OCD

The diagnostic and statistical manual for psychiatric disorders states that obsessions are persistent ideas, thoughts, impulses, or images that are experienced as intrusive and can cause marked anxiety.

Common obsessions are:

1. Contamination. The act of shaking hands with a stranger can trigger an obsession about contaminated hands which will cause increased anxiety. The act of washing hands excessively sometimes to the point of raw, bloody hands will reduce anxiety.

2. The obsession about (safety) an unlocked door will increase anxiety. To reduce anxiety the person will check and recheck the door lock several times a day.

3. The need to have things in a particular order can cause psychic pain and increased anxiety. Arranging items in order will decrease anxiety. 

Compulsions are repetitive behaviors (excessive hand washing, checking and rechecking, etc.) or mental acts (counting and repeating words silently, etc.) In most cases people feel driven to perform the compulsion to reduce the distress (anxiety) that accompanies an obsession. For example, if the individual is obsessed about leaving the door unlocked the person may check the door every few minutes during an entire day. Another example is if the individual has what they perceive as blasphemous thoughts; the person may find relief by counting to 10 backward and forward for each terrible thought. It is not uncommon for people affected with OCD to create rigid rules for themselves and to adhere to them in a loyal fashion; which, in and of itself, causes anxiety.

OCD is extremely uncomfortable to experience. The level of anxiety is moderate to severe and sometime reaches panic level. People with this condition commence in repetitive behaviors to prevent or reduce anxiety not to provide pleasure or gratification. Performing the compulsions may become a major life activity, leading to marital, occupational, and social disability. The avoidant behavior may leave the suffering person homebound.  

Signs and Symptoms: 

1. Avoidant behavior of situations which cause intense anxiety, such as: shaking  someone’s hand or using a public restroom.

2. Frequent trips to the doctor to seek reassurance.

3. The feeling of guilt to the point of a pathological sense of responsibility.

4. Sleep disturbances.

5. Physical symptoms such as, an increased heart rate from a sustained, moderate to severe anxiety level.

6. Excessive use of sleeping pills, tranquilizers and alcohol.

7. Intrusive thoughts and compulsive behaviors over and above what is considered the societal norm.  

Course 

What do you do if you think you have OCD?  

Go to the doctor. The doctor will assess you and your symptoms. The doctor (preferably a psychiatrist) will give you a diagnosis. Once you have the diagnosis read everything there is to read about your diagnosis. Once you have educated yourself about your condition return to the doctor and collaborate with the doctor to reach an acceptable plan of care.  

Some psychiatrists think we have no medications to help curb OCD symptoms. And of course, other psychiatrists think the opposite.  

During my career I met several people with OCD. I saw some medications work on a temporary basis. Long term, not so much. As a nurse, I stopped the behavior, especially if the person was in the process of hurting their body. A good example of this is if a person was washing their hands too much. I would put them on a schedule for hand washing, such as, after using the restroom, before eating meals and so on. I would insist the person put lotion on their hands frequently and even triple antibiotic ointment if they had open sores which were indeed common. 

So, what I am saying here is to treat the obvious wounds if they are present. Next, if you are diagnosed, accept that you have the disorder. Accept that you are going to commence in compulsive behavior. If you are checking a lock several times a day, with the exception of your anxiety, this action does not hurt you or anybody else.  If your symptoms are not interfering with your life then I see no need to be on medications. If your actions are interfering with your daily activities then seek counseling and see a psychiatrist. Again, if medication works for you, take it until your anxiety wanes. Do what your doctor recommends of course. 

If your anxiety level reaches marked, severe, or panic level seek help. No need to be that uncomfortable.  

Jack Nicholson and Helen Hunt were in a movie called “As Good As It Gets” in 1997. This was a wonderful love story, but it also shows how uncomfortable Jack was with his OCD symptoms. This movie puts a little humor on the subject. Also, a fun show to watch is “Monk” on USA. This is a funny show, but it also depicts how Monk feels with his OCD symptoms.

Beyond mild anxiety, any form of anxiety is UNCOMFORTABLE. Rally your family and friends for support. At work let the supervisor know you have some anxiety in the form of OCD. He or she can watch out for your safety if your anxiety reaches marked or panicked level. Socialize when you feel strong, but certainly never shut anyone out of your life because you feel anxiety. Having a strong support system really helps reduce anxiety. ASK FOR HELP when needed. Join or even start a support group. This can be done over the internet or in person. Self acceptance is essential to help reduce your anxiety. Help yourself by helping others.

Tags: 'As good as it gets.', Helen Hunt, monk, obsessive-compulsive disorder, ocd