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Obsessive-Compulsive Disorder
"I couldn't do anything without rituals. They invaded every aspect of
my life. Counting really bogged me down. I'd wash my hair 3 times as opposed to once because 3 was a good luck number and
one wasn't. It took me longer to read because I'd count the lines in a paragraph. When I set my alarm at night, I had to set
it to a number that wouldn't add up to a "bad" number."
"Getting dressed in the morning was tough because I had a routine and if I didn't
follow the routine, I'd get anxious and would have to get dressed again. I always
worried that if I didn't do something, my parents were going to die. I'd have these terrible thoughts of harming my parents. That was completely irrational, but the thoughts triggered more anxiety and more senseless behavior. Because of the time I spent on rituals, I was unable to do a lot of things that were important to me."
"I knew
the rituals didn't make sense and I was deeply ashamed of them, but I couldn't seem to overcome them until I had therapy."
Obsessive-compulsive disorder,
or OCD, involves anxiousthoughts or rituals you feel you can't control. If you have OCD, you may be plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals.
You may
be obsessed with germs or dirt, so you wash your hands over and over. You may be filled with doubt and feel the need to check things repeatedly. You may have frequent thoughts of violence and fear that you'll harm people close to you. You may spend long periods touching things or counting; you may be preoccupied by order or symmetry; you may have
persistent thoughts of performing sexual acts that are repugnant to you; or you may be troubled by thoughts that are against your religious beliefs.
The disturbingthoughts or images are called obsessions and the
rituals that are performed to try to prevent or get rid of them are called
compulsions. There's no pleasure in carrying out the rituals you're drawn to, only temporary relief from the anxiety that grows when you don't perform them.
A lot of healthy people can identify with some of the symptoms of OCD, such as checking the stove several
times before leaving the house. But for people with OCD, such activities consume at least an hour a day, are very distressing and interferes with daily life.
Most adults
with this condition recognize that what they're doing is senseless, but they can't stop it. Some people, though, particularly children with OCD, may not realize that their behavior is out of the ordinary.
Obsessive-compulsive disorder (OCD) is the 4th most common mental disorder in the US, with an estimated lifetime prevalence of 2.3%.1,2
The disorder is often chronic and disabling. Although effective
treatments exist, OCD is underdiagnosed and undertreated. More than 1/2 of OCD patients (54.9%) in the US receive no treatment
at all; worldwide the figure is 59.5%.3
Due to important advances in pharmacologic treatment, many
patients with OCD can be treated in primary care settings.
1/3 of adults with OCD report having experienced their first symptoms as children.
The course of the disease is variable -symptoms may come and go, they may ease over time, or they can grow progressively worse.
Research evidence suggests that OCD might run in families.3
"Take everything you like seriously,
except yourselves."
Rudyard Kipling
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"OCD is a medical
brain disorder that causes problems in information processing. It's not your fault or the result of a "weak" or unstable
personality."
"I couldn't do anything without rituals. They invaded every
aspect of my life. Counting really bogged me down. I would wash my hair 3 times as opposed to once because 3 was a good luck
number and 1 wasn't. It took me longer to read because I'd count the lines in a paragraph. When I set my alarm at night, I
had to set it to a number that wouldn't add up to a "bad" number."
The disturbing thoughts or images are called obsessions
and the rituals performed to try to prevent or get rid of them are called compulsions. There is
no pleasure in carrying out the rituals you're drawn to, only temporary relief from the anxiety that grows when you don't perform them.
A large body of scientific evidence suggests
that OCD results from a chemical imbalance in the brain.
For years, mental health professionals incorrectly
assumed OCD resulted from bad parenting or personality
defects.
Clinical researchers have
implicated certain brain regions in OCD. They have discovered a strong link between OCD and a brain chemical called serotonin. Serotonin is a neurotransmitter that helps nerve cells communicate.
Scientists
have also observed that people with OCD have increased metabolism in the basal ganglia and
the frontal lobes of the brain. This, scientists believe, causes repetitive movements, rigid thinking and lack of spontaneity.
Successful treatment with medication or behavior therapy produces a decrease in the over activity of this brain circuitry. People with OCD often
have high levels of the hormone vasopressin.
In layperson's terms, something
in the brain is stuck, like a broken record. Judith Rapoport, M.D., describes it in her book, The Boy
Who Couldn't Stop Washing, as "grooming behaviors gone wild."
Characteristics and Course
OCD is characterized
by obsessions and compulsions. However, it isn't the only disorder with these symptoms. Obsessions are recurring thoughts, urges or images; in OCD these are experienced as alien, intrusive and distressing.
Compulsions are repetitive behaviors (rituals) that
patients feel compelled to perform.
Obsessions
and compulsions can take many forms. In recent years, public awareness of OCD
has been raised by movies and television shows featuring characters with OCD contamination
obsessions and typical cleaning and hand-washing compulsions.
Another
familiar set of symptoms is an obsessive fear accompanied by a compulsion to check (e.g., fearing burglars and repeatedly checking that doors and windows are locked shut).
However, not all obsessions and compulsions come in neat, sensible pairings.
Typical
obsessions are listed in Table 1; these include preoccupation with contamination, unacceptable violent or sexual thoughts, doubting, concern about asymmetry or imperfections and thoughts that something will go wrong.
Typical
rituals are listed in Table 2; these include washing, cleaning, checking, counting, repeating and arranging.
Although some patients may have obsessions without any compulsions, often the compulsive behaviors are simply not recognized as they can be mental acts or very subtle behaviors.
An OCD patient might need to have specific
thoughts or mental images in order to counter an obsession (e.g., the image of a loved
one being harmed might be countered by picturing something good happening to the person).
Patients
who have fearful thoughtsmay hold their breath until the thought passes, shake their head, or blink. Patients generally perform rituals to reduce anxiety
created by thoughts of fearful consequences.
