By Grant J Everett
Nepean Hospital hosted a forum called An Evening with OCD and Me to raise awareness about Obsessive Compulsive Disorder. Dr Vlasios Brakoulias ran the event, and he’d invited along quite a few highly-accomplished experts who specialise in the many different facets of OCD, including the psychological, pharmaceutical and behavioural aspects.
The yummy snacks we ate before the forum are worth mentioning, as they were all individually wrapped and presented in such a way that nobody would have to worry about contamination. This attention to detail spoke volumes about the empathy of the staff.
More than hand-washing
Many people think that having OCD just means you want to wash your hands too much or are a stickler for detail. However, OCD has a very broad range of components, and the specific symptoms any given person can experience can vary a lot. Sure, you might have heard of the more common ones, like a fear of germs and repeatedly checking things, but there’s far more to OCD than that. The OCD spectrum can go to extremes in exact opposite directions, too. For instance, while one person may have an overpowering need for symmetry and tidiness in their home, another will exhibit hoarding behaviours and stack their entire house to the ceiling with random junk and garbage.
The heart of OCD, of course, is what’s going on within the person. The “unseen” symptoms of OCD can be extremely distressing, and often include uncontrollable intrusive thoughts about scary, revolting, or shameful things.
Persistent feelings of unfounded shame can nibble away at a person over years and years and make them feel as though they are an awful human being. Also, many people with OCD will feel responsible for things that they actually had no involvement with – like tragedies they see on the news, or stuff that happens to their distant loved ones – and this can easily become an endless cycle of ruminating and beating themselves up. It kind of goes without saying that constantly being at war with your own mind will significantly interfere with your ability to concentrate and function.
The outside part of OCD – the rituals and compulsions – are actually coping methods that people with the condition will use to try to manage their unseen anxieties. In this context, a “compulsion” is something that a person with OCD will feel driven to perform over and over again to bring relief from their invasive thoughts and feelings. Unfortunately, any respite that these behaviours provide is only temporary, and actually only serves to reinforce the obsession, creating an ever-worsening cycle of OCD. Avoiding people, things or places that the person associates with their anxiety is also considered to be a compulsion, and can be just as damaging in the long run.
In case you’re saying, “Wow, I think I have OCD!” it’s worth noting that most people will experience low-level compulsions from time to time, especially during severely stressful life events. But for a person to be diagnosed with clinical OCD, they have to tick all of these boxes:
1. Their compulsions must take up an hour (though often much more) of their time each day
2. These compulsions must cause serious distress
3. The compulsions must interfere with their day-to-day functioning
Experts and warriors
Dr Brakoulias has dedicated his career to studying, understanding, treating and spreading awareness about OCD. Dr Brakoulias began by founding a long-term study into OCD at Pialla unit back in 2007, and over that time he’s strived to provide an effective person-centred service that actively promotes recovery. One way he’s carried out this mission is by running a monthly OCD group, which has been faithfully attended by a dozen participants who have a lived experience. Many people from this group were at the forum, and three of them got up to the podium to bravely share in-depth stories about their hardships and victories.
Our very own Jarrod Wellman from Figtree Conference Centre was the first one up to the stand, and he spoke with great insight about his long trip. Following Jarrod’s speech, a man in his early twenties shared how experiencing severe OCD has made it almost impossible for him to work, and how difficult it is to be treated as a “bludger” by people who assume he’s using his condition as an excuse. The final speaker was a lady who’s been fighting with the condition since 1965 when she was only thirteen years old. She told us how her belief in God and the responsibilities of raising a family were two of the biggest factors that helped her to deal with the hardest times. Finally, once the participants had finished, Jarrod’s dad Robert Wellman absolutely dominated the forum when he went up to speak from the perspective of a support person. He had the room in stitches, and shared some very perceptive things.
The assorted Doctors and Professors had a lot to say, too! Professor Vladan Starcevic, a man who has authored many books on the subject of OCD, spoke at length about medications and their level of usefulness. He explained that the symptoms of OCD can be so broad that treating it requires a person to be dealt with on an individual basis. Unfortunately, medications have a very limited efficacy with OCD, but they are still of some use. A specific class of antidepressants known as SSRIs (selective serotonin reuptake inhibitors) and a separate antidepressant known as Clomipramine are the most popular drugs used for treating OCD.
Dr David Berle spoke about the usefulness of psychological treatments such as CBT (Cognitive Behavioural Therapy). CBT is a combination of “talking” and “doing” therapy, and Dr Bell estimated that between twelve and twenty sessions can provide a lot of relief and coping skills. He also stressed the urgency of early intervention, and how important it is for parents to not “accommodate” OCD behaviours in their children, even if the kid is very young. Once OCD becomes ingrained it is hard to shift, which is why it has to be addressed early.
Brian Skepper, a clinical psychologist, talked to us about shame and its relationship with OCD. Brian told us that feelings of severe shame are a silent epidemic, and that rather than hiding these difficult feelings we need to be open with the people who are closest to us so we can rely on them for support. After all, by its very nature, shame isolates people. A very interesting point that Brian made was that although shame and guilt may sound like the same thing, they aren’t. While shame is a feeling that can exist with no real basis, guilt is something that you will only feel after doing something that breaks your own moral code in some way. Shame is what often lies at the very core of a person’s compulsions.
Dr Denise Milicevic is from the Nepean Anxiety Disorder Clinic, and her particular speciality is hoarding behaviours. During a chat with her, I was thrilled to hear that Dr Milicevic is an avid Panorama reader. Thanks, Dr Milicevic!
The official presentation started at 6pm and lasted for two hours, but it went by in a flash. This was followed by a meet-and-greet in the foyer involving some great insights (and far too much caramel slice). I felt as though I’d really gotten a lot out of the forum, so thanks to Robert and Jarrod Wellman for inviting me along, and to Dr Brakoulis for running it. All the doctors and other professionals really knew their stuff, and I’d like to thank them all for a very informative and interesting couple of hours.
- OCD will often present in teenage years or early twenties
- The World Health Organisation has ranked OCD in the top ten of the most disabling illnesses you can have, a list that also includes quadriplegia and Alzheimers
- OCD affects both genders equally
- The severity of OCD can increase and decrease over time for no apparent reason