful coverage of the way it can dominate people’s lives in soaps such as Hollyoaks and Eastenders. But the condition has also received less helpful attention in psychological thrillers such as ‘Sleeping with the Enemy’ and more recently ‘Black Swan’. It’s also sometimes mistaken and misconstrued as being ‘anally retentive’.

Much more needs to be done in terms of awareness and raising the public’s understanding of this mental health problem.


I work with people who experience all kinds of mental illness, which can take over their lives unless something is done to help them. OCD is certainly one of these. So next time you hear someone describing his or her behaviour as “OCD” I dare you to challenge them.

Image credit: justmakeit via flickr.