However, some patients perform rituals simply because of a general sense of foreboding or because it feels
wrong if they do not.
OCD
patients usually have good insight. They recognize that their fears are unrealistic,4 yet, their distress compels them to perform rituals.
In their worst moments, insight may waver and fears may seem not only realistic but inevitable unless the ritual is performed.
Although in severe cases of OCD insight may
be lost, it must have been present at some time to meet diagnostic criteria.5 It's normal to have occasional unwanted thoughts or perform repetitive or superstitious behaviors accompanied by transient anxiety, but an OCD diagnosis requires that symptoms cause marked distress, be time consuming (≥1 hour/day), or significantly interfere with functioning.5
OCD
onset is often in late adolescence or young adulthood, though it can begin at any age. Childhood onset isn't rare.
Onset is earlier in males than in females. The course is chronic and waxes and wanes in severity, often in response to stress.
OCD strikes peopleof all ethnic groups with males and females equally affected.
The social and economic
costs of OCD were estimated to be $8.4 billion in 1990 (DuPont et al, 1994).
People can
be so ashamed of their compulsions and obsessions that they refuse
to seek treatment or allow anyone to know they're dealing with OCD.
OCD symptoms usually
begin during the teen years or in early adulthood and recent research shows that some children develop the illness at earlier ages, even during the preschool years.
Studies
also indicate that at least 1/3 of the cases of OCD in adults began in childhood.
Experiencing OCD
during early stages of a child's development can cause severe problems for the child. It's important that the child receive evaluation and treatment by an experienced mental health professional to prevent
the child from missing important opportunities because of this disorder.
OCD is a medical brain disorder
that causes problems in information processing. It's not your fault or the result of a "weak" or
unstable personality.
"Symptoms"of Obsessive Compulsive Disorder
OCD is a very real,
chronic, often severe condition that's associated with recurrent intrusive thoughts that
cause extreme discomfort or anxiety (obsessions) and/or senseless repetitive actions
(compulsions) that are performed in an effort to try to reduce discomfort
and anxiety.
OCD's symptoms can range from:
Excessive house cleaning
Excessive Hand washing
Object hoarding
Counting things over and over
In today's society
the symptoms are often confused with highly driven individuals who're in total control of their environment.
Personal hygiene,
domestic cleanliness and perfectionism are usually regarded as virtues:
While those experiencing
OCD continue on their way, obsessing and performing their compulsions, many people who are
unaware of the OCD, praise them for their efficiency and organizational
skills.
There's such a
thing as too much of a good thing though!
Individuals with OCD
feel more like someone mysteriously enslaved by incomprehensible forces beyond his or her control. The urges to continually fulfill their tasks can often cause further problems, such as:
skin rashes from too much hand washing
a loss of hair from continual hair pulling
the loss of a job because they're so compulsive
in their quest for perfection that they can't fulfill their full job responsibilities
more symptoms
Persistent, unpleasant, and unwelcome mental images, often
with a violent theme
Putting
poison in food, spreading illness, smothering a child, pushing a stranger in front of a car, running over a pedestrian -
common compulsion that occurs -
repeating or checking behavior
Swearing, making sexual advances,
saying the wrong thing - common compulsion that occurs
- touching
Excessive religious or moral doubt
- common
compulsion that occurs - counting
A need to have things "just so" - common
compulsion that occurs - Hoarding
or saving
OCD has been described as, "hiccups of the mind."
Obsessions: recurrent or persistent mental images, thoughts or ideas, which may result in compulsive behaviors, repetitive, rigid and self-prescribed routines
that are intended to prevent the manifestation of the obsession.
OCD often co-exists with depression and anxiety. Individuals recognize that the obsessive thoughts and ritualized behavior patterns are senseless and excessive although
they can't stop them, in spite of strenuous efforts to ignore or suppress the thoughts or actions.
Obsessions
and compulsions don't always coexist; over 1/2 of OCD sufferers have obsessive thoughts without ritualistic behavior. There's some evidence that the symptoms improve over time and that nearly 1/2 will eventually
recover completely or have only minor symptoms.
OCD is time-consuming,
distressing and can disrupt normal functioning. Much research suggests that a critical feature in this disorder is an overinflated sense of responsibility, in which the patient's thoughts center around possible dangers and an urgent need to do something about it.
The obsessive thoughts or images can range from mundane worries about whether one has locked a door to bizarre and frightening
fantasies of behaving violently toward a loved one.
The compulsive
acts triggered by such obsessions might include repetitive checking for locked doors or unlit stove burners or calls to loved
ones at frequent intervals to be sure they're safe.
Some people are
compelled to wash their hands every few minutes or spend inordinate amounts of time cleaning their surroundings in order to
subdue the fear of contagion.
Certain other obsessive
disorders, including body dysmorphic disorder (BDD), trichotillomania and Tourette's syndrome, may be part of the OCD spectrum.
In BDD, people
are obsessed believing they're extremely ugly.
People with trichotillomania continually
pull their hair, leaving bald patches.
Symptoms of Tourette's syndrome include jerky
movements, tics and uncontrollably uttering obscene words.
a personal note: Here again brings into contention the importance of emotions
and feelings when it comes to experiencing a mental illness. Those experiencing these symptoms have emotions and feelings
concerning the acting out on the symptoms. Can you imagine having these symptoms if you aren't the one experiencing OCD, Tourette's
or other mental illnesses dealing with rituals, obsessions and compulsions? It's time that we all develop empathy and learn
that our emotions and feelings have a great bearing on our mental health!
OCD shouldn't be
confused w/obsessive-compulsive personality, which defines certain character traits (e.g., being a perfectionist, excessively consciousness, morally rigid & preoccupied w/rules &
order).
These traits don't
necessarily occur in people w/obsessive-compulsive disorder, which is a psychiatric condition.
