Surge in Australians seeking treatment for Obsessive Compulsive Disorder
As more and more Aussies show symptoms of Obsessive Compulsive Disorder, sufferer Stephanie Moring candidly reveals her lifelong journey with the condition.
Stephanie Moring fights her preoccupation with crafting.
While such creative pursuits sound benign, she crafts to help manage obsessive-compulsive disorder (OCD).
Rather than the handwashing, counting or lining up objects perfectly typically associated with the condition, Moring, 40, says her particular diagnosis of Pure OCD is driven by “rituals” that are mental and unseen.
“The intrusive thoughts tend to be around taboo topics, like self-harm. It was a very confusing and distressing time because I couldn’t tell if I was suicidal or not, which I’m sure sounds strange, but that’s all part of the doubting disorder,” the North Sydney digital marketer says.
It’s also exactly why she now delves into a rainbow of activities.
“The idea is just to be doing something mindful and creative where there’s no focus on the outcome,” she says.
“I’d buy these colourful bracelets that may have seemed juvenile but I just needed something positive as I was very upset with the idea of not being around anymore.”
Moring admits she still doesn’t understand why garbage cans, police cars, odd numbers and objects such as street arrows that point down all seem negative.
“I didn’t, and still don’t, like pressing the down button for volume or the airconditioner,” she says.
“It’s well managed but I’m well aware that random things like going to dinner with friends or even getting a haircut will bring up intrusive and irrational thoughts.”
OCD is no laughing matter.
In its uncontrolled form, it can be monstrous, with obsessions (intrusive, distressing thoughts) and compulsions (actions undertaken to relieve anxiety) unleashing hell on sufferers’ work and personal lives.
QIMR Berghofer researchers are a step closer to discovering what causes the condition, after finding changes in how distinct brain regions communicate.
Lead researcher Dr Sebastien Naze says the results confirm the disorder likely emerges from a “complex imbalance” that affects “signalling pathways deep within the brain”.
“Participants with OCD were shown to have an imbalance affecting distinct pathways and regions of the brain, which are linked to emotion regulation and reward,” Dr Naze says.
“We aren’t the first researchers to find it but ... this gives us some important clues about what’s causing the disease and how these brain changes could be corrected to reduce symptoms.”
The condition is listed by the World Health Organisation as one of the top 10 most disabling illnesses in terms of lost income and reduced quality of life.
OCD is also associated with high school and work absenteeism, high psychiatric comorbidity, significant functional impairment for both individuals and their families, and an annual loss of $3.4bn to the Australian economy.
FEARS HEIGHTENED
The Covid pandemic saw a significant rise in Sydney patients seeking treatment.
Dr Samantha Tang and Katie Dobinson, clinical psychologists at St Vincent’s Hospital, say there was an increase, particularly via the institution’s This Way Up online treatment programs.
“We saw a 522 per cent increase in monthly OCD program registrations during 2020, when compared with the previous year,” they say.
“Research indicates that OCD will affect approximately 4 per cent of Australians at some point in their lives. We also know from research that the average length of time it takes for an individual to seek treatment for mental health difficulties is seven years.
“As society learns more about OCD, and stigma continues to reduce, we see more people identifying symptoms and seeking treatment. However, we are also aware that many people suffering from OCD may not seek treatment due to a range of reasons, such as stigma, cost, access to supports, or limited awareness.”
Since May 2022, the hospital has registered 1411 people seeking treatment.
Sydney clinical psychologists say concerns about contracting the virus and transmitting it to others, plus compulsive behaviours such as excessive handwashing or cleaning, were heightened due to the lockdowns.
“Research has found that symptoms often got worse (for people with OCD) during the early part of the pandemic, especially in people who worry about contamination,” clinical psychologist Mitchell Howarth says. “Some people even started experiencing new symptoms related to Covid-19.
Howarth also suggests that the condition could be familial.
“Mental health conditions like OCD are never really caused by one thing. They are usually the result of our nature (genetics we inherit from our parents) and nurture (experiences we have throughout our lives),” he says.
Dr Jodie Lowinger, founder of The Anxiety Clinic in Bondi Junction and bestselling author of The Mind Strength Method, says: “The overall stress and uncertainty caused by the pandemic might have impacted individuals with OCD, as the condition thrives on uncertainty.
“The constant updates on case numbers, public health guidelines and news reports may have contributed to heightened anxiety and obsessions.
“There was difficulty accessing treatment due to lockdowns, so we established a digital practice which enabled us to extend our services to people far and wide. It enabled us to help those who otherwise would not have had access to people with expertise in the treatment of OCD.”
