Obsessive Compulsive Disorder (OCD)

• A woman visits her dermatologist, complaining of extremely dry skin and seldom feeling clean. She showers for two hours every day. Do you think its illness?
• A lawyer insists on making coffee several times each day. His colleagues do not realize that he has doubt that coffee is contaminated with poison and he feels compelled to pour most of it down the drain. The lawyer is so obsessed with these thoughts that he spends 12 hours a day at work -- four of them worrying about contaminated coffee.
• A doctor cannot bear to throw anything away. Junk mail, old newspapers, waste papers doubting that all "could contain something valuable that might be useful someday." If he throws things away, "something terrible will happen." He hoards so much clutter that he can no longer walk through his house. Insisting that nothing be thrown away, he moves to another house where he continues to hoard.
• These people suffer from obsessive-compulsive disorder (OCD). Nearly one out of every 40 people suffer from OCD at some point in their lives. The disorder is approximately two times more common than schizophrenia and bipolar disorder.
• OCD is often described as "a disease of doubt." Sufferers experience "pathological doubt" because they are unable to distinguish between what is possible, what is probable, and what is unlikely to happen.

What is Obsessive-compulsive disorder?

Obsessions are intrusive, irrational thoughts or unwanted ideas or impulses that repeatedly keep coming in a person's mind. Again and again, the person experiences disturbing thoughts, such as "My hands must be contaminated; I must wash them"; "I may have left the gas stove on"; "I am going to injure my child." The most important thing is that at one level, the sufferer knows these obsessive thoughts are irrational. But on another level, he or she fears these thoughts might be true. Trying to avoid such thoughts creates great anxiety.

Compulsions are repetitive rituals such as hand washing, counting, checking, hoarding, or arranging. An individual repeats these actions, perhaps feeling momentary relief, but without feeling satisfaction or a sense of completion. People with OCD feel they must perform these compulsive rituals or something bad will happen.

Most people at one time or another experience obsessive thoughts or compulsive behaviors. Obsessive-compulsive disorder occurs when an individual experiences obsessions and compulsions for more than an hour each day, in a way that interferes with his or her life.

Who gets OCD?

People from all walks of life can get OCD. It strikes people of all social and ethnic groups and both males and females. Symptoms typically begin during the teenage years or young adulthood.

What causes OCD?

In layperson's terms, something in the brain is stuck, like a broken record. A large body of research suggests that OCD results from a chemical imbalance in the brain. For years, mental health professionals incorrectly assumed OCD resulted from bad parenting or personality defects. This theory has been disproved over the last 20 years. OCD symptoms are not relieved by psychoanalysis or other forms of "talk therapy," but there is evidence that behavior therapy can be effective, alone or in combination with medication. People with OCD can often say "why" they have obsessive thoughts or why they behave compulsively. But the thoughts and the behavior continue.

People who suffer from head injury sometimes develop OCD. Clinical researchers have implicated certain brain regions in OCD. They have discovered a strong link between OCD and a brain chemical called serotonin. Serotonin is a neurotransmitter that helps nerve cells communicate.

Scientists have also observed that people with OCD have increased metabolism in the basal ganglia and the frontal lobes of the brain leading to repetitive movements, rigid thinking, and lack of spontaneity. It has been observed that People with OCD often have high levels of the hormone vasopressin.

How do people with OCD react to their disorder?

People with OCD generally attempt to hide their problem rather than seek help like other mental illness. Often they are successful in concealing their obsessive-compulsive symptoms from friends and co-workers. An unfortunate consequence of this attitude is that people with OCD generally do not receive professional help until years after the onset of their disease. By that time, the obsessive-compulsive behavior may be deeply ingrained and very difficult to change.

How long does OCD last?

Spontaneous recovery in OCD is rare. So it is important to seek treatment. Although symptoms may become less severe from time to time, OCD is a chronic disease. Fortunately, effective medications and other forms of treatment are available that make life with OCD much easier to manage.

Is age a factor in OCD?

OCD usually starts at an early age, often before adolescence. It may be mistaken at first for other psychiatric conditions (e.g. autism, pervasive developmental disorder, Tourette's syndrome).

Is OCD commonly recognized by professionals?

OCD is often under diagnosed and misdiagnosed. Many people with OCD may present with symptoms of other psychiatric illness like; schizophrenia, bipolar disorder, generalized anxiety disorder. Research shows that OCD, anxiety disorders, Tourette's, and eating disorders such as anorexia and bulimia can be triggered by some of the chemical malfunctioning of the brain.

Can OCD be effectively treated?

Yes, with medication and behavior therapy OCD can be effectively treated. However the outcome of the treatment depends on duration and severity of illness. Medication can regulate chemical imbalances, reducing obsessive thoughts and compulsive behaviors. Commonly used medication to treat OCD are: Escitalopram, Fluoxetine, Fluvoxamin, Clomipramine.

What is behavior therapy, and can it effectively relieve symptoms of OCD?

Behavior therapy is not traditional psychotherapy. One type of behavior therapy is "exposure and response prevention (ERP)" which is effective for many people with OCD. In ERP Patients are deliberately exposed to a feared object or idea, either directly or by imagination, and are then discouraged or prevented from carrying out the usual compulsive response. For example, a compulsive hand-washer may be urged to touch an object he or she believes is contaminated and denied the opportunity to wash for several hours. When the treatment works well, the patient gradually experiences less anxiety from the obsessive thoughts and becomes able to refrain from the compulsive actions for extended periods of time.

Several studies suggest that medication and behavior therapy are equally effective in alleviating symptoms of OCD. However the best results can be obtained with combination of both medication and behavior therapy.

Response to treatment varies from person to person. Most people treated with effective medications find their symptoms reduced by about 40 percent to 50 percent. That can often be enough to change their lives, to transform them into functioning individuals.