Common
Compulsive Ritualistic Behaviors Associated w/OCD
Cleaning/Washing
Hand washing, showering or cleaning oneself repeatedly
Checking/Questioning
Checking to see if light switches, appliances &
faucets are off; if doors are locked; numbers are correct
Collecting/Hoarding
Collecting old objects, mail
or trash to the point of filling up one's home
Counting/Repeating
Counting to a certain number or counting objects
over & over; repeatedly performing a movement or set of movements before being able to move on.
Arranging/Organizing Arranging items in perfect symmetry or in a particular order (i.e., cans or books on shelves)
What are some common compulsions?
The following are some common compulsions:
Cleaning and grooming, such as washing hands, showering or
brushing teeth over and over again
Checking drawers, door locks and appliances to be sure they
are shut, locked or turned off
Repeating, such as going in and out of a door, sitting down
and getting up from a chair, or touching certain objects several times
Ordering and arranging items in certain ways
Counting over and over to a certain number
Saving newspapers, mail or containers when they're no longer
needed
Certain behaviors
are performed compulsively in an attempt to lessen this anxiety. Although they realize their obsessions are excessive & their behavior is unreasonable, they feel powerless to control either. In fact, their symptoms can overwhelm them & result in severe impairment & dysfunction, which can begin at an early age.
How do people w/OCD typically
react to their disorder?
People w/OCD generally
attempt to hide their problem rather than seek help. Often they are remarkably successful in concealing their obsessive-compulsive
symptoms from friends & co-workers.
An unfortunate consequence
of this secrecy is that people w/OCD generally don't receive professional help until years after the onset of their disease.
By that time, the obsessive-compulsive
rituals may be deeply ingrained & very difficult to change.
Daria used to make up excuses for the bald spot on the back
of her head. Sometimes she said her head rubbed against the headboard of her bed when she was asleep. Other times she said
the baseball caps she had to wear at work were too tight. She knew people doubted her stories, especially family members.
But she couldn't face telling them what was really happening: She'd been pulling her hair out since she was 12.
Daria had no idea why she pulled her hair. She just knew that
she couldn't stop. Many times, she did it without even thinking. Daria's mom noticed her doing it while watching TV. The two
of them did some research and learned about a condition that some people have called trichotillomania.
What Is Trichotillomania?
Trichotillomania (pronounced: trik-oh-till-oh-may-nee-ah)
is a type of psychological condition that involves strong urges to pull hair.
Doctors used to believe trichotillomania was rare. But that
thinking is now changing as experts gain a better understanding of the condition and more people come forward for help. Trichotillomania
affects more girls than guys. Most people who have it develop it during adolescence. But trichotillomania can start when a
person is as young as 1 year old.
What
Happens With Trichotillomania?
People with trichotillomania pull hair out at the root from places like the scalp, eyebrows, eyelashes, or pubic area. Some
people pull large handfuls of hair, which can leave bald patches on the scalp or eyebrows. Other people pull out their hair
one strand at a time. Some inspect the strand after pulling it out, or play with the hair after it's been pulled. About half
of people with the condition put the hair in their mouths after pulling it.
It might be hard to understand why someone would pull their
own hair or eyelashes out — or why they wouldn't just stop. But trichotillomania isn't just an ordinary habit that a
person can easily stop. It's a medical condition.
Trichotillomania is a type of compulsive behavior. This means
that people with the condition feel an overwhelming urge to pull their hair. People with trichotillomania also may have other
compulsive habits, such as nail biting or skin picking. Some people with trichotillomania also have problems like depression,
anxiety, or obsessive-compulsive disorder (OCD). Compulsive behaviors like trichotillomania can sometimes run in families.
People with trichotillomania may feel embarrassment, frustration,
shame, or depression about the condition. They may worry about what others will think or say. They may feel nagged by people
who don't understand that they're not doing this on purpose. They usually try to hide the behavior from other people, and
this can make it difficult to get help.
Having trichotillomania can affect how people feel about themselves.
Some people are self-conscious about how hair pulling affects their appearance. Because of this, they might feel
less confident about making friends or dating. Others might feel powerless to control the urge to pull or blame themselves
for not being able to stop. Feelings like these can cause a person's self esteem to suffer.
Why Do
People Feel Compelled to Pull Their Hair?
Doctors don't know for certain
what causes trichotillomania. Some think it might be related to OCD
since OCD and trichotillomania both involve compulsions.
Since compulsions arise as an effort to reduce tension, the urges that lead to hair pulling can be stronger when a person
is stressed out or worried.
Experts think that compulsive
behaviors like hair pulling may be caused by an imbalance of chemicals in the brain. These chemicals, called neurotransmitters (pronounced: nur-oh-tranz-mit-urs), are part of the brain's communication
center. When something interferes with how neurotransmitters work, it can cause problems like compulsive behaviors.
Some people with trichotillomania say that they notice sensations in their scalp or skin. For example, it may be a tingling
feeling that can only be relieved by pulling, like the feeling of relief that comes from scratching an itch. Some
people say that they notice a satisfying feeling when they pull their hair. Others don't even notice when they pull,
and do it without thinking.
Any relief that comes with
hair pulling usually only lasts for a moment. The urge almost always returns. That's because when the mind becomes used to
giving in to the powerful urges that go with compulsive behaviors, the behavior is reinforced The mind gets trapped in a cycle
of expecting to have the urge satisfied. The longer this goes on, the harder it can become to resist the urge.
How Do People
Overcome the Hair-Pulling Urge?
Because trichotillomania is a medical condition, it's not something most people can just stop doing when they feel like
it. People with trichotillomania usually need help from medical experts before they can stop. With the right help, though,
most overcome their hair-pulling urges. When someone is able to stop pulling, hair usually grows back.
Overcoming hair-pulling urges
may involve talk therapy, medication, or a combination of both.
