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OCD
What is OCD?
Obsessive-compulsive disorder (OCD), one of the anxiety disorders, is a potentially disabling condition that can persist throughout a person's life. The individual who suffers from OCD becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing but extremely difficult to overcome. OCD occurs in a spectrum from mild to severe, but if severe and left untreated, can destroy a person's capacity to function at work, at school, or even in the home.
The case histories in this brochure are typical for those who suffer from obsessive-compulsive disorder--a disorder that can be effectively treated. However, the characters are not real.
How Common Is OCD?
For many years, mental health professionals thought of OCD as a rare disease because only a small minority of their patients had the condition. The disorder often went unrecognized because many of those afflicted with OCD, in efforts to keep their repetitive thoughts and behaviors secret, failed to seek treatment. This led to underestimates of the number of people with the illness. However, a survey conducted in the early 1980s by the National Institute of Mental Health (NIMH)--the Federal agency that supports research nationwide on the brain, mental illnesses, and mental health--provided new knowledge about the prevalence of OCD. The NIMH survey showed that OCD affects more than 2 percent of the population, meaning that OCD is more common than such severe mental illnesses as schizophrenia, bipolar disorder, or panic disorder. OCD strikes people of all ethnic groups. Males and females are equally affected. The social and economic costs of OCD were estimated to be $8.4 billion in 1990 (DuPont et al, 1994).
Although OCD symptoms typically begin during the teenage years or early adulthood, recent research shows that some children develop the illness at earlier ages, even during the preschool years. Studies indicate that at least one-third of cases of OCD in adults began in childhood. Suffering from OCD during early stages of a child's development can cause severe problems for the child. It is important that the child receive evaluation and treatment by a knowledgeable clinician to prevent the child from missing important opportunities because of this disorder.
Key Features of OCD
Obsessions
These are unwanted ideas or impulses that repeatedly well up in the mind of the person with OCD. Persistent fears that harm may come to self or a loved one, an unreasonable concern with becoming contaminated, or an excessive need to do things correctly or perfectly, are common. Again and again, the individual experiences a disturbing thought, such as, "My hands may be contaminated--I must wash them"; "I may have left the gas on"; or "I am going to injure my child." These thoughts are intrusive, unpleasant, and produce a high degree of anxiety. Sometimes the obsessions are of a violent or a sexual nature, or concern illness.
Compulsions
In response to their obsessions, most people with OCD resort to repetitive behaviors called compulsions. The most common of these are washing and checking. Other compulsive behaviors include counting (often while performing another compulsive action such as hand washing), repeating, hoarding, and endlessly rearranging objects in an effort to keep them in precise alignment with each other. Mental problems, such as mentally repeating phrases, listmaking, or checking are also common. These behaviors generally are intended to ward off harm to the person with OCD or others. Some people with OCD have regimented rituals while others have rituals that are complex and changing. Performing rituals may give the person with OCD some relief from anxiety, but it is only temporary.
Insight
People with OCD show a range of insight into the senselessness of their obsessions. Often, especially when they are not actually having an obsession, they can recognize that their obsessions and compulsions are unrealistic. At other times they may be unsure about their fears or even believe strongly in their validity.
Resistance
Most people with OCD struggle to banish their unwanted, obsessive thoughts and to prevent themselves from engaging in compulsive behaviors. Many are able to keep their obsessive-compulsive symptoms under control during the hours when they are at work or attending school. But over the months or years, resistance may weaken, and when this happens, OCD may become so severe that time-consuming rituals take over the sufferers' lives, making it impossible for them to continue activities outside the home.
Shame and Secrecy
OCD sufferers often attempt to hide their disorder rather than seek help. Often they are successful in concealing their obsessive-compulsive symptoms from friends and coworkers. An unfortunate consequence of this secrecy is that people with OCD usually do not receive professional help until years after the onset of their disease. By that time, they may have learned to work their lives--and family members' lives--around the rituals.
