Obsessive compulsive disorder

Is the experience of obsessing familiar to you? Do you sometimes find yourself obsessing about something for hours and hours? Do these obsessions cause you a lot of anxiety? If you do, then there is a chance you might be suffering from OCD, or obsessive compulsive disorder. OCD is a fairly common mental disorder present in about two percent of the population, and is characterized by recurrent thoughts that cause anxiety to the sufferer. These thoughts can be about anything, not just cleanliness as it is often erroneously presented. OCD obsessions may very well be about word phrases, people, situations in our life whether real or imagined and pretty much anything else you might think of.

Those obsessions are known to cause compulsions. Just like obsessions, compulsions can present themselves in any imaginable way, be it a certain bodily gesture, a ritual or very often a completely mental act like counting numbers in your head or trying to push the thought away.

OCD can be a very serious problem, and while some OCDers deal with it fairly well by themselves, anyone suffering from OCD should seek treatment, and anyone who suspects they might have OCD should try and get themselves diagnosed.

While the causes for OCD are not completely clear, the most popular medical theory is to do with a physiological dysfunction of a certain part of the brain that's in charge of stopping and starting thoughts, due to a misfiring of certain neurons. That means that anyone, from any cultural and social background can have OCD. OCD was found to be present in mammals other than humans, such as dogs.

Most OCDers (about 80%) also suffer from frequent depression. While OCD can't be healed at this time, it can be treated extremely effectively.

The best known treatment for OCD today is a combination of cognitive behavioral therapy (CBT), which is a special form of psychological treatment combined with drug treatment of the selective serotonin reuptake inhibitor family (SSRI), such as Prozac and more recently Paxil. This type of treatment has astounding success rates with 95% of the patients exhibiting great improvement in their situation.

If you want to get a preliminary diagnosis for OCD, check out http://www.mentalhealth.com/ for an online diagnosis procedure. Note that this test, as admitted by the original authors, should not be considered final! It diagnosed me as not having OCD, while two psychologists afterwards did. If you disagree with the results and suspect you might have OCD nonetheless, try any of the below listed online resources as jumpstart points.

http://www.ocdhelp.org/faq.html (FAQ)
http://members.aol.com/afocd/afocd.htm (Resource Center)
http://www.ocdresource.com/ (Resource Center)

http://www.ocdhelp.org/ (Resource Center)

While it is probably true that many psychological disorders and diseases are over-diagnosed, there are people who suffer from things like OCD who truly do exactly that, suffer. For those people, drugs like Prozac and Paxil can literally save their lives.

SSRI drugs work something like this: Seratonin is a neurochemical that is naturally released by the brain into the bloodstream to help one's mind and body cope with anxiety-inducing or extremely stressful situations. When the increased levels of seratonin are no longer needed in the bloodstream, the brain re-collects it. An SSRI (Seratonin Reuptake Inhibitor) causes the brain to re-collect less of the seratonin than it might naturally, causing seratonin levels in the bloodstream to remain constantly higher, therefore increasing, (NOT decreasing!) someone's ability to think through and cope with a difficult situation. There are people whose brains do not naturally produce enough seratonin to do them the good they need it to do. Those people have a neurochemical imbalance, which is a physicial condition that causes illness, not simply something that makes them feel "different." Seratonin reuptake inhibitors absolutely do not cause people to lose their ability to think, and they are not designed to "shut things off." Proper doseage is of paramount importance to successful psychotropic drug therapy, and sometimes it takes an awfully long time for doctors and patients to figure out exactly how much of these meds someone should be taking. Once the doseage is stabilized, SSRIs are designed to worh with behavior modification, and once new habits are formed, a patient is weaned from the medication.