Therapists teach people with trichotillomania special behavior techniques that help them recognize
the urge to pull hair before it becomes too strong to resist. The person learns ways to resist the urge so that it eventually
grows weaker and then goes away. A therapist can also help a person regain confidence and self-esteem.
Because the urges behind compulsive
habits like hair pulling are so strong, someone may feel more tension or anxiety when first trying to resist the urge. That's
why it helps to work with an expert who can offer support and practical advice about how to reverse this powerful habit.
Some doctors may prescribe
medications that can help the brain deal better with urges, making them easier to resist. Medication therapy can help to correct the imbalance of chemicals in the brain.
Many people find it helpful
to keep their hands busy with a different activity (like squeezing a stress ball or drawing)
during times when pulling is the worst. In the beginning, Daria found that knitting while watching TV helped keep her hands
busy at a time when she might feel the urge to pull her hair.
Homework time was harder,
though. Daria worked with her therapist to realize that she tended to pull more during homework because she was worrying about doing well on a project or test. Daria
and her therapist talked about ways to deal homework stress. Daria discovered that being a perfectionist was adding to her tension. When she
began to feel more relaxed - and still do excellent work - her confidence blossomed.
If you're worried about hair
pulling, talk to a parent, school counselor, or someone you trust about getting help overcoming the problem.
Genetic
studies of OCD & other related conditions may enable scientists to pinpoint the molecular basis of these disorders.
Other theories about the causes of OCD focus on the interaction between behavior
& the environment, on beliefs & attitudes, as well as how information is processed. These behavioral & cognitive theories aren't incompatible w/biological explanations.
Having one or more of these disorders
can make diagnosis & treatment more difficult, so it's important to talk to your doctor about any symptoms you have, even
if you're embarrassed.
Researchers have found that clomipramine (Anafranil), an antidepressant medication, helps alleviate painful, intrusive thoughts & repetitive
behaviors. Clomipramine has a powerful effect on the neurotransmitter serotonin & helps increase
the amount of this important brain chemical to improve communication between the nerve cells.
2 other antidepressant medications, sertraline (Zoloft) <click the underlined link, left,
to read info included w/the purchase of Zoloft - difficult reading> & fluoxetine (Prozac), have also been shown to be effective in easing
symptoms.
Researchers are currently investigating 2 other medications, paroxetine & fluvoxamine, that may be equally effective in alleviating obsessions & compulsions.
Like clomipramine, these medications affect the level of neurotransmitters in the brain & have shown
great promise in treating obsessive-compulsive disorder.
As w/all medications, antidepressants have some side effects. The most common side effects are:
Although these are troublesome, most side effects begin to fade after a few weeks. It's important to ask your physician about potential side effects whenever taking any medication.
Equally important is telling the physician about
any problems that develop after beginning a medication.
Remember.... it's
harder to get OCD under control than to keep it there, so don't risk a relapse by stopping your
treatment w/out first talking to your clinician.
In behavior therapy, a patient is exposed to the feared object or obsession, but prevented from completing the compulsive behavior.
i.e., people who fear contamination may be encouraged to touch dirty laundry and be denied the chance to wash their hands for a specified amount of time.
When they do wash their hands, they may be allowed to do
so for only a specified period of time.
Most often, behavior therapy must include guidelines or a "contract," in which the patient and treatment team agree on certain goals.
A contract may describe whether a patient
can participate in any of the compulsive behaviors. i.e., the contract may allow a patient with an obsession about cleanliness
to shower for only 10 mins. a day.
Families may participate in therapy by attending an information session about the situations that may cause symptoms to worsen and the ways that loved ones
can help the patient overcome the illness. Often family members can help the patient honor the terms of the treatment contract.
Family members also can learn to identify the signs that their loved one is having problems.
Some of the indications that a patient is experiencing emotional difficulties include:
Withdrawal from family and friends
Reappearance of repetitive behaviors
Constant questioning of own judgment
Increased tardiness
Families can also learn to
appreciate progress in their loved one's functioning and view small improvements as success. They can create a strong & supportive environment by encouraging an obsessive-compulsive disorder patient, refraining from criticizing him or her and not
allowing the inappropriate behavior to continue.
For a more "in-depth" reading
of how cognitive behavioral therapy works with OCD click here! (an out of network website for additional info!)
self help coping methods...
Obsessive
compulsive symptoms, when allowed to run rampant in your mind, will isolate you from the world around you. To satisfy those compulsions it'll require distance (first physically & subsequently mentally)
from people.
You must decide which way you'll go: will you let OCD rule your life & cause you to give up relationships
w/family & friends, or will you work at making a happy, healthy & fruitful life for your family & yourself?
The above decision
w/in yourself to become a happy, healthy, interactive person is critically important because it'll
affect your attitude toward each & every battle w/OCD you'll encounter in your lifetime.
OCD is an opponent
to your goal & reminding yourself of this commitment will give you strength & a sense of overall purpose when facing a compulsion that you don't want to resist.
You need to stand
your ground & fight OCD as it opposes you in your daily activities.
Recognize that giving in to your compulsions never makes your OCD better & gives fuel to the fire. When faced w/the urge to act
out a compulsion, OCD'ers MUST learn to reason w/in themselves the following:
"If I don't engage in compulsive rituals, no one
will die or be harmed.
"Whatever "disasters" I'm trying to prevent hasn't
killed me yet & will not kill me an hour from now."
"If I give in to my compulsive rituals, OCD is
going to continue to dominate my life & keep me from happiness."
"I WILL NOT let it have victory over me."
This line
of reasoning is very effective for many patients. Experiment a little & discover what works best for you. Realize in the
beginning that you'll probably have to start very small.
Give up washing
your hands &/or check or reduce the amount of time you wash &/or check & work up to overcoming bigger anxieties at you own pace.
Don't let other
people push you too much, but remember that old saying, "No pain, no gain." Every victory you achieve will bring you that
much closer to your goal & will give you a sense of accomplishment & regained control over your own life.
