Obsessive Compulsive Disorder?
Question:
Answers:
People with obsessive-compulsive disorder (OCD) have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. Most of the time, the rituals end up controlling them.
For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Being afraid of social embarrassment may prompt people with OCD to comb their hair compulsively in front of a mirror-sometimes they get "caught" in the mirror and can't move away from it. Performing such rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts.
Other common rituals are a need to repeatedly check things, touch things (especially in a particular sequence), or count things. Some common obsessions include having frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts the person dislikes, or having thoughts that are prohibited by religious beliefs. People with OCD may also be preoccupied with order and symmetry, have difficulty throwing things out (so they accumulate), or hoard unneeded items.
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 out of the ordinary.
OCD affects about 2.2 million American adults, and the problem can be accompanied by eating disorders,6 other anxiety disorders, or depression. It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood. One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families.
The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. If OCD becomes severe, it can keep a person from working or carrying out normal responsibilities at home. People with OCD may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves.
OCD usually responds well to treatment with certain medications and/or exposure-based psychotherapy, in which people face situations that cause fear or anxiety and become less sensitive (desensitized) to them. NIMH is supporting research into new treatment approaches for people whose OCD does not respond well to the usual therapies. These approaches include combination and augmentation (add-on) treatments, as well as modern techniques such as deep brain stimulation.
Obsessive-compulsive disorder (OCD) is a psychiatric disorder most commonly characterized by a subject's obsessive, distressing, intrusive thoughts and related compulsions (tasks or "rituals") which attempt to neutralize the obsessions. Thus it is an anxiety disorder. It is listed by the World Health Organization as one of the top 10 most disabling illnesses in terms of lost income and diminished quality of life.[1]
The phrase "obsessive-compulsive" has worked its way into the wider English lexicon, and is often used in an offhand manner to describe someone who is meticulous or absorbed in a cause (see also "anal-retentive"). Such casual references should not be confused with obsessive-compulsive disorder; see clinomorphism. It is also important to distinguish OCD from other types of anxiety, including the routine tension and stress that appear throughout life. Although these signs are often present in OCD, a person who shows signs of infatuation or fixation with a subject/object, or displays traits such as perfectionism, does not necessarily have OCD, a specific and well-defined condition.
To be diagnosed with Obsessive-Compulsive Disorder, one must have either obsessions or compulsions alone, or obsessions and compulsions, according to the DSM-IV-TR diagnostic criteria. The Quick Reference to the diagnostic criteria from DSM-IV-TR (2000) describes these obsessions and compulsions:[2]
Obsessions are defined by:
Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress.
The thoughts, impulses, or images are not simply excessive worries about real-life problems.
The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action.
The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind, and are not based in reality.
The tendency to haggle over small details that the viewer is unable to fix or change in any way. This begins a mental pre-occupation with that which is inevitable.
Compulsions are defined by:
Repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly.
The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive.
In addition to these criteria, at some point during the course of the disorder, the sufferer must realize that his/her obsessions or compulsions are unreasonable or excessive. Moreover, the obsessions or compulsions must be time-consuming (taking up more than one hour per day), cause distress, or cause impairment in social, occupational, or school functioning.[2] OCD often causes feelings similar to those of depression.
More at URL
When you have to do something a certain amount of times. I do things in odd numbers only. If I drum my fingers on the table I will do it 3 or 7 times. I blink in odd numbers when I'm driving between road signs, posts, mail boxes, anything on the side of the road. These are very, very small O.C.D.s.
OCD Symptoms
Typical Obsessions
Obsessions are recurrent, intrusive, and unwanted thoughts, impulses, or images that cause significant anxiety. At first the obsession may be experienced as relatively benign. Over time, the person associates it with fear and disabling anxiety. Obsessions fall into the following common thematic categories:
* Fear of contamination with dirt, germs, or poisons
* Fear of having a serious illness
* Fear that one's actions hurt other people or cause bad things to happen
* Inability to discard useless items (hoarding)
* Inappropriate sexual and aggressive thoughts and images
* Need for symmetry, order, or exactness
People who fear contamination may obsess about shaking hands or touching public doorknobs. Those who obsess about the implications of their actions often fear they endanger others. They may feel they have left a door unlocked or hit someone while driving. Obsessions with symmetry and order may cause significant anxiety over furniture arrangement, eating habits, or clothing. Inappropriate sexual impulses and pornographic images, often of an aggressive nature, can dominate a person's mind. Obsessions of aggression can also center on violent emotions, shouting out in public, or harming others. Hoarding useless items, like outdated catalogs or clothing, is common in OCD and may coincide with an obsession over order.
People suffering from OCD realize that they create their obsessions. They feel that the content of their obsessions is out of their control, inappropriate, not indicative of their character, and something they wouldn't normally think or communicate to others. Thus, their anxiety is intensified not only by recurrent obsessions, but also by the strangeness of the obsessions.
Typical Compulsions
Compulsions are repetitive, often ritualized behaviors that are intended to suppress the anxiety caused by obsessions. Compulsions common in OCD are the following:
* Asking for assurances
* Avoiding places or situations
* Cleaning
* Counting
* Doing certain tasks slowly and deliberately
* Doubting and checking, e.g., locks, lights, and ovens
* Hoarding possessions
* Ordering or arranging
* Repeating behaviors, including speech and action
* Washing, e.g., excessive hand-washing or bathing
Compulsive washing and cleaning are subsequent to the obsessive fear of germs or contamination. Compulsive people have been known to shower for 4 hours, or to wash their hands until they are raw. Others make sure their bath towels are arranged by some exact design, or that the soap is dry before they leave it. People may check the lock on a door several times an hour, or repetitively return home to make sure the oven is off. Some people count incessantly in an attempt to distract or soothe aggressive thoughts. Others depend on patterned behavior to control anxiety, such as avoiding traffic intersections or avoiding a change in routine.
A general theme of compulsive behavior is adherence to some often elaborate set of rules or routine. People with OCD will go to great lengths to satisfy the requirements of a routine, which often results in patterned, idiosyncratic behavior, e.g., slowly and meticulously preparing a bathroom for a shower that lasts for several hours. People who know OCD sufferers may call them perfectionists, especially if they only get a glimpse of the compulsive behavior.
More Questions & Answers...