I am an animal behaviorist. I have a good deal of education and experience in treating (mostly) canine behavior problems, thereby preventing those pets from being euthanized. (Behavior problems kill more animals in the USA every year than cancer and car accidents combined, btw.) I'm afraid that seeing someone call behavior modification a "placebo" gets under my skin a bit. I have had dogs come to me with multiple lacerations over 50-80% of their bodies because they literally flung themselves out of plate glass windows when they were left alone, or when they heard a thunderstorm approaching. I have had dogs who would routinely bite the snot out of anyone who was around them if their primary caretaker wasn't there. I have had dogs that lick their feet until their bones are exposed among a mass of infected, oozing flesh because of their severe anxiety disroders. Psychotropic medications, properly dosed, and used in conjunction with systematic, humane behavior modification cured those dogs of their problems and they are alive and happy today because of it. If SSRIs and b-mod implemented by someone who knows what they're doing can do that for a canine, imagine how much good those same things could do for a human, who has the ability to clearly vocalize their symptoms to their doctors, and to understand the way the program is designed to work when it's explained to them!

I have been dealing with OCD for years, and I have found that cognitive behavioral therapy can be immensely helpful, reducing the symptoms of OCD by over 50% in under a year, in my case, with no chemical intervention (and no side effects). All this method requires is to be able to make the realization that you have a disorder, and the determination to combat the obesessions and compulsions alike.

An example of this theory: Say you have a compulsion consisting of tapping the mouse button - not clicking, just tapping it - a certain number of times. This compulsion is an OCD ritual, designed to prevent you from thinking about the obsession (if I click the mouse, then my parents won't get into an accident, and I don't have to worry about it). By refusing to obey the compulsion (i.e. not tapping a certain number of times), you are forced to come face-to-face with the obesessive thought. While you may not be able to to deal with the anxiety immediately, and may have to resort back to the compulsion on the first few tries, over time you will become desensitized to the obession and stop obsessing about it, in which case the compulsion is no longer necessary.

Studies have shown that brain scans of individuals with OCD who have undergone this type of therapy show similar improvements to those treated with medication, and in some cases even more so.

I first realized I had a problem when I was about eight years old. It started out with simple counting; every time I had a birthday, my new age became the number I was most obsessed with. I'm not sure if the obsession started at the age of eight, but that's the earliest I can remember it occurring. I was obsessed with finding words or phrases that comprised of eight letters or syllables. I would count the syllables and recite the words and phrases in my mind over and over until I felt a kind of strange satisfaction. The first time I can remember this happening was when my older sister and I were visiting my grandmother while our mother was working. My grandmother had a habit of locking me in one of the bedrooms if she became angry with me, and sometimes she would leave me there for hours at a time. I didn't have anything else to do while locked in there, so I spent most of my time counting away.

The counting didn't bother me much at first, but it had started to scare me by the time I reached ten years of age. I remember sitting awake one night, unable to fall asleep because I was obsessively counting (the counting sheep method doesn't work for me). I jumped out of bed and ran into my mother's room, hysterically crying. She was awake, and I yelled at her "What's wrong with me? I think I have some kind of disease or something!" She asked me what was wrong and when I explained to her what my problem was, she replied "You're just smart. All the smart kids do stuff like that." I didn't really believe her, but the fact that she wasn't scared made me feel better. I'm not sure if I was able to get to sleep that night though.

Counting my age continued until I was fifteen, and then stopped. However, that hasn't been the only obsession/compulsion I've indulged in. Other ones include:

- counting the steps it takes to get to destinations, or only allowing myself to place one foot into each square of cement.

- counting the syllables of song lyrics, movie lines and the beats of music. I do this constantly, especially when I am feeling more stressed than usual. Song lyrics can stay in my head for days at a time, until I have memorized the amount of syllables it has and I feel comfortable to leave that obsession alone.

- chewing my food on the right side, then the left, then the left again, and then the right. This appeases my obsession with symmetry. While I'm chewing in this way, I picture the first chewing action as a circle; I picture the second and third chewing actions as squares; and I picture the last as another circle. This creates a picture in my mind of a circle, two squares and another circle, which can be folded over perfectly and symmetrically.

