OCD is not a throwaway line

Being 'a bit OCD' seems to be turning up more and more in everyday conversation. It's a jolly way of saying you like things a bit neater or more in straight lines than the average person.

Except that's not what OCD is at all. A recent tweet by Stephen Fry along similar lines is discussed in this powerful piece by David Adam, where he examines what's wrong with talking about OCD as a minor behavioural quirk:

This matters for two reasons. First: the more that OCD is cemented in the public consciousness as a trivial and superficial tic, the more that misleading impression damages vulnerable people. It takes real courage to confront mental distress and seek help. Yet when people with OCD do so, they often find bafflement and hostility, even from within the medical profession. If OCD is simply someone who washes their hands then why is this patient telling me of unwanted thoughts to hurt their children? If OCD is someone who lines up their DVDs in alphabetical order, then is this teacher who wonders if she knocked someone down in her car last night and compulsively calls hospitals to make sure she didn't, safe to carry on working? Those aren't hypothetical examples. Parents with OCD are separated from their families. Workers are suspended from their jobs, but not because they pose any threat. One of the defining features of obsessive thoughts is that they are unwanted; we don't act on them. They get treated in that way because their symptoms either weren't recognised as OCD or because the reality of OCD was blurred by the popular misconception.

Second: people with OCD get their information from the same sources. We believe OCD is something else. If OCD is angst about symmetrical cakes then what is wrong with me? Why can't I shake these crazy ideas about catching HIV from my cat? Why do I think about having sex with next door's rabbit? Those too are genuine OCD examples. And here's the killer line: they are the kind of weird thoughts that everybody has from time to time. OCD is when they get stuck.

OCD is listed by the World Health Organisation as one of the 10 most debilitating illnesses in the world. Despite this, it's still mainly hidden, and misunderstood, Adam describes it as:

a disorder of thought: harrowing, distressing, torturing, impossible-to-shake thought. That's the O in OCD – obsession – and it's what causes most of the D from the same abbreviation. (It stands for disorder but means distress.) Ironically, the compulsions, the C in OCD, the most visible and least understood feature of the condition, are almost always what we do to make ourselves feel better. Compulsions are a response to an obsessive irrational thought.

We still don't know why our mental wiring goes disastrously wrong like this, and chemical and therapeutic treatments are still quite trial-and-error. Adam points out that there is a gap of over 10 years between people first experiencing the symptoms, and going for help (more of his story here). A lot of this is the stigma attached to mental health problems, particularly such extreme and irrational thoughts - who would want to own up to them? But this is a mainstream mental health problem, affecting roughly 1 in 100 people (probably more, as it's under-reported). 

So if you're just 'a bit OCD', be thankful, be very very thankful. 

MPs and Mental Health - in praise of politicians

Whilst David Cameron had his day before the judge last week, his fellow MPs were doing something quite amazing. During a debate on mental health, several of them spoke in public for the first time of their struggles with mental illness - depression, OCD and the like.

Kevan Jones, MP for Durham North, said he had "thought very long and hard" about whether to speak publicly about his mental health problems.

"In 1996 I suffered from quite a deep depression related to work issues and other things going on in my life at that moment," he said in the Commons.

"Like a lot of men, you try and deal with it yourself. You don't talk to people. I just hope you realise, Mr Speaker, what I'm saying is very difficult right now."

He said it was important to talk about mental health in Parliament because "we are... in politics designed to admit that somehow if you admit fault or frailty you are going to be looked upon in a disparaging way, in terms of both the electorate and your peers as well".

He "didn't know" whether his admission would affect how people viewed him or his career prospects but added: "I actually don't care now because if it helps other people who have suffered from depression in the past - good."

Full marks to our politician for this one, it's great to hear of the positive feedback they've received, and it's starting to feel like things are changing in our attitudes to mental illness, that we're becoming more understanding and sympathetic. A Private Members Bill is due soon to tackle discrimination against people with mental health conditions.

Channel 4 have a season of programmes on mental health coming up,  something which the BBC did a couple of years ago.