Long-lasting Symptoms
OCD tends to last for years, even decades. The symptoms may become less severe from time to time, and there may be long intervals when the symptoms are mild, but for most individuals with OCD, the symptoms are chronic.
What Causes OCD?
The old belief that OCD was the result of life experiences has been weakened before the growing evidence that biological factors are a primary contributor to the disorder. The fact that OCD patients respond well to specific medications that affect the neurotransmitter serotonin suggests the disorder has a neurobiological basis. For that reason, OCD is no longer attributed only to attitudes a patient learned in childhood--for example, an inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable. Instead, the search for causes now focuses on the interaction of neurobiological factors and environmental influences, as well as cognitive processes.
OCD is sometimes accompanied by depression, eating disorders, substance abuse disorder, a personality disorder, attention deficit disorder, or another of the anxiety disorders. Co-existing disorders can make OCD more difficult both to diagnose and to treat.
In an effort to identify specific biological factors that may be important in the onset or persistence of OCD, NIMH-supported investigators have used a device called the positron emission tomography (PET) scanner to study the brains of patients with OCD. Several groups of investigators have obtained findings from PET scans suggesting that OCD patients have patterns of brain activity that differ from those of people without mental illness or with some other mental illness. Brain-imaging studies of OCD showing abnormal neurochemical activity in regions known to play a role in certain neurological disorders suggest that these areas may be crucial in the origins of OCD. There is also evidence that treatment with medications or behavior therapy induce changes in the brain coincident with clinical improvement.
Recent preliminary studies of the brain using magnetic resonance imaging showed that the subjects with obsessive-compulsive disorder had significantly less white matter than did normal control subjects, suggesting a widely distributed brain abnormality in OCD. Understanding the significance of this finding will be further explored by functional neuroimaging and neuropsychological studies (Jenike et al, 1996).
Symptoms of OCD are seen in association with some other neurological disorders. There is an increased rate of OCD in people with Tourette's syndrome, an illness characterized by involuntary movements and vocalizations. Investigators are currently studying the hypothesis that a genetic relationship exists between OCD and the tic disorders.
Other illnesses that may be linked to OCD are trichotillomania (the repeated urge to pull out scalp hair, eyelashes, eyebrows or other body hair), body dysmorphic disorder (excessive preoccupation with imaginary or exaggerated defects in appearance), and hypochondriasis (the fear of having--despite medical evaluation and reassurance--a serious disease). Genetic studies of OCD and other related conditions may enable scientists to pinpoint the molecular basis of these disorders.
Other theories about the causes of OCD focus on the interaction between behavior and the environment and on beliefs and attitudes, as well as how information is processed. These behavioral and cognitive theories are not incompatible with biological explanations.
Do I Have OCD?
A person with OCD has obsessive and compulsive behaviors that are extreme enough to interfere with everyday life. People with OCD should not be confused with a much larger group of individuals who are sometimes called "compulsive" because they hold themselves to a high standard of performance and are perfectionistic and very organized in their work and even in recreational activities. This type of "compulsiveness" often serves a valuable purpose, contributing to a person's self-esteem and success on the job. In that respect, it differs from the life-wrecking obsessions and rituals of the person with OCD.
Source:
National Institutes of Health
National Institute of Mental Health
NIH Publication No. 99-3755
Printed 1991, Revised 1994, Revised September 1996, Reprinted 1999
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Hi,
My symptoms are just like yours. I am always trying to fine tune my diagnosis and have convinced and unconvinced myself that I am every mental case in the universe. Actually, I think I'm a mixed bag with OCD and Depression. Don't know which is worse. I've had symptoms for 20 years and have had times when I've been completely symptom free. The jumping out of a window and train thing are really easy obsessions to deal with...Some of the best advice I ever got was that the best thing to do is to Laugh at your OCD whenever you can. That takes away its power. I think meds are fine but good counseling with Behavior Cognitive Therapy is a must. Settling your mind with some meditation, it takes practice, is so beneficial. Pick up some Buddhist readings and allow your mind to heal. Remember, the mind always wants to return to a state of homeostatis. You are not Mad. OCD brains are some of the best in the world! We just have to learn how to throttle 'em back. Good Luck and Stay Positive! (Fri Jul 27 22:55 2007) Hello everyone! This is a very encouraging website and its good to hear from other peoples experience.
