Obsessive Compulsive Disorder (OCD) Overview

OCD (obsessive compulsive disorder) is a mental health condition which causes obsessive thoughts and the need to carry out compulsive behaviours. It varies in how much it can get in the way of someone carrying out everyday activities. OCD usually starts presenting in someone during early adulthood. OCD affects an estimated 750,000 people in the UK.

What are the signs and symptoms of OCD?

Some examples of signs of OCD in an individual may include:

  • Obsessive and intrusive thoughts which repeatedly enter a person’s head and trigger feelings of disgust or anxiety, for example
  • Compulsive behaviours which give the illusion of helping to relieve the feelings triggered by the intrusive thoughts.

Some pregnant women may develop OCD for the duration of their pregnancy and post-partum. An example of a compulsive behaviour relating to the baby may be repeatedly checking they are still breathing.

How does OCD get diagnosed and treated?

OCD can be difficult to diagnose as people often feel ashamed of their symptoms.

The easiest way to access treatment is through self-referral to a mental health service, or to go via a GP who can assess symptoms in conversation with the person to determine the need to access treatment.

The most common treatments are antidepressant medicines known as SSRIs (selective serotonin reuptake inhibitors) which help alter brain chemistry. This can help with obsessive thoughts.

A person with OCD will often undergo therapy alongside medication to tackle the underlying cause of their OCD, such as a major life event that may have triggered the person to develop a coping mechanism for difficult emotions.

OCD may also occur in someone with autism and is often seen alongside anxiety and depression. Therapy can help the person deal with the psychological manifestations of these conditions too.

There are a few ways to determine whether an employee with OCD might require reasonable adjustments:

The employee may or may not wish to disclose their OCD, as many people feel shame regarding their OCD. Regardless, questions regarding the nature of any additional needs and what extra support may be required can be broached sensitively. For example:

  • Have they required adjustments in the past? It is important that an employer does not jump to conclusions or assumptions based on their existing understanding of OCD, which is often misunderstood by people who do not have the condition.

What reasonable adjustments are possible for employees with OCD?

Employers have a legal duty to make reasonable adjustments for employees with OCD if they know, are aware of, or could ‘reasonably be expected to know’ that the employee has OCD. Most employees will tell their employer what reasonable adjustments they need. They often involve simple changes in the way an employer might usually do things.

If the employee does not disclose a health issue or disability which may affect their performance up front, an employer should broach the subject sensitively if they suspect that there may be a disability behind the employee’s reduced performance. Reasonable adjustments can then be made in accordance with the employee’s needs, including, in the case of OCD:

  • Extra time to complete tasks to accommodate difficulties the person may have juggling work tasks and compulsions.
  • A structured working day to allow the employee to concentrate more easily and to allow them to make use of their ability to pay great attention to detail, as is often the case for someone with OCD.
  • Providing regular, sensitive feedback and reassurance, so that an employee with OCD who may come across as particularly vulnerable to criticism, or stressed in a work environment, can stay abreast of what they are doing well, or what they could improve on.
  • Time off to attend appointments, so that the person can work on recovery while staying in work.
  • Flexibility regarding working from home if the employee struggles with their OCD when in public or around other people. Contamination fears are common in people with OCD – they may worry about spreading or picking up germs from others.
  • Raising awareness so that colleagues understand the employee’s OCD and can help ensure the employee feels comfortable at work. This might involve learning more about the condition to gain a better understanding of what the employee might be facing day-to-day.

OCD Signposting

OCD UK – charity providing evidence-based support to people living with OCD, supporting them in their recovery with resources and advice, and through the current Covid-19 pandemic (03332 127890).

OCD Action – charity working towards better public understanding of OCD and quicker diagnosis and treatment timelines, as well as providing resources for people with OCD, including an online discussion forum (0845 390 6232).

Mind – mental health charity with resources and advice to support someone with OCD and the impact this may have on their mental health (0300 123 3393).

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