I too was diagnosed quite late in life, having first experienced OCD at 8 years of age. When the OCD got worse in my early twenties I began to oscillate between periods of overt ritualistic behaviour and severe depression during which I became 'immobile' and, on rare occasions, suicidal.

Three separate psychiatrists failed to diagnose OCD (or if they did they weren't letting me in on the diagnosis) and I eventually endured four years of psychoanalytical therapy which was of no value to me at all (having lightened my bank account of $10,000).

It was only when I read a book on the subject that I realised what I had. I then sought help from a specialist OCD unit in Britain. The rituals have not greatly improved with treatment but the depression is under much better control.

The key to my modest success has been Cipramil (only 10 mg daily), cognitive therapy and, most importantly, reading other people's accounts of the disease.

I believe every patient should become an expert in their own illness. A thorough knowledge of OCD is the key to tackling the daily symptoms endured by sufferers. Of course, reading medical literature on the subject can become a obsession in itself (fueling endless ruminations) but it is patronising of physicians to assume that self-help measures cannot be undertaken by OCD sufferers.