Find a Neutral Zone....
Compulsions to wash excessively, i.e., can be very strong upon arriving home after becoming "contaminated" from some experience
away from the home. Coming in contact w/a sick person, touching some supposedly dirty object or walking thru a smoke-filled
room may trigger the desire to ritualize.
Often it's very helpful to find a place in your home where you can go to sit, relax, distract yourself until the urge subsides. Call this area your "neutral zone."
It can be a secluded den
or office, bedroom, backyard patio, any place where the urge to ritualize can be allowed to subside. After approximately 30
minutes to an hour in this neutral zone, it often is possible to return to normal home activities.
Find out what works best for you.
Redirect your obsessive nature toward a more satisfying, healthy outlet...
Obsessions &
compulsions may have been occupying most of your thinking for some time. Physical activities, crafts or hobbies can help to
take the place of the OCD thoughts in your mind.
In dealing w/my own post traumatic stress disorder,
I can identify with this...
Volunteering or using your craft or hobby talent
to make something to donate can help. Remember that you can truly help yourself by helping others.
Find someone - preferably a professional
with OCD expertise, to guide you & encourage you in your endeavor....
Education plays an important role in the relationship with an OCD sufferer. Just like anyone experiencing any mental
disorder, there are difficulties that must be faced that are sometimes agonizing & tiresome.
Educating yourself about
OCD on a continual basis to learn of any new treatment options, medications, or any new discoveries about the disorder is essential.
Use positive thinking & self talk to help each of you thru difficult times.
Set up a certain place to
keep your equipment of hobby/craft needs out & accessible so that when the urge to perform rituals begins, the individual experiencing the distress, can go to a healthy habit & keep busy in a positive way.
Find a support group that you feel comfortable with. Use the resources of support & guidance of others that may be experiencing similar problems.
When the sufferer is doing well and having a good day, a bit
of humor and laughter, offered with sensitivity, is great balm to soothe away some of the painful feelings and thoughts which arise.
Be prepared to support the sufferer on a long-term recovery program and don't make day-to-day comparisons.
Recovery always includes slips and set-backs - the important thing
is that the set-back isn't interpreted as failure.
The guilt and stress that will arise from thoughts and feelings of failure could make the set-back much more difficult to overcome, than if it's viewed as an opportunity to learn.
There can be no simple, straight-forward
plan that'll smooth away every rock on the road to recovery. Every person who has OCD and every family who has a sufferer as a member, has a different
set of symptoms and circumstances to deal with, different relationships, personalities and a whole complex array of different influences.
Try these ideas and
strategies and draw upon all the resources and support that you have. Slowly, but surely, you and sufferer will discover the treatments and self-help strategies and ideas that will work for you."
10/24/03 Gene Mutation Tied to Severe Compulsive Behavior
A double mutation on the human serotonin transporter gene (hSERT) could cause severe obsessive compulsive disorder (OCD), says
a US National Institutes of Health study.
The gene controls the
movement of chemicals between nerve cells in the brain. It's believed that OCD is linked
to low levels of serotonin in the brain.
The study found that 6 out
of 7 people in 2 separate families who had a single mutation on the hSERT gene had OCD.
4 people with a 2nd mutation on the same gene had the most severe OCD symptoms.
The study was published in
the journal Molecular Psychiatry.
this may be a helpful resource for you to find help
or support where you live! i checked it out & it seems to be a useful tool!
NAMI-C.A.R.E. is a peer-based, mutual support group program
for individuals facing the challenges of recovering from any serious mental illness.
Led by consumers, for consumers, NAMI-C.A.R.E. employs guidelines
& principles of support designed to empower its members.
NAMI-C.A.R.E. is not illness-specific & welcomes persons
w/all psychiatric diagnoses.
A support group model that focuses on allowing all participants
to share their experiences & learn from each other in a safe & confidential environment.
How do I join a group?
Find your local NAMI affiliate or state organization & ask if they
have a NAMI-C.A.R.E. group.
Contact Maggie Scheie-Lurie (this is an e-mail link) at NAMI's national office.
How can I start a group?
NAMI consumer members may contact Maggie Scheie-Lurie to receive a NAMI-C.A.R.E. Startup Kit & Facilitators' Manual
or enquire about facilitator training.
There are several types of support groups available
for people suffering from OCD. Some groups are professionally assisted, highly structured and therapeutic in nature. Other
support groups are informative and provide a supportive, informal empathetic environment for people coping with OCD. They are often led and organized by people who suffer from OCD.
Professionally Assisted Support Groups
The first type is the professionally assisted support-group.
This kind of group is organized and run by a mental health professional. It is actually group therapy. The therapist runs
the group and members pay a fee per session. It is usually held at the therapist office and may or may not be underwritten
by insurers. It is an extension of the individual therapy sessions.
Mutual Support Groups
The second type of support group is the
mutual support group. This type of group is run by an individual or individuals who are OCD sufferers. Usually, these individuals
have recovered from their OCD and are presently managing their symptoms. In these meetings, participants discuss specific topics,
such as medication, symptoms, cognitive behavior therapy, etc.
The goal of these support groups is informational, not therapeutic. Guest speakers including mental health professionals are invited
to speak on a specific topic of interest to the group. Mutual support groups usually are held at a public facility, such as
a local school or church. There is usually no fee for mutual support groups unless there is a fee for the room or for refreshments.
Twelve Step Groups
The third kind of support group is the twelve step group.
There is a network of Obsessive Compulsive Anonymous (OCA) groups throughout the United States. These groups are run by the
members of the group in the same manner as the original 12-step group, Alcoholics Anonymous. A listing of these groups by
location is available on the OCA website at http://members.aol.com/west24th, or by calling the OCA National Headquarters at (516) 739-0662.
