What actually is OCD and how to identify if you have it?
It will not be an exaggeration if I were to say that, there are very few people in this world who have neither heard nor used the term ‘OCD.’ OCD is a very casually used term amongst many, to tease a person who is very keen on either cleanliness or orderliness. Many movies have been made in vernacular languages with ‘OCD’ as their central theme. Movies like ‘Monk,’ ‘Aviator’ in Hollywood; In Bollywood, Irrfan Khan’s character in the movie ‘Krazzy 4’ and more recently, the movie ‘Mahanubhavudu’ in Telugu movies are some examples of depiction of the concept of ‘OCD’ by respective film industries. As is the business of entertainment and films, people with OCD and the situations they face are shown to be very funny and entertaining enough for us to watch the movies but in reality the kind of pain an OCD patient undergoes all the time is not funny by any means. The usual myth surrounding the concept of OCD as mental illness is usually only to an extent of washing or cleaning mania. Well, to bust those myths, OCD is a lot more than just a cleaning mania. Hereunder, I further bust other similar myths surrounding OCD and explain what actually constitutes an OCD problem.
OCD is short for Obsessive-Compulsive Disorder. It is a common, chronic, anxiety disorder which disrupts the life of a person by affecting the person’s social functioning very badly. Obsessive-Compulsive Disorder is a long lasting mental illness, characterized by recurring intrusive, uncontrollable thoughts or images or impulses, associated with or without compulsive rituals (compulsions like checking objects, counting numbers, cleaning etc.) as an attempt to suppress the anxiety provoking thoughts, which relaxes the person. People affected with OCD spend most of their time in performing these rituals repeatedly, to save themselves from the intense anxiety provoked by intrusive thoughts. Because of these thoughts and rituals, the person experiences significant emotional distress leading to disturbed professional and personal life. If the person suffering from OCD were for example to be a Student, he/she will not be able to concentrate on their academics, if the person is an employee then he/she cannot do the tasks assigned to them properly. This problem of OCD, paves way for marital disputes too, as one of the persons in the relationship, will be obsessed with their rituals and cannot give enough time to the spouse and children. Eventually, what this OCD does is, it disturbs the overall social functioning of the person.
OCD tends to affect almost 2-3% of population in the whole world. Both men and women are at equal risk, though studies show that young single men are more likely to have checking rituals whereas women are more likely to have cleaning rituals. Usually Obsessive Compulsive Disorder manifests its symptoms in the late adolescence or early adulthood.
As I have already explained above, intrusive thoughts and compulsions are signs and symptoms of OCD. These intrusive thoughts as such may or may not be associated with compulsives for it to constitute an OCD problem.
Intrusive thoughts could non-exhaustively be as mentioned below:
- contamination
- the need for symmetry
- aggressive and sexual thoughts
- obsessional doubting
Likewise, most common Compulsions (or rituals) that I have observed in my experience are,
- uncontrollable desire to clean
- uncontrollable desire to keep everything in order and in symmetry
- Number counting
- Constant need to check objects.
Contrary to popular belief, the affected person won’t be performing these rituals for pleasure or on purpose. The affected people are also aware that their thoughts and reactions to the thoughts are indeed abnormal but they can neither control nor help themselves.
The causes as such are unknown but the risk factors of OCD are identified and they are
- Genetics – people with first degree relatives (i.e., parents or siblings) who have OCD are at high risk to develop OCD.
- Brain structure and functioning – As per some studies, defect in certain areas of brain is also associated with OCD in that person.
- Environment – Bad effects of environment like childhood trauma which includes sexual abuse or dysfunctional families is also associated with OCD. Growing up by seeing some close relative who has OCD (which the psychologists call ‘modeling’) also results in development of OCD in that person.
Do not be confused by mild obsessive compulsive behaviors we usually tend to exhibit like checking gas cylinder or checking the lock frequently, to be double sure or like singing the same song repeatedly. These acts do not constitute OCD, as these thoughts and rituals will not stay for long time and they do not disturb our daily activities. Long standing OCD may result in other psychiatric conditions like depression, body dysmorphic disorder, delusional disorder.
Diagnosis of OCD takes many years as the suffering people go to any extent to hide their ritualistic behavior, thereby delaying diagnosis and so the treatment too. Most of the times, family seeks medical help only when things get out of hand when they are fed up of this person’s obsessive and compulsive behavior. It rarely so happens, that the patients themselves come to professionals like me for help.
Unlike any other psychiatric illnesses, OCD is completely curable if the person seeks medical help early enough. If this problem of OCD reaches a psychotic stage (i.e., losing touch with reality) then complete cure is not possible and only recovery is possible. Cure being of permanent nature where there shall be no relapses of OCD while recovery is temporary only. So, timely diagnosis and treatment is very important.
Treatment for OCD is done by Medication and/or Psychotherapy.Psychotherapy involves
- Cognitive Behavioural Therapy (CBT) which involves both behavioral and cognitive strategies
- Psychodynamic psychotherapy
For better understanding, I will further explain OCD with some cases I have dealt with in my experience as a Psychologist,
- A middle aged woman, suffering with obsessive thoughts of illness. She suddenly experiences burning in her throat and wants to take an antacid. If she cannot take the tablet immediately, she becomes very anxious and in that anxiety she loses her control and attacks people who are around her. Anyone who does not give her an antacid immediately, becomes an enemy for her and so a target during those uncontrolled attacks based on anxiety. She has a history of her close relative dying of cancer which might have triggered this issue.
- A 24 years old man, suffering with thoughts of sexuality. He strongly believed his walking and talking style are like a woman. He is embarrassed and tensed whenever he has to be in interaction with the society at large. He wraps his face with a kerchief so that people cannot see his facial expressions which he believes to be like that of a woman. He counts numbers, steps forwards and backwards whenever he experiences anxiety because of these thoughts. He could not even finish his graduation because of these OCD thoughts and is under constant suffering. He has a history of childhood sexual abuse which might have triggered this issue.
- A middle aged 50 year old, orthodox married woman, suffering since 30 years with OCD symptoms of fear of contamination. She is constantly in anxiety and needs to clean and wash her hands and feet because of fear of contamination. She washes her hands at least 10 times before she starts cooking. Whenever she uses the washroom, she takes a head bath. Her mind is always preoccupied with fears of contamination. Her whole family is disturbed because of her OCD problem. She does not attend any family functions, tours or social gatherings. In this case the person is exhibiting the obsessive thoughts of contamination and rituals of cleaning. She has history of growing up with very orthodox maternal aunt and married into an unorthodox family which triggered this issue for her.
- A 30 year old man, suffering with thoughts of sex related to Gods. He suddenly sees an image of nude goddess. Immediately he becomes anxious and guilty. He accuses himself for thinking of a goddess like that and feels that he is committing a sin. He has a strong family history of OCD.
In my clinical experience I have seen almost all kinds of OCD. Early identification, diagnosis and treatment will result in 100% cure. In my opinion one should not neglect any symptoms quoted in this blog and also please do not be embarrassed to visit a psychotherapist or a psychologist if you identify or relate with any of the symptoms given above or you can get in touch with me as well via my email ID (drkavithanarayandas@gmail.com).
Cheers.
