Obsessive-compulsive disorder: Getting a grip on OCD

We all have our little habits and whims we take to heart, like checking several times whether we’ve turned the oven off before leaving the house, or polishing our knick-knacks until they sparkle. And even though we know these are eccentric habits, we hang on to them. There’s no cause for concern there. However, these rituals can become obsessive in some people and take over their lives.

We all have our little habits and whims we take to heart, like checking several times whether we’ve turned the oven off before leaving the house, or polishing our knick-knacks until they sparkle. And even though we know these are eccentric habits, we hang on to them. There’s no cause for concern there. However, these rituals can become obsessive in some people and take over their lives.

People with obsessive-compulsive disorder (OCD) are overwhelmed by persistent, recurrent or unreasonable ideas, thoughts or imagery (obsessions), and they use rituals (compulsions) to dominate them. They can’t stop themselves from performing these rituals. OCD is one of the anxiety disorders that influence people’s thoughts, behaviours, emotivity and senses. Most adults with OCD admit that their rituals and obsessions are not sensible. Some adults and most children with OCD, however, are not conscious that their behaviour is not typical. OCD affects both men and women.

There are many obsessions and compulsions associated with OCD. For example, sufferers who are obsessed with dust or germs may feel compelled to constantly wash their hands… which they could do dozens or even hundreds of times per day, until their skin is raw. Persons who develop an obsession with intruders may check their door locks several times before going to bed. Other common rituals include the need to check things repeatedly, to touch objects in a specific sequence, or to count items. Common obsessions include thoughts of injuring or attacking loved ones, of imposing unwanted sexual acts, or of acting in ways contrary to their own religious beliefs. OCD sufferers may also pull their hair repeatedly. These rituals do not bring them any pleasure; at best, they bring them temporary relief from their obsessive thoughts.

It is estimated that one in fifty Canadians has OCD; most of these individuals also suffer from other mental illnesses (e.g. depression) or from eating disorders. The disease usually develops in adolescence or early adulthood.

The way the disease develops varies. Symptoms can come and go, and improve or worsen over time. If the disorder becomes severe, it can stop the individual from working or handling household duties. Some may even try to “treat” themselves by avoiding situations that trigger their obsessions, or by using alcohol or drugs to help them relax.

No clear cause has been identified for OCD. Many years of research have shown that the disorder may be a consequence of changes in the brain’s chemical balance and function. It is also known that having parents or family members who have OCD increases the risk of suffering from the disease, although no responsible gene has yet been identified for the disease. Many also believe that habits learned and encouraged in our environment can contribute to the onset of OCD, as can a stressful event.

There’s a difference between being a perfectionist and suffering from OCD. It may be that your floor is so clean you could eat off of it, or that your clothes have to be put away in a very specific way. But this doesn’t necessarily mean you suffer from OCD. If your life is affected by obsessions and compulsions, and you feel powerless towards them, you should consult your physician or a mental health specialist.

Your doctor will review your medical history, symptoms and behaviours, and will also ask various questions. He or she may also wish to speak to family members or friends, if possible. A physical exam and lab tests (to check the thyroid gland, for example) may also be performed.

OCD can be difficult to treat, but it is possible to cure it. Some people will require treatment for their whole lives, but the treatment may manage symptoms in such a way that they no longer control their life. The two most commonly used treatments are medication and psychotherapy, although a combination of the two appears to be more effective.

Studies suggest that cognitive behaviour therapy may be the most effective form of psychotherapy for both adults and children. It involves “restructuring” one’s thoughts and routines in order for compulsive behaviours to no longer be necessary. One approach in particular involves helping individuals gradually face the situations that cause them fear or anxiety so that they become less sensitive to them. Learning these techniques takes a lot of effort and training, but once they have learned to control these obsessions and compulsions, the benefits of enjoying a better quality of life greatly outweigh the effort required.

Medication can also help alleviate these obsessions and compulsions. Drugs from the antidepressant class may help, for example, because they increase brain concentrations of serotonin and these levels may be unbalanced in persons with OCD. Pharmaceutical treatment is tailored to each patient and people can react differently to various treatments. It is important to know that it may take several weeks before symptoms improve. It is also not unusual for patients to have to try several pharmaceutical treatments before finding the one best suited to them. The physician may also recommend drug combinations in order to increase treatment efficacy. If you have any questions on these drugs, speak to your pharmacist.

People with OCD cannot treat their disease on their own, but they can help control their symptoms in different ways, for example by taking their medication as prescribed, by paying attention to the warning signs of a relapse, and by avoiding drinking alcohol or taking illicit drugs. Other ways to improve one’s quality of life when living with OCD include getting informed, joining self-help groups, taking up a sport or hobby, learning relaxation techniques and keeping a well-organized schedule.