But all this has to be seen in the light of yesterdays report into mental health services in the UK, which was scathing in it description of what's offered to the mentally ill at the moment. I was startled  by the stat that half of all ill-health in the under 65s is mental illness, and the report claims that 3/4 are not getting the proper treatment. Though sadly that's not surprising - my experience at local level is that GPs are far less clued up on mental illness than they are on physical illness, and local specialist services are under-resourced. So all of the above is a start, but there is a long way to go.

A Personal Experience of Obsessive Compulsive Disorder

This week is OCD Awareness Week, and here's a snippet from one persons account of their OCD:

OCD all started for me on Christmas Day 1980. I was eight years old and, after the excitement and over-indulgence of the day, vomited in the late evening. I recall my Mums' words very clearly; “you've eaten far too much and made yourself sick”. From there, I developed an irrational fear of vomiting. Every evening I would lie in bed waiting for my Mum to check on me so I could ask “I'm not going to be sick am I Mum? It's all in my mind”. OCD was born.

I look back on my childhood with sadness. A time which should be protected from fear. A time which should be carefree and without worry was a time of endless angst. I feared electrical plugs being left in and would sleep at night with the plug from my electric blanket against my face. It seemed the only way to be sure it wasn't still plugged in. I rocketed from one anxiety to another with no respite in between. Nobody recognised a child who was suffering. I was “just a worrier”.

In my late teens my anxieties receded. I was able to complete a psychiatric nursing qualification and met and married my husband aged 21. I secured a job and purchased my first house. Life was just as I dreamed.

And then OCD returned.

The fear of vomiting returned. I became preoccupied with the need to repeatedly check best before dates on food. I would seek continual reassurance from my husband that my meal was okay for me to eat. I lost count of the number of carefully prepared meals which had to be thrown away as the fear could not be quashed. I began to develop fears in my work. “What if I give someone the wrong medication”, “What if I give someone an injection which paralyses them”. The compulsion to check my work to quell my anxieties was overwhelming. I felt trapped in an endless cycle of anxiety, check, anxiety, check. It was exhausting.

It was in 1995 where I reached breaking point.
read the rest here

OCD affects about 750,000 people in the UK. For many of these, the fear of what others will think prevents them every telling anyone else, and stops them from going to their GP. Removing the sense of stigma will mean that 3/4 of a million people don't need to suffer in silence.

Short notice I know, but if you're one of my millions of Somerset readers (ok, you both know who you are) there's an event in Bath this evening. Other events later this week.

Mental Health & OCD: Watching our Language

Yesterday was world mental health day, and this week is OCD Awareness Week. Obsessive Compulsive Disorder is rated by the World Health Organisation as one of the top 10 most debilitating illnesses you can have. It affects around 2% of the population at one time or another.

a few links
on the role of churches in mental health, good piece from the Huffington Post.

A Mind campaign to tackle the stigma of mental health problems has just had extra funding from the government and Comic Relief

The MOD has just launched an initiative aimed at supporting those suffering mental illness as a result of war.

Good primer on OCD here, it's aimed at teenagers but pretty good for adults too.

BBC piece on how we use terms like 'obsessive compulsive' and 'schizophrenic' as adjectives for other things, often reinforcing mistaken views of what the terms mean, and what's involved in having these illnesses. A snippet:

The flippant use of such terms nowadays may offend some and not bother others. But such a dynamic is part of the words' evolution, says Joel Rose, director of OCD Action.

"Five years ago people wouldn't have known what you were talking about if you mentioned OCD," he says. "Now they have a sense of what it is about and use it, but don't really fully understand it. The next five years will be about working to fully educate people.

"What we want people to understand is how serious and debilitating OCD can be. We're talking about people who might clean a floor repeatedly for eight hours or someone who can't leave the house. It's not having a tidy house or arranging the tins of food in your cupboard. We also want to get across that it is treatable."

Indeed, many of those diagnosed with the condition have successfully learned to manage it. Overcoming its metaphorical use, however, may prove more difficult.