Obsessive Compulsive Disorders

 

What is Obsessive Compulsive Disorder (OCD) and who does it affect?

Obsessive Compulsive Disorder (OCD), is an anxiety disorder characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as counting, sorting hording, washing, checking, or cleaning are often performed in a ritualistic fashion with the hope of temporarily relieving anxiety, preventing obsessive thoughts or making them go away. Performing these rituals, provides only temporary relief, and not performing them markedly increases anxiety. 

 

OCD affects about 2.2 million American adults, and can be accompanied by eating disorders, other anxiety disorders, or depression. It affects  men and women in roughly equal numbers. OCD usually appears in childhood, adolescence, or early adulthood. One-third of adults with OCD develop symptoms as children, and according to research OCD may run in families.

 

Types of OCD and their signs and symptoms

People who are obsessed with germs or dirt, may develop a compulsion to wash their hands over and over again, or perpetually clean and reclean themselves, homes, even their dirt road. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Fear of embarrassment may prompt people with OCD to comb their hair compulsively in front of a mirror, they sometimes  get “caught” in the mirror and cannot move away from it. Performing such rituals is not pleasurable, and at best produces temporary relief from the anxiety created by obsessive thoughts.

Other common rituals include a need to repeatedly check things, count things, or touch things (especially in a particular sequence). Common obsessions include having frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts which the person dislikes, or having thoughts that are prohibited by religious beliefs or cultural morays. People with OCD can also be preoccupied with order and symmetry, may have difficulty throwing things out (so they accumulate), or hoard unneeded items (to the point they can scarcely use some rooms in their house or automobile.

Healthy people also have rituals, such as checking to see if the stove is off several times before leaving the house. The difference is that people with OCD perform their rituals even though doing so interferes with daily life and they find the repetition distressing. Although most adults with OCD recognize that what they are doing is senseless, some adults and most children may not realize that their behavior is beyond the norm.

Treatment of OCD

According to the National Institute of Mental Health, the practitioners who are most helpful with anxiety disorders are those who have training in cognitive-behavioral therapy and/or behavioral therapy, and who are open to using medication if it is needed. At Behavioral Health and Addiction Services, we follow this treatment strategy. 

Making Treatment More Effective

Joining a self-help or support group and sharing problems and accomplishments with others is often helpful. This includes Internet chat rooms, however advice received over the Internet should be taken with a double helping of caution; especially be leery of anyone who may have a hidden agenda such as "this brand name medication is the answer accept no substitute". Talking with trusted friends, family, or member of the clergy can also provide support, but is no substitute for care from a mental health professional.

Stress management techniques such as: meditation, progressive muscle relaxation, autogenic relaxation, guided imagery, hypnosis, and biofeedback can be very helpful. to calm and may enhance the effects of therapy. There is evidence that aerobic exercise may have a calming effect. 


The family unit can be very important in the recovery process of patients with any anxiety disorder. Ideally, family should be supportive, but not help perpetuate the symptoms. Family members should never trivialize the disorder, or expect improvement without treatment. Finally the compulsion should NEVER BE DENIED TO THE INDIVIDUAL AS IT ONLY MAKES THE ANXIETY WORSE.

About the Author:

Donald W. Ahrens Jr, PMH-NP, A.R.N.P. is a psychiatric Nurse Practitioner who provides full spectrum psychiatric service (both psychotherapy and medication therapy) to the people of Wichita and the surrounding metropolitan area.

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