Everyone has things they do repetitively from time to time. You may feel that your hands aren’t quite clean, so you go back and wash them to your satisfaction. Or you may get in the mood to clean your house, even though you just did a thorough cleaning. These are normal behaviors, but people suffering from obsessive-compulsive disorder (abbreviated OCD) do them to the point where their lives are impacted, and others take notice of how often they perform these tasks.
Frequent thoughts are known as obsessions. The repeated behaviors and rituals are called compulsions. The symptoms of this disorder usually contain elements of both behaviors, but it’s also possible to have one or the other. It’s believed that roughly one-third of people who have been clinically diagnosed with obsessive-compulsive disorder also suffer from tics, which are sudden, intermittent and brief movements of a body part (usually the face) or uttering sounds.
More than 2 percent of the United States population aged 18 to 52 suffers from obsessive-compulsive disorder, according to statistics compiled by the National Institute of Mental Health. That’s approximately 3.3 million Americans who feel compelled to perform rituals or have unwanted thoughts that they believe they cannot control.
They may be inherited, and the tendency toward OCD can be observed in certain families. But researchers are still not sure why people are compelled in the way that they act, although they believe that certain parts of the brain control these actions. Add in that potential abnormality with stress and other environmental issues, and you have your classic obsessive-compulsive disorder.
Living with a person who has obsessive-compulsive disorder can be frustrating. You will be a bystander as the person delays and otherwise impairs normal, daily activities like leaving the house on time, preparing meals and interacting with other people. In its extreme forms, it breaks down the quality of life to such a degree that the person needs to seek clinical help or medication to control the behaviors. Worse, some people attempt to self-medicate with drinking or drugs, hoping to calm their actions by tranquilization or develop eating disorders, extreme anxiety or depression.
Obsessive-compulsive behavior starts as early as childhood for some people, and a formal diagnosis can usually be made before a person reaches age 20. At times, a formal diagnosis is tricky because the behaviors may vanish for some time and then return with a vengeance. The problem is one that affects men and women equally.
Like the movies, OCD has certain repeating themes. In fact, such odd behaviors are often portrayed as comic triggers in television and films (for example, Sheldon on the popular Big Bang Theory television show, who must always knock three times on his neighbor Penny’s door). But while we laugh at these behaviors in context, living with them can be nightmarish.
Doctors can treat OCD sufferers with medication and psychotherapy, usually tried in combination. In therapy, the therapist may try to discuss different ways of thinking and reacting to certain situations. This is a way to help the patient understand the roots of the behavior and to develop ways to avoid acting in a troublesome manner. A particular therapy called exposure and response has been clinically proven to be very effective in limiting negative behavior in those who have obsessive-compulsive disorders.
Patients may be prescribed anti-anxiety medications, and, in some cases, antidepressants. The anti-anxiety drugs will usually take immediate action, while the antidepressants may take some time to take effect — in some cases, weeks. There are side effects with antidepressants that patients should report immediately to their physicians.
If you are not sure if you have obsessive-compulsive disorder, you might run down the checklist of factors.
1) Repetition – Do you have repeated thoughts or mental images that cause fear or extreme reactions? Many OCD sufferers report that they have outrageous fears of common, everyday things like germs, which usually manifests itself in compulsive cleaning. In other cases, the patient may have a fixation on violent actions, imagining themselves battling home invaders or hurting their friends or family. Likewise, a patient may focus on sex acts or their conflicts with various religious beliefs.
2) Rituals – While these are often an important part of life, the true obsessive-compulsive does them far in excess of normal behaviors. If you constantly check the stove to make sure it’s not on, wash your hands many times a day, keep everything that you ever come in contact with in proximity (called hoarding), repeatedly lock or unlock your home’s entrances, or even count objects in your possession, you may have obsessive-compulsive disorder.
3) Ordering – This is often seen in children, who, for example, must have their food served in a certain way (for example, not having each dish touch another or eating food in a certain order). This need for symmetry often leads to an emotional breakdown if the pattern is changed.
4) Avoidance – This obsessive-compulsive disorder prevents a person from shaking hands or touching objects that others have “contaminated” with their own touch. This usually goes hand-in-hand with compulsive cleaning or a fear of dirt.
5) Doubts – The true obsessive-compulsive person is always seeking reassurance. They may constantly ask friends and relatives about certain things and may not want to leave the house for fear that they may have left the stove on.
6) Strict Routines – Some people have habits, such as taking the same route to work each day or always stopping for coffee at a particular location. But the true obsessive-compulsive becomes extremely upset if there’s any deviation from that routine.
7) Counting – The obsessive-compulsive is consumed with knowing exactly how many toothpicks are in the container or must count and recount the silverware in a drawer.
Anxiety follows if they are somehow prevented from following this compulsion.
If you have any of these behaviors, talk to your doctor. Most obsessive-compulsives are not getting any pleasure from the performance of their appointed thoughts or tasks, and treatment can help them on a path toward a more normal life. There is no shame in seeking help for a problem that may affect your quality of life.
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