G.O.A.L (Giving Obsessive Compulsive Another Lifestyle)
Groups
The fourth kind of support group is the G.O.A.L
(Giving Obsessive Compulsive Another Lifestyle) Group. The original G.O.A.L. group was started by a psychologist and an OCD
sufferer in 1981. The purpose was to prevent relapse by continuing to have sufferers work on exposure and response prevention
therapy in a group. A G.O.A.L group is professionally assisted. This means that there is a therapist present at every meeting,
but his/her job is merely to provide technical information; it
is the members themselves who actually run the group. The OCF national office sells a manual and a video about G.O.A.L. that
outline how to organize and conduct this type of group. Please call the OCF at (617) 973-5801 to purchase this video and manual.
OCD Chicago, an affiliate of the OCF, holds a biweekly G.O.A.L.
support group for OCD sufferers and their friends and family. This group meets on the first and third Wednesday of every month
from 7-9pm at Flourish Studios, 3020 North Lincoln Avenue, Chicago, IL 60657. If you are interested in participating, please
call (773) 880-1635 or email info@ocdchicago.org.
If you struggle with OCD, it may provide some comfort to know you are not alone. 1 in 50 adults in the United States is reported to have OCD. Imagine if you could connect with others like you, across the globe, anytime. Now you can.
OCDTribe is a free online support community, with thousands
of members, designed specifically to connect individuals with OCD from around the world. Members receive 24/7 access to the latest in social networking features
such as blogs, forums, messaging, profile pages, groups, games and more. OCDTribe offers members a place to share stories,
encouragement, and friendship.
Do you struggle with obsessive-compulsive behavior,
anxiety, depression, or fear? All are welcome, including family members and friends, to this Christian-based support group for OCD and related disorders.
Contact Larry Snapp, a licensed professional counselor who will be leading the group, at (303) 332-4384 or via email at ocdsurvival@hotmail.com. Meetings will be held at the New Life Church at 17690 East Iliff
Avenue in Aurora, CO. The group meets once a month, every third Thursday, at 7pm.
Posted: July 8, 2008
Attention: Adults with OCD in Dallas County,
Texas
All adults suffering from OCD (and
their friends and family) who are interested in forming a support group in Dallas County, TX, please contact
G.B. at (972) 322-0094. This support group will be free and G.O.A.L.-oriented. If you are interested in participating in a
conference call forum for OCD support, please call (616) 597-8000, access code 890718, at 8pm CST on Wednesdays.
Posted: June 9, 2008
Calling All Adults with OCD in Central Florida
We currently have at least three local professionals (all with Doctorate degrees that treat OCD) that are definitely interested in
contributing to a group; all we need now is you! Please contact Javina at javina.barton@gmail.com or call (407) 414-2719 any time if interested in volunteering
or attending.
There are some other important terms that I believe are
being ignored and those are:
Emotions
Feelings
The reason I believe this is this:
Those with any mental illness will feel similar to someone
with a disability. Mental illness can be considered a disability at times. But having a disability means that you are "different"
than normal people. Being different than normal people, especially experiencing a mental illness which carries its own negative
stigma forces you to experience certain emotions and feelings.
What you do with the emotions and feelings you are experiencing
is very important. What the medical community hasn't stressed is the importance of expressing emotions and feelings in the
"physical sense." It's barely discussed for emotional stability so how can we expect for them to expound upon the importance
of how we express these very important factors?
Triggers are the beginning of an emotional experience aren't
they? When you're triggered by a certain experience emotions and feelings begin to form within your mind and within your heart.
You feel threatened by the trigger. You feel suddenly unsafe. These feelings are important to recognize. Once you begin to
recognize and identify what you are feeling you can then begin to control your destiny with OCD.
It's so important.
The same goes for other mental illnesses. Another important
feeling is "acceptance." Having OCD makes you different and people are uninformed and uneducated
concerning mental illnesses. Feeling unaccepted because you are different brings feelings and emotions with it!
A very important factor is learning to accept yourself. Learning to accept who
you are with Obsessive Compulsive Disorder. It's part of you and it's up to you to accept if first before others can accept
it and then accept you for who you are.
This is why the underlined link words that take you to other sites that contain emotions, feelings
and to sites that will teach you about some important tools that you can use to accept yourself are so important for you to
utilize.
Deep brain stimulation approved for
obsessive-compulsive disorder
People with severe obsessive-compulsive disorder have a new
treatment option available: The Food and Drug Administration has approved deep brain stimulation as a therapy for the disorder.
With deep brain stimulation, electrodes permanently implanted
in a person’s brain emit electrical signals that alter the functioning of the brain’s complex circuitry.
Scientists aren’t yet sure how the intervention works.
In some cases, it may activate brain circuits that are sluggish; in other cases, it may inhibit circuits that are overactive.
With OCD, it’s believed that hyperactive circuits contribute
to heightened anxiety and, often, depression. People with the disorder indulge in repetitive behaviors, such as washing their
hands incessantly or repeatedly making sure a door is shut, as a way of controlling anxiety.
The FDA granted what’s known as a “humanitarian
device exemption” to Medtronic Inc. for its Reclaim deep brain stimulation system as a therapy for obsessive-compulsive
disorder. The designation allows Medtronic to market the device on a limited basis to fewer than 4,000 patients.
The agency said its decision was based on a study of 26 patients
with severe OCD that showed a 40 percent reduction in symptoms after a year of deep brain stimulation therapy. All the patients
had tried and failed other therapies.
This is the first time deep brain stimulation has been approved
as a therapy for a psychological disorder. The treatment is already approved for patients with so-called movement disorders
-- Parkinson’s disease, essential tremor and dystonia.
Medtronic and other device makers see a large potential in deep
brain stimulation and are working with scientists across the U.S. investigating the therapy for conditions such as severe depression, epilepsy, chronic
pain and Alzheimer’s disease.
