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What is obsessive-compulsive disorder? Obsessive-compulsive disorder (OCD) is an illness that causes people to have unwanted thoughts (obsessions) such as, "My hands may be contaminated and I must continually wash them" and to repeat certain behaviors (compulsions) over and over again. We all have habits and routines in our daily lives, like brushing our teeth before bed. However, people with OCD have patterns of behavior that get in the way of their daily lives. Obsessive-Compulsive Disorder (OCD) can be devastating. Especially when you don't know what it is: a common treatable illness. Being diagnosed as OCD is nothing to be ashamed of. It's the first step in treating the illness. OCD is not a sign of weakness or flaw. And it's not your fault. It is an illness with multiple causes. And it is treatable. Intense anxiety and even panic can come whenever the person attempts to stop the ritual. The tension and anxiety build to such an intense degree that he surrenders once again to the thoughts or behaviors. Unlike an alcoholic, who feels compelled to drink but also enjoys the drinking experience, the obsessive-compulsive person achieves relief through the ritual but no pleasure. Most people with OCD know that their obsessions and compulsions make no sense, but they can't ignore or stop them. Common Features of Obsessions and Compulsions There are seven common features of obsessions and compulsions. The first three are related to obsessions and worrying in general; the last four are for people who experience both obsessions and compulsions. Listen to which ones fit you.
What are obsessions? Obsessions are ideas, images and impulses that run through the person's mind over and over again. A person with OCD doesn't want to have these thoughts and finds them disturbing, but he or she can't control them. Sometimes these thoughts just come once in a while and are only mildly annoying. Other times, a person with OCD will have obsessive thoughts all the time. The following are some common obsessions:
What are compulsions? Obsessive thoughts make people with OCD feel nervous and afraid. They try to get rid of these feelings by performing certain behaviors according to "rules" that they make up for themselves. These behaviors are called compulsions. (Compulsive behaviors are sometimes also called rituals.) For example, a person with OCD may have obsessive thoughts about being afraid of germs. Because of these thoughts, the person may spend hours washing his or her hands after using a public toilet. Performing these behaviors usually only makes the nervous feelings go away for a short time. When the fear and nervousness return, the person with OCD repeats the routine all over again. The following are some common compulsions:
How common is OCD? For many years, OCD was thought to be rare. The actual number of people with OCD was hidden, because people would hide their problem to avoid embarrassment. Some recent studies show that as many as 3 million Americans ages 18 to 54 may have OCD at any one time. This is about 2.3% of the people in this age group. No one completely understands the cause of OCD. However, research suggests that it is the result of a chemical imbalance of neurotransmitters, the substances which send messages between nerve cells in the brain. One of the most important neurotransmitter is serotonin and an imbalance of serotonin may be responsible for OCD behaviour. This serotonin imbalance can be corrected with certain medications. Are other illnesses associated with OCD? People with OCD often have other kinds of anxiety, like phobias (such as fear of spiders or fear of flying) or panic attacks. They often have depression too. About 70% of adults with OCD have an episode of major depression at some time in their lives. Alcohol and drug abuse can become problems when people with OCD turn to these substances for relief. Only a few disorders seem to be related to OCD. These disorders include hypochondriasis (fear of being seriously ill when you aren't sick at all), dysmorphophobia (extreme concern with a small or imagined body defect) and trichotillomania (a compulsion to pull out your own hair). They usually respond to the same medicines that are helpful in treating OCD. Many individuals are able to keep their obsessive compulsive symptoms under control during the hours they are at work or school and can be remarkably successful in concealing their symptoms from friends a co-workers. How is OCD Treated? Drug therapy is used to restore chemical imbalances of the brain. OCD can also be managed with cognitive behaviour therapy - a gradual approach, through understanding and changing habits, to reducing obsessions and re-learning behaviour. Many medical professionals think a combination of the two is most effective. Several medicines are available to treat OCD. These medicines include: