Child and adolescent MH

The National & Specialist OCD, BDD and Related Disorders Service

A Psychiatry Trainee’s perspective

Feb 5, 2019

4
min read

When I was in my second year at medical school, I signed up for a charity blind date night, in which entrants would pay £5 to be set up on a blind date with another student. With trepidation, I rode my bike into town to meet my blind date. Turns out, he was another medical student – in fact I already knew him. He was a well-liked, out-going, highly extroverted and often silly young man in our year – the sort of person who would sign up to a university talent competition as a belly dancer and win (which he did). The sort of person that you would never expect to have a serious mental health disorder (which he also did).

“What I like most about the National OCD & BDD Service is that they keep things simple. OCD is a highly treatable condition and the team has a great success rate for getting young people back on their feet.”

On our third date, he told me that he had OCD (Obsessive Compulsive Disorder). Over the course of the next few months, I found out more about how his OCD affected him and how, behind that bubbly and happy exterior, he was fighting against sexual and violent intrusive thoughts that frequently made him cry with anxiety. Seeing how such a vivacious, intelligent and outgoing young man could often be crippled by thoughts not in his control, highlighted to me just how powerful the mind – and mental illness – can be.

Following on from this experience, I became increasingly interested in mental health, especially OCD. When I moved to clinical school, I arranged for my elective placement to be in an OCD inpatient facility and met another young man struggling with the condition. He told me that his greatest achievement over the past 8 months was simply being able to eat a biscuit that someone else had given him. This young man’s OCD created “rules” that he had to follow regarding food and where it came from. The overwhelming power of his OCD meant that he was essentially starving to death – unable to resist the increasingly complex compulsions that his OCD made him do, in response to his high levels of anxiety. For years following my meeting with this patient, his story stuck with me, and it was after this that I knew I wanted to become a psychiatrist.

I started my core psychiatry training with SLaM in 2017. Right from the start, I knew that I wanted to work with people with OCD and anxiety disorders. Fortunately, I was allocated a job with the National & Specialist OCD, BDD and Related Disorders Service for young people at the end of last year, and I began working with the team 6 months ago. This team is the only specialist service in the UK for children and young people with these conditions. The team is made up of three doctors and twelve clinical psychologists who provide medical and psychological treatment for OCD and BDD. Over the course of 6 months, I have met a large number of young people who suffer with these conditions, and I have been struck by how debilitating they can be.

OCD and BDD stops young people from reaching their full potential at school, from doing activities they used to enjoy, and sometimes from even hugging the people they love. OCD and BDD infiltrate into family life, making young people and their family members perform increasingly complex rituals in order to temporarily alleviate the anxiety experienced by that young person. But, as long as young people and their family continue to perform these compulsive behaviours, OCD will continue to thrive and increase its demands.

What I like most about the National OCD & BDD Service is that they keep things simple. OCD is a highly treatable condition and the team has a great success rate for getting young people back on their feet. With a combination of ERP (Exposure Response Prevention therapy) and the right medication, the team helps patients to fight back against their OCD by encouraging them to resist the urge to perform their compulsions, as they learn that the anxiety that evokes always comes back down and will eventually go away completely.

Despite the high effectiveness of treatment offered, I have been impressed with how the team are also passionate about improving the treatment for OCD and BDD. There are currently a number of research projects that members of the team are working on. These include the development of Multi-Family Group therapy (MFGs), to give families of patients with OCD the opportunity to meet other families in similar circumstances, and work through CBT tasks together in a collaborative manner. The team have also been working hard to ensure that every child or young person with OCD are able to access treatment, no matter what their background or social circumstances. The Ethnicity Project was set up last year in an attempt to increase awareness of OCD in the SLaM local boroughs, by providing workshops and teaching presentations in local schools in an attempt to improve referral rates of patients from different ethnic backgrounds. The team are also proactive in going out to local services across the country to teach them more about how to recognise and treat OCD and BDD. We have also recently helped produce a video to improve awareness of OCD and the numerous ways in which it can present (www.ocdisnotme.com).

I am now in my final few days of this placement and I have been reflecting on what a fantastic team this is. Every day, I am struck by how passionate my colleagues are in fighting OCD and BDD, and helping to give young people their lives back. What has been even more rewarding is seeing how young people have been empowered by the treatment offered here, and more able to fight back against OCD and BDD, enabling them to live more fulfilling and meaningful lives.

Author
Dr Jessica Coffin

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