THE TREATMENTS
Adam Guastella, clinical psychologist and University of Sydney professor of child and youth mental health, shares a story about one of his clients, a young woman who wasn’t able to leave the house because she was worried a burglar would break in.
In these situations, he uses cognitive behaviour therapy (CBT), a goal-oriented treatment that focuses on changing behaviour, working with clients’ thoughts and feelings, and using evidence to guide actions and judgments.
“We started looking at evidence like crime rates in the area she lived in and the likelihood that she would be broken into,” he says.
“We would start with leaving one window open. With each step she would gain confidence that perhaps the house wouldn’t be broken into. We got to the point where she was able to walk out of the house for two hours and come back. This would have made many people anxious, but we had to show her that she didn’t need to respond to those feelings.”
The longer OCD remains undiagnosed and untreated, the more crippling it becomes. For now, Dr Tang believes a combination of psychological (talk therapy) and pharmacological interventions (medications) is the most effective treatment.
Then there’s transcranial magnetic stimulation (TMS), suggested by Guastella, which involves using a magnetic coil to stimulate the brain.
“There is growing evidence that circuit-based methods like TMS and brain stimulation can be effective,” Guastella says
“The federal government has supported its use for depression and we might see down the track these treatments ... approved for disorders like OCD.
“There’s a lot of interest around whether we can directly target the brain circuits.”
As more and more people “come out” about their own experiences with the disorder – which affects about 3 per cent of the population – it’s important to realise that, with appropriate treatment, those impacted can lead normal lives.
Famous figures like soccer superstar David Beckham have opened up about living with OCD: “I’ve got this obsessive-compulsive disorder where I have to have everything in a straight line or everything has to be in pairs. I’ll put my Pepsi cans in the fridge and if there’s one too many then I’ll put it in another cupboard somewhere,” Beckham said in a 2006 ITV1 interview.
While OCD’s onset typically coincides with adolescence, Howarth says children can experience similar symptoms.
“Like adults, kids with OCD spend a lot of time doing their compulsions. This can involve things such as hand washing, asking for reassurance from parents that bad things won’t happen, organising things and avoiding certain activities,” he says.
Lowinger’s final message is simple: “Don’t suffer in silence when the right evidence-based strategies with a trained clinical psychologist can turn lives around and help people move from ‘anxiety’ to ‘action’. Help for OCD is about learning to sit with the discomfort of uncertainty – an increasing challenge in an increasingly uncertain world.”
IT’S NOT ALL BAD
For me, the condition has felt like a driving force for success.
I was unusually committed to colour-coded items and counting, as well as a clean, organised bedroom growing up.
In my teen years, I was well-groomed, efficient and punctual at school events and university lectures. By early adulthood, I was very independent, living alone earlier than most and relying on my daily rituals to keep me accountable and in check.
Over the years, therapists said my obsessive behaviour was obstructing my wellbeing, and that my goal of perfection was unattainable.
Recently, my therapist and I dabbled in a particular exercise which involved dividing my thoughts and feelings into three different versions of me. I would move between three chairs (all identical) and talk about life as a ‘pedantic ruler’, ‘inner leader’ and ‘vulnerable child’.
My therapist would ask a simple question and, depending on what chair I’m sitting on, I would answer as that person.
The aim of the game is to better understand my feelings and events from the past.
My inner leader is the calm, rational one, while the vulnerable child shares inner fears.
Then there’s the pedantic one, the one who drives my compulsions and forces me to abide by a mental ‘rule book of shoulds’. Everything ‘should’ be in a certain way or order.
Despite the pitfalls, I credit my enduring love of detail with helping, rather than hindering, my career as an editor.
Don’t get me wrong; there are days when cleaning and tidying rituals seem like an endless chore, but I still feel they’re a way for me to stay in control.
Whether you’re a person who washes their hands hundreds of times a day (and still doesn’t feel clean), or the hoarder and listmaker who frets over not having collected enough rubbish in their house (and makes lists of everything they do), there is help available.
OCD Bounce, a research collective between the University of New South Wales, Griffith University and the Sydney Children’s Hospitals Network, is a good place to start. For more details, visit ocd.org.au
Men’s Health Week (June 12-18) is celebrated every year around the world. The theme for 2023 in Australia is Healthy Habits.
Lifeline: 13 11 14
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Kids Helpline: 1800 55 1800
Originally published as Surge in Australians seeking treatment for Obsessive Compulsive Disorder
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