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OCD

 
     
 
Many of us occasionally have to go back and double-check that an iron is unplugged or the car door is locked. But for sufferers of obsessive-compulsive disorder (OCD), obsessive thoughts and compulsive behaviors become so excessive that they interfere with our daily lives. And no matter what we do, we just can't seem to shake them.

If you or someone you love has obsessive-compulsive disorder, you may feel isolated and helpless. Whether you suffer from uncontrollable thoughts, irrational urges, or feel compelled to perform the same rituals over and over again, there is a variety of help available. Educating yourself about the disorder is an important first step.

What is obsessive-compulsive disorder (OCD)?

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational -but even so, you feel unable to resist them and break free.

Like a needle getting stuck on an old record, obsessive-compulsive disorder (OCD) causes the brain to get stuck on a particular thought or urge. For example, you may check the stove twenty times to make sure it's really turned off, wash your hands until they're scrubbed raw, or drive around for hours to make sure that the bump you heard while driving wasn't a person you ran over.

Understanding obsessions and compulsions

Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. You dont want to have these ideas but you can't stop them. Unfortunately, these obsessive thoughts are often disturbing and distracting.

Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you're afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviors often end up causing anxiety themselves as they become more demanding and time-consuming.

Most people with obsessive-compulsive disorder fall into one of the following categories:

  • Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.
  • Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.
  • Doubters and sinners are afraid that if everything isn't perfect or done just right something terrible will happen or they will be punished.
  • Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.
  • Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don't need or use.

Signs and symptoms of obsessive-compulsive disorder (OCD)

Most people with obsessive-compulsive disorder (OCD) have both obsessions and compulsions, but some people experience just one or the other.

Common obsessive thoughts in OCD include:

  • Fear of being contaminated by germs or dirt or contaminating others.
  • Fear of causing harm to yourself or others.
  • Intrusive sexually explicit or violent thoughts and images.
  • Excessive focus on religious or moral ideas.
  • Fear of losing or not having things you might need.
  • Order and symmetry: the idea that everything must line up ''just right''.
  • Superstitions; excessive attention to something considered lucky or unlucky. g eyes

Common compulsive behaviors in OCD include:

  • Excessive double-checking of things, such as locks, appliances, and switches.
  • Repeatedly checking in on loved ones to make sure they're safe.
  • Counting, tapping, repeating certain words, or doing other senseless things to reduce anxiety.
  • Spending a lot of time washing or cleaning.
  • Ordering or arranging things "just so"
  • Praying excessively or engaging in rituals triggered by religious fear.
  • Accumulating "junk" such as old newspapers or empty food containers.

Obsessive-compulsive disorder (OCD) symptoms in children

While the onset of obsessive-compulsive disorder usually occurs during adolescence or young adulthood, younger children sometimes have symptoms that look like OCD. However, the symptoms of other disorders, such as ADD, autism, and Tourette's syndrome, can also look like obsessive-compulsive disorder, so a thorough medical and psychological exam is essential before any diagnosis is made.

Therapy for obsessive-compulsive disorder (OCD)

The most effective treatment for obsessive-compulsive disorder is often cognitive-behavioral therapy. Antidepressants are sometimes used in conjunction with therapy, although medication alone is rarely effective in relieving the symptoms of OCD.

Cognitive-behavioral therapy for obsessive-compulsive disorder (OCD)

Cognitive-behavioral therapy for obsessive-compulsive disorder involves two components:
  1. Exposure and response prevention involves repeated exposure to the source of your obsession. Then you are asked to refrain
    from the compulsive behavior you'd usually perform to reduce your anxiety. For example, if you are a compulsive hand washer, you
    might be asked to touch the door handle in a public restroom and then be prevented from washing up. As you sit with the anxiety,
    the urge
    to wash your hands will gradually begin to go away on its own. In this way, you learn that you don't need the ritual to get rid of your anxiety-that you have some control over your obsessive thoughts and compulsive behaviors.
  2. Cognitive therapy focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part of cognitive therapy for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior.

Four Steps for Conquering Obsessive Thoughts and Compulsive Urges

Psychiatrist Jeffrey Schwartz, author of Brain Lock: Free Yourself from Obsessive-Compulsive Behavior, offers the following four steps for dealing with OCD:
  • RELABEL - Recognize that the intrusive obsessive thoughts and urges are the result of OCD. For example, train yourself to say, "I don't think or feel that my hands are dirty. I'm having an obsession that my hands are dirty."Or,''I don't feel that I have the need to
    wash my hands. I'm having a compulsive urge to perform the compulsion of washing my hands."
  • REATTRIBUTE - Realize that the intensity and intrusiveness of the thought or urge is caused by OCD; it is probably related to a biochemical imbalance in the brain. Tell yourself, "It's not me-it's my OCD," to remind you that OCD thoughts and urges are not meaningful, but are false messages from the brain.
  • REFOCUS -Work around the OCD thoughts by focusing your attention on something else, at least for a few minutes. Do another behavior. Say to yourself, "I'm experiencing a symptom of OCD. I need to do another behavior."
  • REVALUE - Do not take the OCD thought at face value. It is not significant in itself. Tell yourself, "That's just my stupid obsession.
    It has no meaning. That's just my brain. There's no need to pay attention to it." Remember: You can't make the thought go away,
    but neither do you need to pay attention to it. You can learn to go on to the next behavior.
Source: Westwood Institute for Anxiety Disorders

Family therapy

Because OCD often causes problems in family life and social adjustment, family therapy can often be beneficial.
  1. Family therapy promotes understanding of the disorder and can help reduce family conflicts.
  2. It can motivate family members and teach them how to help their loved one.

Group therapy

Through interaction with fellow OCD sufferers, group therapy provides support and encouragement and decreases feelings of isolation.

Treatment for obsessive-compulsive disorder (OCD)

  • Treatment Guidelines for Obsessive-Compulsive Disorder -Guide for people with OCD and their family members.
    Includes in-depth treatment advice. (Expert Consensus Guidelines)
  • How to Find the Right Therapist -Guide to finding professional help for obsessive-compulsive disorder. Includes questions to
    ask a potential therapist. (International OCD Foundation)
  • OCD Medication -Fact sheet on medication for obsessive-compulsive disorder.Includes information about side effects and
    treatment success rates. (Understanding OCD)