The success of these efforts depends on identifying the function
of various brain circuits and learning how to alter them without damaging other brain activities. Much of this science is
still in its infancy.
Experts warn that deep brain stimulation involves brain surgery, carries potentially
severe complications and should only be performed at centers with proven expertise.
On average, people w/OCD see 3 to 4
doctors & spend over 9 years seeking treatment before they receive a correct diagnosis. Studies have also found that it
takes an average of 17 years from the time OCD begins for people to obtain appropriate treatment.
A woman visits her
dermatologist, complaining of extremely dry skin and seldom feeling clean. She showers for 2 hours every day.
A lawyer insists on making
coffee several times a day. His colleagues don't realize that he lives in fear that the coffee will be poisoned and he feels compelled to pour most of it down the drain.
The lawyer is so obsessed
with these thoughts that he spends 12 hours a day at work: 4 of them worrying about contaminated coffee.
A man can't bear to throw
anything away. Junk mail, old newspapers, empty milk cartons all "could contain something valuable that might be useful someday." If he throws things away, "something terrible will happen."
He hoards so much clutter
that he can no longer walk through his house. Insisting that nothing be thrown away, he moves to another house where he continues
to hoard.
A 10 year old girl keeps apologizing for "disturbing" her class. She feels that she's too restless and is clearing her throat too loudly. Her teachers are puzzled and
over time become annoyed at her repeated apologies since they didn't notice any sounds or movements. She's also preoccupied with "being good all
the time".
These people suffer obsessive-compulsive
disorder (OCD). The National Institute of Mental Health estimates that more than 2% of the US population or nearly
1 out of every 40 people, will suffer from OCD at some point in their lives.
The disorder is 2 to 3 times more common than schizophrenia
& bipolar disorder.
According
to a survey conducted in the early 1980's by the National Institute of Mental Health (NIMH),
the Federal agency that supports research nationwide on the brain, mental illnesses & mental health, provided new knowledge
about the prevalence of OCD.
Prior to this survey, the amount of individuals experiencing OCD's obsessions & compulsions was thought
to be extremely minimal.
People whose brains
are injured sometimes develop OCD, which suggests it's a physical condition. If a placebo is given to
people who're depressed or who experience panic attacks, 40% will say they feel better.
If a placebo is
given to people who experience obsessive-compulsive disorder, only about 2% say they feel better.
This also suggests a physical condition.
Many healthy people can identify with some of the symptoms of OCD, such as checking the stove
several times before leaving the house. Those with OCD can consume hours a day repeating their behaviors finding it distressing enough to interfere with daily life.
The course of the disease
is variable, meaning the symptoms may come & go. Symptoms may ease over time, or can grow progressively worse. Research
suggests that OCD might run in families although scientists
haven't identified the gene.
"Getting dressed in the morning was tough because
I had a routine, & if I didn't follow the routine, I'd get anxious & would have to get dressed again.
OCD is likely
the cause of a number of intertwined & complex factors, which include genetics, biology, personality development &
how a person learns to react to the environment around them.
Resistance
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're at work or attending school. Over the months or years, resistance may weaken and when this happens, OCD may become
so severe that time consuming rituals take over the sufferers' lives, making it impossible for them to continue activities
outside the home.
OCD sufferers often attempt to hide their
disorder rather than seek help. Often they're successful in concealing their obsessive-compulsive symptoms from friends
and coworkers.
An unfortunate consequence of this secrecy is that people
with OCD usually don't receive professional help until years after the onset of their disease.
By that time, they may have learned to work their lives
and family members' lives around the rituals.
What Causes OCD?
Doctors don't know the exact cause of obsessive compulsive disorder.
An
insufficient level of serotonin, one of your brain's chemical messengers,may contribute to obsessive compulsive
disorder. People who have obsessive-compulsive disorder & who take medications that enhance the action of serotonin often show great improvement.
Disorders
such as OCD, which had previously been thought to be character flaws or worse, are now being attributed to the intricacies of the human mind.
What science
is learning about the relationship between brain chemistry & individual behavior offers hope. There's growing evidence that OCD has a neurobiological basis. OCD is no longer attributed to family problems or to attitudes
learned in childhood:
an unusually
extreme emphasis on cleanliness
a belief that
certain thoughts are dangerous & unacceptable
The search
for causes now focuses on the interaction neurobiological factors & environmental influences. Brain imaging studies using
a technique called positron emission
tomography (PET) have compared people with &
w/out OCD.
Those with
OCD have patterns of brain activity that differ from people with other mental illnesses or people with no mental illness.
PET scans
show that in patients with OCD, both behavioral therapy and medication produce changes in the caudate nucleus, a part of the brain.
This is graphic evidence that both psychotherapy and medication affect the brain. Be assured that OCD is far from a rare condition.
OCD
in children and adolescents is common compared to some other major diseases of childhood. Not as common as asthma, but
OCD is far more common than juvenile-onset diabetes.
This brain chemical, one of many that allows the nerve cells to communicate with one another,
is thought to regulate mood and sleeping patterns.
Other studies have found that people suffering from obsessive-compulsive disorder, like those
who have a depressive illness, take an abnormal amount of time to begin dreaming after they've first fallen asleep. That finding adds to the theory that
the illness is caused by imbalances in the brain chemicals that control sleep.
Still other research supports the theory that biology plays a role in showing that people suffering
from OCD have an abnormal response in their growth hormones when they take a medication that treats high blood pressure.
These findings give some credence to the theory that links
the illness to normal biological responses to threats. According to this theory, healthy people become accustomed to a stimulus
that - although originally thought to be a threat - turns out to be harmless.
OCD people never develop an "immunity" to the stimulus and continue to feel anxious. Over time, their anxiety develops into obsessions, which then give rise to the compulsive behavior.
Studies indicate that the illness can become more ingrained if patients wait before they seek
help. With proper treatment people suffering from OCD can return to a fully functioning life.
