OCD Treatment and Therapy in Singapore

What is OCD?

Obsessive Compulsive Disorder (OCD) is a mental health condition characterised by persistent thoughts that drive unwanted mental acts and physical behaviours. OCD thoughts and their associated repetitive behaviour rituals can be very time-consuming and disruptive, creating a huge negative impact on your mental health and quality of life.

The two core symptoms of OCD are:

• Obsessions: Unwelcome thoughts, unpleasant mental images, frightening impulses, and/or irrational fears that cause significant distress. OCD obsessions typically intrude at inopportune times, are very difficult to ignore, and keep coming back.
• Compulsions: Compulsive, repetitive behaviours that provide temporary respite from the distressing intrusive thoughts. OCD compulsions often become heavily ritualised and time-consuming, and can significantly interfere with daily life.

If you have Obsessive Compulsive Disorder, you will usually experience both obsessive thoughts and compulsive behaviours. However, some people experience only one of these two major symptoms.

OCD left untreated can lead to the development of other forms of mental illness, so it's vital to seek help from an OCD specialist as soon as possible. Professional treatment can help you to reduce or eliminate your symptoms and enjoy a happier, healthier lifestyle.

What Are Common OCD Symptoms?

Obsessive Compulsive Disorder does not manifest in the same way for every individual. However, people with OCD often experience similar unwanted thoughts and/or common compulsions.

• Fear of being dirty or contaminated
• Fear of something terrible happening to loved ones
• Fear of causing something terrible to happen yourself
• Distressing sexual or religious thoughts
• Desire to self-harm or harm others
• Excessive handwashing and cleanliness
• Repeatedly checking on things (e.g. door locked, oven turned off)
• Arranging things to be perfectly ordered or symmetrical
• Ritualistic counting (often preoccupied with certain numbers)
• Unwillingness to throw things away (hoarding)

What Is It Like to Have OCD?

People may go to a counselling session for many different reasons. Often, it’s to get help in overcoming a specific issue or set of issues that is negatively impacting their quality of life. Some common examples include:

• Distressing thoughts that won’t go away
• Unhealthy behaviours (e.g. smoking, gambling)
• A fear or phobia (e.g. spiders, flying)
• Going through a divorce or separation
• Difficulty relaxing and/or sleeping
• Loss or illness of a loved one
• High levels of stress, worry, and/or anger
• Persistent feelings of sadness

In other cases, a person may be motivated to pursue self-growth, address other current or future concerns, or simply want professional advice on how to improve their overall mental health – similar to someone hiring a personal trainer in order to improve their overall physical health.

Your individual counselling experience may also encompass career counselling, life coaching, and other aspects of personal growth and emotional well-being.

You may have heard the term "OCD" used to refer to people who are very clean, neat, or orderly. However, OCD is not simply a desire for things to be tidy, or arranged in a certain way, or performed in a particular order. It is a debilitating condition that can cause immense distress, and can severely interfere with your ability to function at work, school, or home.

For example, someone with Obsessive Compulsive Disorder might be bothered by unwanted thoughts about germs. They may think that their hands become exposed to germs each time they touch a "contaminated" object. To reduce anxiety caused by this germs fear, they will engage in the compulsive behaviour of washing their hands far more than is normal or necessary - even to the point of scrubbing their skin raw. But the relief never lasts, and before long, the cleaning rituals need to be enacted again.

Often, people who have OCD recognise that their intrusive thoughts and repetitive behaviours are abnormal, irrational, or excessive. They may suspect that what they are experiencing is a mental illness, even if they have not yet received an OCD diagnosis.

What Causes OCD?

The exact causes of Obsessive Compulsive Disorder are not yet known. However, there are several known risk factors that increase the likelihood of someone developing OCD.

Genetic predisposition may play a role in whether someone will develop Obsessive Compulsive Disorder. Women are three times more likely to develop OCD than men. You are also much more likely to be diagnosed with OCD if one of your immediate family members has it. According to one study review, the likelihood of inheriting OCD from a parent with the same condition may be as high as 50%.

People with Obsessive Compulsive Disorder often have other mental health conditions. According to a large-scale US survey, 90% of respondents with OCD also had another mental illness such as severe depression, bipolar, or anxiety. However, because depression usually occurs after OCD has already developed, this diagnosis may result from the psychological difficulties of living with OCD.

You may be at higher risk of developing Obsessive Compulsive Disorder if you experienced interpersonal traumatic events during childhood, such as abuse or neglect, overly strict or otherwise dysfunctional parenting, or your parents going through a messy divorce. Non-interpersonal traumatic events, such as surviving a car accident, are not thought to increase risk.

A child or young teen may develop Obsessive Compulsive Disorder shortly after contracting a streptococcal infection (strep throat). This diagnosis is called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcus, or PANDAS for short. As most kids contract streptococcal infections and make full recoveries, the odds of PANDAS occurring are very low.

Psychological Treatment for OCD

There are several types of therapy with high success rates for managing or even overcoming Obsessive Compulsive Disorder. Some people respond better to certain therapies than others. Your therapist will work with you to tailor a programme of treatment to your specific situation and needs

Cognitive Behavioural Therapy (CBT) is a conversational form of therapy that identifies negative thoughts and feelings that lead to unhealthy behaviours. By working to adjust the thoughts and feelings that trigger obsessions and compulsions, CBT can transform harmful mental patterns and behaviours into healthy ones. Cognitive Behavioural Therapy is well regarded by mental health professionals as an effective way to treat OCD.

Eye Movement Desensitisation and Reprocessing (EMDR) is a newer type of psychotherapy that was originally developed for healing PTSD. It has since also become known as an effective treatment for other mental illnesses, including OCD. EMDR helps you to reprocess the habitual thoughts and feelings that occur when you have an obsessive or compulsive reaction, thereby reducing your psychological distress.

Another behavioural therapy with high treatment efficacy for OCD is Exposure and Response Prevention (ERP), also known as Aversion Conditioning. ERP involves repeated and prolonged exposure to situations that typically cause you distress. Starting with exposure to your least anxiety-provoking situation, the therapy then escalates to more challenging exposure tasks as your comfort levels increase.

In some cases, medication increases treatment efficacy. Drug treatment with selective serotonin reuptake inhibitors (SSRIs) can help to relieve the symptoms of Obsessive Compulsive Disorder, in conjunction with behaviour therapy. If necessary, your therapist can work with your family doctor to arrange a prescription for you.

However, SSRIs tend to provide only temporary relief, which ends as soon as you stop taking the medication. They can also have unpleasant side effects, such as lethargy, weight gain, agitation, and insomnia. If you are medicating as part of OCD treatment, the best approach is to take a short-term course of drugs to relieve the worst immediate symptoms, while engaging in psychological treatment to tackle the root causes of your condition and provide long-term relief.