clomipramine (brand name: Anafranil), fluoxetine (brand name: Prozac), sertraline (brand name: Zoloft), paroxetine (brand name: Paxil) and fluvoxamine (brand name: Luvox). These drugs can cause side effects such as dry mouth, constipation and drowsiness. Sometimes they also affect a person's sexual performance. It may be several weeks before a person with OCD notices the benefits of his or her medicine. Under the guidance of a trained therapist, behavioral therapy can also be used to treat OCD. In behavioral therapy, people face situations that produce their obsessions and anxiety. Then they are encouraged not to perform the rituals that usually help control their nervous feelings. For example, a person who is obsessed with germs might be encouraged to use a public toilet without washing his or her hands more than once. To use this method, a person with OCD must be able to tolerate the high levels of anxiety that can result. Over time, behavioral therapy can make the symptoms of OCD go away. OCD Self-Assessment Questionnaire The following questionnaire will help you identify the types of problems that most trouble you. Read through the statements listed and note the ones that are true for you. If you note two or more items in any group, this is an indication that you should specifically address those concerns in your self-help program. Don't be surprised if you check more than one item in several groups. Many people have more than one type of OCD symptoms. A. What Symptoms Bother You? Note each item that has troubled you in the last month. Washing and Cleaning ___ 1. I avoid touching certain things because of possible contamination. ___ 2. I have difficulty picking up items that have dropped on the floor. ___ 3. I clean my household excessively. ___ 4. I wash my hands excessively. ___ 5. I often take extremely long showers or baths. ___ 6. I'm overly concerned with germs and diseases. Checking and Repeating ___ 1. I frequently have to check things over and over again. ___ 2. I have difficulty finishing things because I repeat actions. ___ 3. I often repeat actions in order to prevent something bad from happening. ___ 4. I worry excessively about making mistakes. ___ 5. I worry excessively that someone will get harmed because of me. ___ 6. Certain thoughts that come into my mind make me do things over and over again. Ordering ___ 1. I must have certain things around me set in a specific order. ___ 2. I spend much time making sure that things are in the right place. ___ 3. I notice immediately when my things are out of place. ___ 4. It is important that my bed is straightened out impeccably. ___ 5. I need to arrange certain things in special patterns. ___ 6. When my things are rearranged by other, I get extremely upset. Hoarding ___ 1. I have difficulty throwing things away. ___ 2. I find myself bringing home seemingly useless materials. ___ 3. Over the years my home has become cluttered with collections. ___ 4. I do not like other people to touch my possessions. ___ 5. I find myself unable to get rid of things. ___ 6. Other people think my collections are useless. Thinking Rituals ___ 1. Repeating certain words or numbers in my head makes me feel good. ___ 2. I often have to say certain things to myself again and again in order to feel safe. ___ 3. I find myself spending a lot of time praying for non-religious purposes. ___ 4. "Bad" thoughts force me to think about "good" thoughts. ___ 5. I try to remember events in detail or make mental lists to prevent unpleasant consequences. ___ 6. The only way I can stay calm at times is by thinking the "right" things. Worries and Pure Obsessions While I do not engage in any behavioral or thinking rituals: ___ 1. I often get upset by unpleasant thoughts that come into my mind against my will. ___ 2. I usually have doubts about the simple everyday things I do. ___ 3. I have no control over my thoughts. ___ 4. Frequently the things that pop into my mind are shameful, frightening, violent, or bizarre. ___ 5. I'm afraid that my bad thoughts will come true. ___ 6. When I start to worry I cannot easily stop. ___ 7. Little, insignificant events make me worry excessively. B. In the past month, how much time have you spent, on an average day, engaged in these symptoms. Note the hours or minutes for each.
Now total up the number of hours and minutes you listed in part B. If you spend more than two hours each day obsessing or ritualizing in any type of symptoms, you may need professional help in guiding you through this program. ___ 7. Little, insignificant events make me worry excessively. B. In the past month, how much time have you spent, on an average day, engaged in these symptoms. Note the hours or minutes for each.
Now total up the number of hours and minutes you listed in part B. If you spend more than two hours each day obsessing or ritualizing in any type of symptoms, you may need professional help. |