- fixing my hair in symmetrical styles. I am obsessed with braids. I usually wear my hair as two braids, or two buns. I've been known to spend hours in front of the mirror, trying to fit every hair into place to make my style as symmetrical as possible. I missed a large amount of high school simply because I thought my hair wasn't symmetrical enough to go out in public.

I think the obsession with symmetry slowly progressed into an obsession with beauty, to the point where I developed what psychologists would call Body Dysmorphic Disorder, which is another form of OCD. I look in the mirror and see an ugly person staring back at me. I know I'm not ugly, but I still obsess over the thought that other people will think I am. For this reason I find it difficult to go out in public, especially during the daytime. I would much rather leave the house at night, when my physical flaws are less visible. I deliberately missed school on days when yearbook pictures were taken, and have avoided having my picture taken on casual occasions as well.

I visited a psychiatrist two years ago, who prescribed me Prozac. He said it would help with depression and OCD, but the effects of this drug on my behavior convinced me to stop taking it altogether. Prozac made me unbelievably hyperactive. My friends and boyfriend were afraid to tell me how much they hated the way I acted while taking Prozac because they thought it might eventually be beneficial. It also made me more fidgety, and caused more OCD episodes than I'd ever experienced before. When I told my psychiatrist about this, his response was to prescribe me with more Prozac. That lasted for about 2 weeks before I couldn't take it any longer and ended up flushing the medication down the toilet.

Since then I have found that the best way to deal with obsessions and compulsions is to figure out why I do them and eliminate the behavior. It has been a very tough process, because these are things I've gotten used to doing from a very young age. I don't think I'll ever be able to stop counting, but I have been able to get rid of some of the behaviors associated with my obsessions with symmetry and beauty. I force myself to stick with the first hairstyle I do, and with the first outfit I put on, so I'm not obsessively fixing my hair or my clothes for hours anymore.

The counting and chewing obsessions don't bother me, so I don't bother with trying to get rid of them. I have strong reservations about calling the things I do a "disorder". They are just things I do, and when they start disrupting my life I work on eliminating them. We have more control over our thoughts and actions than we might think.

Obsessive compulsive disorder (OCD) can be extremely potent when combined with bipolar disorder, depression, and/or anxiety problems. Unfortunately these issues frequently combine in a toxic stew that's a mess to get out of. Recently I've had great difficulty getting out of panic attacks and strong bipolar cycles. This time, I have few luxuries. My obsessions have gone from less to more life disabling, and I'm at a loss to curb my thoughts.

deek2000 has it on target when he/she advocates cognitive therapy. Everyone from the shrink to my (few) friends tell me to keep attacking whatever's bothering me by trying the activity repeatedly. Meanwhile, I am told to realize the irrationality of the infinite (negative) possiblities I've spun. Sometimes cognitive therapy can be overridden with severe obsessive thoughts to the point where thoughts suffocate the mind. In order to drive a car I've adapted some cogntive skills, but there are days when I need to drive (like everyday) but can't start the car. What to do?

I find looking through the problem helpful. Many people including me find driving traumatic out of fear of hitting a person (especially a child), pet, or car. In my case I have a great fear of accidentally harming someone backing out of a parking space. I find it calming to remember that if indeed I do hit something, I will know it; therefore, I need focus only on avoiding the situations and not sounds coming from the immediate area. Anyone who has been in an accident knows the crunching, "thud" sound of metal hitting metal. I could circle the parking lot over and over, looking for two vacant parking spaces, or park way off somewhere at the end of the lot. Instead, I try to recognize that people tend to congregate near the doors of a store. I don't stick around the fire lanes or the doors of the strip mall, and maybe park a few rows back. Yeah, it's still OCD but at least I'm out of the house and establishing a comfort level for later attempts. My driving is the last barrier between a functional life and agoraphobia.