My problem is i have suffered from depression/anxiety since i was in my teens but have never had any diagnosis. I've been given anti-depressants several times - just started on prozac - and had very general counseling but don't feel like i really understand what 'condition' i have.
I tend to worry alot about by mental health and i convince myself i have schizophrenia and so keep reading about it and convincing myself despite the symptoms to not match up with the way i feel.
Also every time i see a window i think im going to jump out of it or if i see i train i think i will jump under it even though i don't feel suicidal as such. Before starting Prozac i just couldn't cope and had loss of appetite trouble sleeping and very depressed moods.
When i was a teenager i remember being convinced that the side of my face was caving in.
Could these symptoms/experiences add up to OCD? Would be great to be able to understand my condition better rather than think i am going mad. (Thu May 24 16:18 2007) I have struggled with OCD as long as I can remember. Now I am married with children. One of my biggest challenges is that my husband does not seem to understand OCD and thinks I am just being silly/lazy/selfish when I have problems with it. Does anyone have any suggestions? (Fri Aug 18 10:33 2006) I think I may have ocd, but I'm not sure. It started out when a pet who meant so much to me died. I kept doing things to check that she was still ok/there. I've been trying to just overcome it on my own, and its been working okay. But how do I know if I really have it, and I should be doing something else to help me get over it? (Tue Feb 7 23:15 2006) I was wondering if anyone knows if OCD can get worse suddenly, My girlfriend has the disorder and is fine but i worry that it could suddenly become much worse. Is that a possibility? I just want to be able to help her and am scared the disorder could take her over without me being able to get her therapy or some other help. I don't want to lose her to this. She's fine now, and barly shows any symptoms, but she has told me if she gets too stressed it gets much worse. (Wed Nov 2 0:24 2005) I know I used to have this disorder. I think it started with ADHD and got to OCD in a couple years, then I got depressed for the next couple of years, and now I working off that OCD, while I try to make my High School Golf Team.
Life is tough. Hi Sach, learn as much as you can about OCD. Understanding the frustration for both you AND your partner is very helpful in coping. Do not be an "enabler" to the rituals that your boyfriend has. Meaning, let him do them (you can't stop him), but do not partake in it. For example if he asks you to repeat a word more than once or something. Don't.
Also is he seeing a therapist? Therapy is key in controlling OCD.
I have had OCD as far back as I can remember. I did not think it could be cured. It was time consuming, and debilitating and embarrassing. I saw a therapist, was prescribed Zoloft and I am happy to say I am now symptom free. Therapy and medication is what I personally needed.
Please let him know that you support him, and there is help out there.
You are good to ask. Good luck.
(Fri Sep 3 21:55 2004) How the disorder affects your relationship is dependent on how well the gentelman chooses to respond to his symptoms from the disorder as they occur. Does he have help in knowing how to handle them so that they interfere only minimally in his everyday life or not at all? And more importantly how badly does he want to live a productive life in spite of his illness? You must be very determined to avoid acting on the impulses that often occur because of the nature of the illness. The illness (disorder)makes you beleive that you have to perform senseless rituals and compulsions to avoid disaster when really it is the irrational senseless behaviors that end up causing a person inflicted with the disorder their majority of their big problems. These behaviors can cause a great deal of embarrassment and alot of time lost if you get caught up in them. I have this disorder myself so I know. It caused alot of trouble to my marriage and other relationships before I learned about the disorder and started practicing "Behavior Therapy" and got some support from other sufferers. i have just recently become serious in a relationship with a gentleman with ocd. he is 34 and has been struggling with this since he was 11. how will this affect any kind of future relatioship we may have? i really want this to work, but i want to know how to help or what i should do.. (Wed Jul 9 13:08 2003) |
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