Mind Game: Obsessive Compulsive Disorder

An estimated 2.3 percent of adults are afflicted with Obsessive Compulsive Disorder (OCD), according to the National Institute of Mental Health, and for many, the symptoms begin during childhood or adolescence.

This anxiety disorder is a neurological malfunction that creates unrelenting, intrusive thoughts and extreme anguish for those affected. Obsessions may range from a fear of hitting someone while driving, to unbearable worries about contamination.

These fears can be alleviated only one way—by acting out compulsions, which become repetitive acts of checking and rechecking to ensure the fear is unfounded.

Although OCD was added to the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-III) in 1987, many people still live with its destruction unaware there is help or even a name for their bizarre fears and behaviors.

Furthermore, “Families often don’t know that they have a sick child,” says Judith L. Rapoport, M.D., author of The Boy Who Couldn’t Stop Washing. Children may keep their obsessions and compulsions a secret in order to avoid appearing crazy.

The devastation of OCD is not just seen in the adult or child with the disorder. OCD has a negative impact on the whole family, which often falls apart from the stress caused by the disorder. It is not unusual for the OCD sufferer to rely on family members to help alleviate his fears. He may insist that a child, parent, or spouse check electrical outlets or may badger loved ones with constant questions for reassurance.

In some homes where fear of contamination is the obsession, family members are banned from certain rooms or areas of the home to prevent them from contaminating the areas. Family members may also be required to live up to unreasonable standards of cleanliness in order to satisfy the OCD person.

In other homes, compulsions such as hoarding are so out of hand that the home literally becomes a maze in which family members must maneuver through narrow trails, dodging tall stacks of boxes, newspapers, or whatever is hoarded.

What’s the Cause?
To understand the OCD mind, many researchers explain that the brain is stuck, in a sense, and replays a particular thought over and over again, like a broken record. In other words, it tricks the sufferer, and she cannot trust her own judgment.

Those who don’t understand OCD often ask the affected, “Why don’t you just stop?”

But it isn’t that simple. Researchers believe the disorder to be neurobiological, and therefore, the obsessions are not a matter of choice. Differences have been found in the brain of OCD sufferers through brain-imaging techniques. Some studies have found abnormalities in the neurotransmitters, such as serotonin.

The occurrence of OCD is also higher in families with depressive and anxiety disorders. For most, there is no known event that relates to their particular obsession(s). Nevertheless, researchers feel that environmental stressors may at least play some role in the development of OCD for those who are biologically predisposed.

Is There Help?
Although there is no known cure for OCD, there are a number of treatments available. Caution should be used in weighing treatment options, as some are not supported by a preponderance of evidence. Questionable treatments for OCD include psychotherapy, hypnotherapy, psychosurgery, and electroconvulsive therapy (ECT).

The two most common, effective, and proven forms of treatment available for OCD are psychotropic drugs and behavioral therapy. Many doctors suggest medication in combination with behavioral therapy, which teaches techniques to relieve or stop the intrusive thoughts and to control compulsive behaviors.

The severity of untreated OCD generally tends to worsen over time and can become completely debilitating. If someone in your family has symptoms of OCD, contact your mental health provider for a confidential evaluation.

Although there is no cure for OCD, with proper treatment many OCD sufferers are able to lead normal and productive lives. BW

Common Obsessions

• Fear of running over someone while driving
• Fear of contamination
• Fear of harming others
• Fear of blurting obscenities or insults
• Preoccupation with a part of the body
• Violent, horrific, or disgusting images
• Superstitions or persistent thoughts of lucky/unlucky colors, etc.
• Extreme concern with religious issues, values, or morals

Common Compulsions

• Repeated checking of doors, ovens, locks, plugs, etc.
• Repeated rituals such as counting, going in and out of doors a number of times, etc.
• Excessive arranging and rearranging
• Hoarding or collecting mail, newspapers, food, etc.
• Repeated confessions or asking repeated questions for reassurance
• Prolonged or repeated bathing or hand washing
• Repeatedly checking for mistakes
• Repeatedly drawing up lists