Obsessive Compulsive Disorders: Providing Support

Obsessive Compulsive Disorder

“So what do I do when she comes back from break and has to clean her whole desk and equipment before she starts work again?”

Many of us do things that are quirky. We check the lights, the iron, or the locks before we get on with our day. Some of us repeatedly check these things and some of us get so caught in the process that we are unable to get to work.

What is Obsessive Compulsive Disorder?

Obsessive-Compulsive Disorder is characterized by recurrent obsessions and/or compulsions that are severe enough to be time consuming or cause marked distress or significant impairment. Obsessive-Compulsive Disorder is made up of two parts; obsessions and compulsions. Obsessions are persistent, disturbing, intrusive thoughts, ideas, images or impulses which cause marked anxiety. You may be able to relate to this. It is similar to the anxiety that you may feel thinking that you left the stove on high that morning before you left for work. Compulsions are repetitive behaviors or mental acts that are done to prevent or reduce this anxiety or distress that is experienced.

For most of us, our quirky behaviours do not interfere with our ability to maintain a job or look after ourselves or our families. But for about 1.5% of the population, these obsessions and compulsions are so severe that the person is unable to lead a productive, healthy life.

Most individuals with Obsessive Compulsive Disorders fall into five categories:

Washers – fear contamination and usually have cleaning compulsions
Checkers – repeatedly check things like ovens, irons, etc.
Doubters and Sinners – fear terrible things will happen if all not perfect
Counters and Arrangers – ruled by magical thinking and superstitions
Hoarders – can’t throw things away, if they do terrible things will happen

These may seem rather mild, but when put into context you can see how OCD can be so debilitating. Not just washing your hands 9 or 10/day, but 100 times a day, and to the point where you are removing the skin from your hands and making yourself more susceptible to the germs and infections that you are trying to avoid.

The A&E show, Hoarders, documented the struggles of people who could not part with their belongings and the roads they took to recovery. It was not just about collecting. It showed the incredible anxiety that these people faced and how the possessions helped to sooth those anxieties. Their health and their life was at stake.

This is one of the saddest of all the mental illnesses as it usually begins in childhood to early adulthood. It impacts our young children. The average age of onset for males is 6 – 15 years old, while with females, it is 20 – 29 years old.

OCD is not about choice or intelligence. It is about incredible anxiety that overtakes a person’s life and the behaviours that they do, to try and deal with that anxiety. Beverly Beuermann-King Click to tweet

Treatment for Obsessive Compulsive Disorder

Treatment options were not very successful, but usually involved behaviour modification. It wasn’t until the discovery that antidepressants helped to reduce the anxiety that behaviour modification became more successful. Now many people with OCD can live very productive and successful lives.

As leaders who may deal with someone with OCD, remember that:

it is not about choice, but about anxiety
stress plays a role in making the symptoms more severe and the behaviours more ingrained

In the case above, the desk cleaning wasn’t interfering with her job. However, if it had, the leader would be best advised to find useful strategies that would enable the employee to get her area cleaned and not let it bleed into her job duties.

Guidelines when working with someone with OCD:

(1) Recognize signals and watch for behavior changes.

Signals to watch for include, but are not limited to:

Large blocks of unexplained time that the person is spending
Doing things again and again (repetitive behaviors).
Constant questioning of self-judgment; excessive need for reassurance.
Simple tasks taking longer than usual.
Perpetual tardiness.
Increased concern for minor things and details.
Severe and extreme emotional reactions to small things.
Inability to sleep properly.
Daily life becomes a struggle.

People with OCD usually report that their symptoms get worse the more they are criticized or blamed, because these emotions generate more anxiety.

(2) Modify expectations. People with OCD consistently report that change of any kind, even positive change, can be experienced as stressful. It is often during these times that OC symptoms tend to flare up. You can help to moderate stress by modifying your expectations and by using validating, supportive, and encouraging statements.

(3) Remember that OCD symptoms are different for each person. Just as there is a wide variation between individuals regarding the severity of their OCD symptoms, there is also wide variation in how rapidly individuals respond to treatment.

(4) Recognize “small” improvements. People with OCD often comment that no one understands what it takes to accomplish something such as cutting down the number of times they wash their hands or clean their desk. While these gains may seem insignificant, it is a very big step. Acknowledgment of these seemingly small accomplishments is a powerful tool that encourages them to keep trying.

(5) Support taking medication as prescribed and understand that all medications have side effects that range in severity. Show empathy around their mediation challenges.

(6) Keep communication clear and simple. There is always that lingering “What if?” for the person with OCD. Recognize that the person with OCD is triggered by doubt. Avoid lengthy rationales and debates.

(7) Don’t let it become all about the OCD. Have conversations that are “symptom free,”. It is okay not to ask, ”How is your OCD today?”

(8) Consider using a contract if the OCD is impacting the person’s ability to do their job. These may include accommodations for when the anxiety becomes overwhelming.

Support Can Make All The Difference

Your ability to understand and work with someone who has a mental illness can make all the difference in their ability to be successful. Often someone with a mental illness does not disclose the challenges they are facing because they:

wonder if you will be supportive, reject them or even know or understand what OCD is
fear being passed over, fired, forced out or blacklisted
worry what people around the office will think if they also found out
worry that they’ll regret their decision
fear not being trusted with important tasks or responsibilities

Canada became the first country in the world to release a national standard for mental health in the workplace. The standard is voluntary, but it is designed to help organizations and their employees improve their workplace psychological health and safety. One of the ways to do this is to be a supportive leader and make it possible for people with mental illnesses to be as productive as they can be in our workplaces. We know that mental illness has an impact on the organization, the rest of the workforce, as well as the individual. To promote understanding and reduce the stigma around illnesses such as OCD, organizations can sponsor workshops on stress management and specific mental illnesses, bring in a peer-support speaker to talk about their OCD experiences, facilitate the formation of work-based support groups or invest in mental health-specific programs such as mental health first aid training for front-line supervisors. Mental illness makes it difficult for those experiencing them to be successful and productive, but not impossible. By taking some of the steps we described, we make it easier for us all to be engaged, successful and healthy.

If you have some strategies to share – comment on this posting!