Obsessive Compulsive Disorder

What is Obsessive Compulsive Disorder?

A woman is about to leave her home for the day, and as she stands at the front door, she wonders if she’s turned off the coffee pot. She runs back for a quick check, and satisfied, she leaves the house. It’s happened to everyone, and these minor memory lapses and quick checks are all a normal part of the human experience. There are times, however, when these small checks can swell in size and take over someone’s life. If this woman had obsessive-compulsive disorder (OCD), for example, she might need to check the coffee pot 20 times, and then turn the oven on and off five times before she could leave. Once she had left her house, she might become convinced that she hadn’t done some part of the ritual properly, and so she returns home to start again. The woman might never make it to work, as she cannot free herself of the ritual.

It might sound like a rare condition, but OCD impacts many more people than you might imagine. In fact, the International OCD Foundation estimates that one in 100 adults and one in 200 children have OCD. The disease can be a terrible and terrifying disease, both for the person who is affected and for the family of that person, but there are effective treatments available that can silence the urges for good.

Obsessive Compulsive Basics

People with OCD are consumed by unpleasant thoughts. These thoughts become obsessions, and the person might be helpless to fight them. In order to soothe the mind and chase those intrusive thoughts away, the person will engage in a series of rituals or behaviors.

A person with OCD might obsess over:

  • Germs and infection
  • Order and symmetry
  • Luck and numerology
  • Being good or pleasant

Consuming behaviors can including:

  • Hand washing
  • Checking switches on appliances
  • Checking doors and windows
  • Counting to a certain number
  • Using a number of steps in processes
  • Arranging items in a precise order

These thoughts don’t bring the person pleasure. By contrast, the thoughts might cause the person to feel intense fear and loathing. When the person is relaxing or at ease, the thoughts begin to invade the mind. People with OCD may experience these thoughts in the evening, when they are about to fall asleep, or they might be consumed with unpleasant thoughts while they’re at work, trying to complete a complicated task.

According to a study published in the journal Child and Adolescent Psychiatric Clinics of North America, most adults know that their behaviors are strange or not normal. Many children, on the other hand, may not know they’re behaving strangely. This could mean that adults with OCD might hide their activities from their families, while children might act out these rituals in the open. Both groups, however, do not gain pleasure from performing these activities. They may believe that their activities help to keep something terrible from happening, but the activities themselves don’t cause happiness. A woman might wash her hands 100 times in order to keep her from giving her child an infection, but her hands may be chapped and bleeding after these marathon sessions.

Some people experience terrifying fears that they will hurt someone else. For example, if a person with OCD hits a bump in the road, that person might become convinced that the bump in the road was a body, and the person might circle the scene hundreds of times, unable to turn away. Some people believe they can keep their families safe from terrible accidents if they walk backwards around their rooms 30 times per night, in just the right way. If they do the activity wrong, by contrast, they become convinced that the deaths are coming and they will be the person’s fault.

To be diagnosed with the disease, a person must spend at least one hour per day on the rituals, and those rituals must be unpleasant.

It’s important to note that people with OCD spend a significant amount of time on these rituals. Many people with OCD spend significantly longer than an hour on these rituals. Some people become severely disabled, unable to leave the house because they must spend time on the rituals.

Risk Factors

According to the American Academy of Family Physicians, OCD is often caused by a chemical imbalance in the brain. Chemicals that transmit messages from one brain cell to another are in short supply in people who have OCD, so messages are either lost or simply repeated over and over. Some of these chemicals allow chemical signals to shut off once they are delivered. Since people with OCD don’t have enough of these chemicals, the signals are never shut off and they may receive the same message, over and over. It’s possible that some types of brain injuries can cause OCD. People who are hit on particular parts of their heads seem to develop difficulty with spontaneous thought, and this could cause OCD.

According to the National Institute on Mental Health (NIMH), OCD can also run in families.

NIMH says people who have OCD have a 25 percent chance of discovering someone else in their immediate family who also has the disease. It seems that there is some genetic component at play in the disease, although researchers have yet to isolate the specific genes responsible.

Long-Term Effects

People living with OCD are under an incredible amount of pressure, as they truly believe that the rituals they perform make a difference, but only if they do those rituals properly. This long-term stress can cause heart disease and ulcers, and some repetitive rituals can have health effects of their own. People who wash their hands 100 times per day, for example, might develop skin irritations, and people who scrub their hair repetitively might pull that hair out.

People who have OCD might also feel a significant amount of shame and embarrassment about their disorder. After all, most adults know that their behavior is not normal, and they may live in fear that someone will discover their rituals. Even though they know they’re not behaving appropriately, they cannot stop. This can be incredibly isolating for the person with OCD. The person struggles each day, is unable to stop, and is unable to talk about the disease with friends or loved ones. It’s a terrible way to live.

OCD will not resolve on its own, and children who have the disease will not simply outgrow it.

In fact, the disease can progress and strengthen as the child grows, and the longer the behaviors are allowed to go on unchecked, the harder it is for the person to change those behaviors.

Living with someone who has OCD can also be difficult. You might be embarrassed that your child turns the lights on and off during a dinner party, or you might face questions from your child’s school about your child’s repetitive behavior in class. Living with an adult with OCD means living with someone who keeps secrets, and these secrets can be incredibly damaging to the family’s sense of cohesion and trust.

Confronting the person and forbidding the activity is rarely helpful, either. As a study published in the journal Science and Medicine has demonstrated, people with OCD often have a restructuring of the basal ganglia in the brain that is driving the disease. This brain disorder stands behind the disease, making it difficult for the person to change the behavior. Just like a person can’t cure an irregular heartbeat through sheer willpower, a person with OCD often can’t stop the intrusive thoughts and repetitive behaviors through force of will alone. Asking someone with OCD to change without help is simply unfair, and in fact, it might drive the person deeper into a sense of isolation.

Getting Help

Often, this means family members must confront the person with the reality of the situation, and present the idea of therapy as a viable option.

There are many treatments that can help treat OCD. Some doctors use medications to treat the disease, while others combine medications with talk therapies that can help the person with OCD learn to stop the obsessive thinking patterns before they start. For these treatments to work, however, the person needs to be convinced to use them.

Since the person with OCD may seem fragile and upset due to the very nature of the disease, it may be a good idea to hold these interventions with the help of an interventionist.

This professional can help structure the conversation so it will do the most good and cause the person the least amount of pain. The interventionist may also be able to provide the family with information about OCD, which can help them learn to support the person through the recovery process.