Obsessive-compulsive disorder



Obsessive-compulsive disorder (OCD) is characterized by recurrent obsessional thoughts or compulsive acts.

Obsessional thoughts are ideas, images or impulses that enter the individual's mind again and again in a stereotyped form. They are almost invariably distressing (because they are violent or obscene, or simply because they are perceived as senseless) and the sufferer often tries, unsuccessfully, to resist them. They are, however, recognized as the individual's own thoughts, even though they are involuntary and often repugnant.

Compulsive acts or rituals are stereotyped behaviours that are repeated again and again. They are not inherently enjoyable, nor do they result in the completion of inherently useful tasks.

It must be recognized that this is different from the obsessions that are a feature of autistic spectrum disorders in that the obsessions are not enjoyable or in any way beneficial, which can sometimes be the case with autism, for instance an obsession to study an interest.

The National Institute of Mental Health (USA) describes Obsessive-compulsive disorder in these words: "Obsessive-Compulsive Disorder, OCD, is an anxiety disorder and is characterized by recurrent, unwanted thoughts (obsessions) and/or repetitive behaviors (compulsions). Repetitive behaviors such as handwashing, counting, checking, or cleaning are often performed with the hope of preventing obsessive thoughts or making them go away. Performing these so-called "rituals," however, provides only temporary relief, and not performing them markedly increases anxiety."

Signs and symptoms
Signs and symptoms of Obsessive-compulsive disorder (OCD) include a set of signs and symptoms separately of obsessions and compulsions. They are generally severe ans time-consuming. Typical signs and symptoms of OCD - obsessions as well as compulsions - are briefly outlined below.

Obsessions
Typical OCD obsessions manifest in the following ways:


 * Same doubts get repeated again and again,
 * The person remains immersed in images related to sex
 * Aggressive and horrific impulses continuously surface, and
 * Extreme obsessions with orderliness and symmetrical designs.

All the above manifestations come involuntarily and repeatedly, and the persons affected find it difficult to control and get over them. Taking a practical view, obsessive OCD signs and symptoms include the following:


 * Doubts regarding having locked the doors,
 * Doubts regarding having turned off the stove or taps, etc.,
 * Frequent hand washing to clean it and get rid of dirt,
 * Loss of hair due to frequent pulling of hair,
 * Skin lesions due to frequent picking of skin,
 * Feeling of extreme distress when things are not orderly,
 * Avoiding shaking hands on account of fear of contamination,
 * Avoiding touching objects and articles fearing contamination,
 * Involuntary images of hurting a child, hurting someone in an accident,
 * Impulsive thoughts of obscenities and pornographic images,

Compulsions
In plain words, compulsions are repetitive behaviors that one is driven out to perform - repetitive behavior and action done to reduce or prevent anxiety/ distress related to one's obsessions. Typical obsessions revolve around the following:


 * Counting again and again,
 * Washing and cleaning repetitively,
 * Checking anything again and again,
 * Repeatedly demanding reassurance,
 * Repeating certain actions again and again,
 * Arranging articles and objects to make them appear orderly,

Compulsive OCD symptoms may typically involve doing actions compulsively without any reasons to ensure to give effect to one or more of the above, and may typically involve, for example, the following:


 * Repeatedly washing hands until the skin becomes raw,
 * Checking doors to see that they are closed properly,
 * Counting same or more things in a certain pattern, and
 * Seeing the stoves repeatedly to ensure that the same is off.

Causes
Exact causes of Obsessive-compulsive disorder (OCD) are yet to be fully understood and analyzed though generally it is believed to arise on account of certain biological and environmental factors. Strep throat and insufficient serotonin are also believed to contribute to OCD.


 * Biological factors: Some studies indicate that OCD may result due to changes in the natural chemistry of the person affected.


 * Environmental factors: According to some researchers OCD arises from behavior habits and behavior patterns which one learns and imbibes over a period of time.


 * Strep throat: Some studies indicate that children develop OCD after having strep throat, an infection with group A beta-hemolytic streptococcal pharyngitis — strep throat.


 * Insufficient serotonin: It is also believed that insufficient level of serotonin (one of the brain's chemical messengers) contributes to OCD.

Risk factors
Earlier it was believed that the prevalence the obsessive-compulsive disorder (OCD) was rare. With better diagnosis, it has been now found to a disorder which is more common than many other mental illness. For instance, according to the National Institute of Mental Health (USA), there are around 2.2. million persons in the USA having this disorder. This disorders mostly develop during adolescence or early childhood, generally around the age of 10. In adult, its onset begins at around the age of 21 years. A number of risk factors contribute to its development which may be grouped into three broad categories: family history, stressful events in life, and pregnancy.


 * Family history: Although researchers have so far not found any gene responsible for development of this disorder, generally speaking, if a person has one or more parents with this disorder and/ or sibling/s with this disorder, the chances of developing OCD increases.


 * Stressful life events: Certain stressful events in life may trigger the development of this disorder. Some people may react strongly to the stress trigging the "intrusive thoughts, rituals and emotional distress characteristic of obsessive-compulsive disorder."


 * Pregnancy: Some studies have indicated that preganant mothers and new mothers are at a higher risk of developing this disorder though exact reasons for the same are not known.

Treatment
The National Institute of Mental Health (NIMH) of the USA summarizes the treatment techniques of OCD in these words: "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." Treatment may involve psychotherapy as well as medication.

As the exact causes of OCD are not known, there is no particular way to prevent it from developing. Immediately after its diagnosis, getting treatment can prevent it from worsening.

OCD is a serious disorder and can negatively impact the life of the person affected with it, in the short as well as in the long run. A combination of psychotherapy, medications and self-care can assist in controlling its symptoms helping the affected person to lead a normal life. Self care involves a number of steps, the major ones among them are:


 * Following and complying with the treatment plan and the advice of the helath care personnel even if it appears uncomfortable,
 * Following the directions given by the health care personnel and advising them of side effects, if any,
 * Getting support of loved ones and close relatives like parents and sibling/s to enlist their encouragement during tough moments,
 * Getting involved in social activities in preference to isolating oneself,
 * Enlisting the co-operation of the a support group to exchange and share common experiences,
 * Learning more and more about this disorder to understand it better,
 * Always avoiding use of alcohol and other drug abuse.