Self-Help Information: Obsessive Compulsive Disorder
Obsessive-Compulsive Disorder (OCD), one of the anxiety disorders, is a
potentially disabling condition that can persist throughout a person’s life.
The individual who suffers from OCD becomes trapped in a pattern of
repetitive thoughts and behaviors that are senseless and distressing but
extremely difficult to overcome.
OCD occurs in a spectrum from mild to severe, but if severe and
left untreated, can destroy a person’s capacity to function at work,
school, or even in the home.
How Common is OCD?
For many years, mental health professionals thought of OCD as a
rare disease because only a small minority of their patients had the
condition. The disorder often went unrecognized because many of
those afflicted with OCD, in efforts to keep their repetitive
thoughts and behaviors secret, failed to seek treatment. However, a
survey conducted in the early 1980’s by the National Institute of
Mental Health (NIMH) showed that OCD affects more than 2 percent of
the population. Although OCD symptoms typically begin during the
teenage years or early adulthood, recent research shows that some
children develop the illness at earlier ages, even during the
preschool years.
Key Features of OCD
Obsessions
These are unwanted ideas or impulses that repeatedly well up in
the mind of the person with OCD. Persistent fears that harm may come
to self or a loved one, an unreasonable concern with becoming
contaminated, or an excessive need to do things correctly or
perfectly, are common. Again and again, the individual experiences a
disturbing thought, such as, "My hands may be contaminated – I must
wash them"; "I may have left the stove on"; or "I am going to injure
my child." These thoughts are intrusive, unpleasant, and produce a
high degree of anxiety. Sometimes the obsessions are of a violent or
a sexual nature or concern illness.
Compulsions
In response to their obsessions, most people with OCD resort to
repetitive behaviors called compulsions. The most common of these
are washing and checking. Other compulsive behaviors include
counting (often while performing another compulsive action such as
hand washing), repeating, hoarding, and endlessly rearranging
objects in an effort to keep them in precise alignment with each
other. Mental problems, such as mentally repeating phrases, list
making, or checking are also common. These behaviors generally are
intended to ward off harm to the person with OCD or others. Some
people with OCD have regimented rituals while others have rituals
that are complex and changing. Performing rituals may give the
person with OCD some relief from anxiety, but it is only temporary.
Most people with OCD struggle to banish their unwanted,
obsessive thoughts and to prevent themselves from engaging in
compulsive behaviors. Many are able to keep their
obsessive-compulsive symptoms under control during the hours when
they are at work or attending school. But over the months or years,
resistance may weaken, and when this happens, OCD may become so
severe that time-consuming rituals take over the sufferer’s lives,
making it impossible for them to continue activities outside the
home.
What Causes OCD?
The old belief that OCD was the result of life experiences has
been weakened before the growing evidence that biological factors
are a primary contributor to the disorder. The fact that OCD
patients respond well to specific medications that affect the
neurotransmitter serotonin suggests the disorder has a
neurobiological basis. For that reason, OCD is no longer attributed
only to attitudes a patient learned in childhood – for example, an
inordinate emphasis on cleanliness, or a belief that certain
thoughts are dangerous or unacceptable. Instead, the search for
causes now focuses on the interaction of neurobiological factors and
environmental influences, as well as cognitive processes.
Do I Have OCD?
A person with OCD has obsessive and compulsive behaviors that
are extreme enough to interfere with everyday life. People with OCD
should not be confused with a much larger group of individuals who
are sometimes called "compulsive" because they hold themselves to a
high standard of performance and are perfectionistic and very
organized in their work and even in recreational activities. This
type of "compulsiveness" often serves a valuable purpose,
contributing to a person’s self-esteem and success on the job. In
that respect, it differs from the life-wrecking obsessions and
rituals of the person with OCD.
Treatment of OCD
Clinical and animal research sponsored by NIMH and other
scientific organizations has provided information leading to both
pharmacologic and behavioral treatments that can benefit the person
with OCD. One patient may benefit significantly form behavior
therapy, while another will benefit from pharmacotherapy. Others may
use both medication and behavior therapy. Others may begin with
medication to gain control over their symptoms and then continue
with behavior therapy. Which therapy to use should be decided by the
individual patient in consultation with his or her therapist.
(The above information was condensed from a public domain
brochure produced by the National Institute of Mental Health. For
the full text of the brochure, visit the NIMH website at
www.nimh.nih.gov).
Recommended Books to Read
Overcoming Obsessive-Compulsive Disorder – Client Manual.
Gail S. Steketee, Oakland, CA: New Harbinger, 1998.
Confronting the Bully of OCD: Winning Back Our Freedom
One Day at a Time.
Linda Maran, Brooklyn, NY: Fifteenth Street Publishing,
2004. This book is written by a lay person who has lived with
OCD for twenty-nine years. She shares her struggles and recent
triumphs in conquering the "bully" of OCD. Through the telling
of one woman’s story, this book is meant to encourage others
with OCD to fight back and learn how to live satisfying and
productive lives.
Brain Lock: A Four-Step Self-Treatment Method to Change Your
Brain Chemistry. Jeffery M. Schwartz, New York: Regan
Books, 1996. This book focuses on a cognitive treatment for OCD
developed at UCLA. The four-step process (re-label, reattribute,
refocus and revalue) focuses on changing cognitions or thinking.
Scattered throughout the book are brief case histories, which
illuminate the many presentations of OCD, and demonstrates ways
different individuals overcame the disorder by using the
four-step process.
Tormenting Thoughts and Secret Rituals: The Hidden Epidemic
of Obsessive-Compulsive Disorder. Ian Osborn, New York:
Pantheon, 1998. Written by a psychiatrist who struggles with
OCD, this book describes the history, symptoms, and treatment of
OCD through case histories of both the author’s patients and
famous historical figures. Written for both the professional and
lay public, this book provides the reader with a broad
understanding of the disorder and treatment options.
Obsessive-Compulsive Disorder: A Guide.
Obsessive Compulsive Information Center, Madison Institute
of Medicine, 1998. This pamphlet describes the symptoms and
causes of OCD. It then describes the treatment options, with an
emphasis on medication.
Need Additional Help?
Washington State University College of Veterinary Medicine
Counseling and Wellness Services offer free individual counseling for these
and related issues for veterinary students (WSU Veterinary Students ONLY).
For more information or to schedule an appointment call or e-mail:
Carolyn Wyatt PhD
ADBF 1035
335-0774
cwyatt@vetmed.wsu.edu
NOTE: The information contained in these self help
documents is not to be used as a substitute for professional care. Neither
the authors, Washington State University nor the College of Veterinary
Medicine assume liability for injury incurred by following the information
presented in these self-help documents