Biological
factors involving
brain structure and activation are associated with OCD. Abnormalities of the frontal lobes, basal ganglia, and cingulum are
common in people with OCD. Basal ganglia are involved in routine behaviors, like grooming and the frontal lobes in organizing
behaviors and in planning.
The cingulum consists of fibrous bands that
assist in communicating the brains behavioral and emotional messages. Support for its role in OCD is the fact that surgical
severing of the cingulum has relieved and even cured people with the disorder.
First of all, it's important to understand that no one person causes obsessive compulsive disorder in another, nor do people bring the illness upon themselves as a
result of weak morals or character.
Secondly, it's imperative that those experiencing symptoms of
OCD seek a complete evaluation with a licensed psychiatrist of psychologist who can accurately
diagnose the disorder.
Third, follow the treatment recommendations of your doctor and voice any concerns or questions.
One of the most effective ways to cope with OCD is to
learn as much as you can about it. By doing
so, you can help yourself and your loved one
regain a healthy, fulfilling life.
An abnormally low level of serotonin is perhaps the most well-established link between the brain
& OCD. Serotonin is a chemical neurotransmitter that transmits information from one nerve to another throughout the brain.
It's released by one synapse(nerve ending), crosses a gap, &
is picked up by another synapse. After a message is sent, enzymes in the brain clean serotonin out of the synapses. Drugs used to treat OCD, known
as selective serotonin reuptake inhibitors (SSRIs), increase & sustain serotonin levels & reduce or eliminate symptoms.
If you're a family member or
friend of someone w/OCD, your first & most important task is to learn as much as you can about the disorder, its causes
& its treatment. At the same time, you must be sure the person w/OCD has just as much, if not more, access to info about
the disorder.
Women
w/OCD may experience a worsening of symptoms during pregnancy & postpartum.
A recent study suggests that fluctuating hormones may trigger symptoms during pregnancy. The same study reports OCD in 30%
of women observed.
Many with OCD have symptoms that result in walls of doubt between themselves and people with whom they come into
daily contact.
i.e., the washer who'd become terrified if a stranger would come
up to and touch her babies is "convinced" that others are more careless about the presence of dirt or germs on their hands.
Fact is, most
family members, friends and fellow employees wouldn't touch our babies or walk on our carpets if they thought that something
harmful was on their hands or shoes.
True, your definition of what's harmful may be different from theirs, but this is where you must
put the principle into practice.
Being a participant
in society involves trusting the people around you to a reasonable extent. If you've lost the ability to judge what's "reasonable trust," remember how you acted toward people before developing OCD or take notes from a friend you respect in a similar role as yourself (i.e., another mother, father, student, business person, etc.).
Start small and
work up to more difficult matters. If you feel compelled to clean excessively after a guest
has been in your home, try to delay responding to this urge.
Remind yourself
of your need to be more trusting of people. If you must clean or wash, keep it to the bare minimum and stay committed to delaying longer and doing less the next time.
It'll take courage, but you'll be happier in the long run.
OCD and Relationships
Let's look at the basics of how OCD
can affect a relationship....
Just like living with a chronic
physical illness that includes certain disabilities from its symptoms, OCD is a medical illness with debilitating symptoms that can cause a strain on most relationships.
Whether it be with your immediate
family, a spouse, girlfriend or boyfriend or your close friends, having OCD causes most people to tend to isolate themselves because of the despair, shame and frustration that they suffer with as a result of their obsessions and compulsions.
For the family, spouse or
friends who don't have OCD:
There is a constant "awkward" feeling with the efforts to understand and accommodate the symptoms the loved one with OCD is experiencing.
In the same light, the individual
that is experiencing the OCD realizes that their own obsessions and compulsions are strange, hard to deal with and annoying. Sometimes feelings of guilt emerge for having to expose a loved one to these behaviors.
It's extremely important to maintain a peaceful environment and a flow of communication between the OCD sufferer and their loved ones. Stress can trigger the disorder to escalate. Each person in the relationship must get in touch with their feelings and emotions to allow themselves the freedom to feel the pain and process it.
Explaining this to friends
and family may seem difficult to do, but in the long run, everyone involved will appreciate your efforts. Sometimes there can be tension from lack of information and education about your disorder.
People with OCD
avoid many situations or objects that trigger their compulsions. The family and friends that surround the ocd sufferer may trigger avoidance behaviors without even realizing it.
After you've come
far enough in your recovery to feel that you've identified your triggers, communicate them to your close ones, so they can be aware of what could set your compulsions off.
Share your knowledge and understanding of
the disorder with your family and friends....
Hopefully, you'll both be
able to talk about the disorder and express your feelings about it, openly and honestly. This will be a great beginning to the healing process for both of you and any other family members of friends that are involved.
Communicating your knowledge of the disorder, especially when you learn something new and enlightening can be the foundation for a truly supportive home life.
Tell your family members when you're having a particularly
hard day....
Ask your family to acknowledge your improvements, however small, for encouragement and reward for the progress. Things like cutting down a hand washing routine by 5 minutes or reducing
a checking ritual from 50 checks to 40 checks may seem insignificant, but represents a great step forward and gets easier
if there's acknowledgment by others.
Recognition and praise is always encouraging, but family members or friends may not realize the importance.
Click here to visit the Red Cross page that allows you to access your local chapter of the Red Cross by entering your zip code in the
specified box, to see how you can help in your area. You can also call your local Red Cross Chapter that you can find the
number for online or in your local phone book to volunteer for any openings that may need to be filled or you can find another way to help others there as well!
you've been visiting anxieties 101...
please have a great day & take a few minutes to explore some of the other sites in the emotional feelings network of sites! explore the unresolved emotions & feelings that may
be the cause of some of your pain & hurt... be curious & open to new possibilities! thanks again for visiting at anxieties
101!
