Quick question

Which of the below four people have obsessive-compulsive disorder (OCD)?

  1. the person who wants everything to be in order otherwise something awful will happen tomorrow
  2. the person who re-checks their email draft because they are afraid they’ve said something inappropriate
  3. the person who washes their hands so they don’t spread contamination to loved ones
  4. the person who is shocked by their own thoughts and wonders if they are some unstable or evil human


It could be any (or none) of the above.

OCD could be the world’s most misunderstood mental illness.


What is OCD?

OCD is a process of thought or action that keeps repeating and has a big impact on someone’s life.

It doesn’t matter whether is about contamination, harm, thoughts, symmetry or something else. The content of OCD is only limited by the human imagination. It looks different for different people.

OCD is so diverse that it’s more helpful focus on what’s common.

Everyone who lives with OCD shares three experiences:

  1. Unwanted (and uninvited) thoughts, mental images, urges or ideas. The impact of these can range anywhere between unsettling to horrifying. People want to get rid of these. We call these obsessions.
  2. Repetitive thoughts or actions they do to get rid of those feels from the obsessions. We call these compulsions.
  3. The above two are affecting their life, wellbeing, performance or something else in a significant way. We call this disorder.

Here’s a little more about OCD.

What’s the impact?

In Australia, one in 50 people live with OCD in any given year. If they all came together you’d need to fill the MCG five times.

When you add up the impact of OCD on each day, it takes a person out of their role (either at home, in the family, at work) an average of around 6 days in any given month. That’s a lot of missing out of life.

Worse, OCD usually first strikes somewhere between childhood to just when someone is getting the hang of “adulting” (i.e., early 20’s). These are both pretty important times in life. OCD can interfere with how they learn to view themselves and their world.

Shame, stigma and stereotypes prevent people from seeking help. People often don’t realise they have OCD. Instead, they think they are crazy (to clarify, they are not!). To complicate things, psychological treatment is quite specialised. Put this all together and the research shows that it takes around 10 years between when OCD strikes and people begin effective treatment.

Help is available

A specific form of Cognitive Behaviour Therapy, called Exposure and Response Prevention has strong evidence for its effectiveness. If that doesn’t work, there are other emerging treatment options. There are also specific medication options. Often it helps to combine therapy and medication (talk to your GP to work out what is right for you).

The psychological treatment for OCD requires some specialised knowledge skills beyond standard therapy. Any person who is a registered psychologist can have these skills (or develop them fairly quickly), but not all do.

I’ve spoken to too many people who have had trouble finding someone who provides Exposure and Response Prevention… or knows what to do when it doesn’t work. Their stories are heartbreaking. Their suffering is deep and real. The 10 years I mentioned above? That’s an average in the research. For some people it’s multiple decades before they find good help.

That’s why I created a directory of clinicians in Australia with a special interest in treating OCD. Mental health professionals apply to listed so that people with OCD can find them easier. You can view this at OCD.org.au.

I’m also researching how we can improve treatment and provide evidence-based psychological therapy for OCD.