I still have some problems with reflection on past events, such as "What I did yesterday might have some deleterious effect on today." I'm still struggling mightily with this. A few days ago I was totally zoned out while driving. It was Easter/Passover weekend, so the roads were jammed. Yep, I missed a SUV by a few feet, making a left turn (in the US) totally disregarding oncoming traffic. I have not driven since then because of the thought that the past performance of a near accident might indicate future events. I am still convinced that the best way to get over this thinking is to continue the action while trying to recognize the falsity of my illusion. Yet, it's difficult to practice self-cognitive therapy hurling down some suburban street. Since I can't live with Mom and Dad all my life, I better start recognizing that I'm still a competent driver, I just have to check the traffic lights carefully.

At least today I'm not concerned that my toes are going to fall off because they're a bit cold.

I am waiting for another "thud" to happen, even when sitting in my bedroom.

As always, see a doctor or accredited professional before taking any layman's advice. It's always a good idea to talk concepts over with competent counselors. Yes, even compulsive concerning disclaimers.

I’ve lived with Obsessive Compulsive Disorder (OCD) in some capacity for quite awhile but never realized it until recently, recently being the last few years. You’d think it would take a load off my mind. You’d assume that knowing the cause of many problems and pains would ease those pains. You’d be wrong. This is the part of the story that I should convey my disdain for medicine that would aid my disorder. Jack Nicholson hit the nail on the proverbial head in As Good As It Gets: “I’m using the word hate here about a pill.” To me it feels like taking those pills may change my personality. I don’t want to change unless I cause the change, unless I sanction the change, unless I facilitate the change. Therefore I have chosen, for the time being, to try to change through help from friends and working on it myself. I choose friends over chemicals. Many have criticized this decision. Many are not I.

My OCD is far from severe, but none-the-less, painful. I have gained and loss many friends because I cannot accept certain developments. A great deal of my OCD is social. I may ask a question, hear the answer, and instead of moving on my mind does not accept the answer. The OCD cycle inhibits it. This cycle is where the brain does not realize that a situation has been resolved, such as hand washing. OCD sufferers with a hand washing may wash their hands, but their mind thinks they still have not gotten them clean, so they will wash again, etc. They obsess about a situation then compulse to solve it. I obsess that my social life is constantly in a state of despair and compulse to solve it, which only, in reality breaks it down. Now for those who are alien to OCD this sounds crazy. It gets worse when you have OCD and still know it sounds crazy. Many OCD, if not nearly all OCD sufferers know what they are doing does not make sense. It’s realizing this and then cutting off the compulsion that is imperative.

I have been blessed with many friends who have supported me. I feel almost guilty some days when I realize how many have stuck by me regardless of my near paranoid state of mind some days. Regardless, I feel it can be attributed to a deeper level of commitment between friends united with a level of near empathy for what I am feeling. My friendships are based on the same principles as others: trust, support, tolerance, and compassion: four qualities everyone, not just OCD sufferers, require for a healthy life.

I have many other compulsions but I have been slowly phasing them out with the help of friends. My social compulsions still exist however.

Me: “You ok?”
Friend: “Yeah”
Me: “Sure?”
Friend: “Yeah”
Me: “No, seriously, what’s wrong?”
Friend: “Nothing I’m fine”
Me: “Come on, just say whatever it is”
Friend: “Nothing, I’m fine”

That conversation is quite accurate to many I have. Worse yet they are much longer. People can only take so much, on both sides of the coin: the ones who suffer with OCD and the ones who suffer from those with OCD.

I write this for personal growth coupled with sharing my experience. People should know the pain of OCD, the thinking of a person with OCD, and moreover that OCD is not just washing hands and avoiding cracks in the sidewalk. It can ruin friendships, relationships, and lives. Getting help from friends and family is imperative regardless of chemical help outside that. Just supporting a person can go a long way: even a person without OCD. You’d think caring about a person could be enough… and you’d be right.