Obsessive Compulsive Disorder (OCD)
What Can I Do To Help My Disorder?
If OCD Is Common, Why Do I Feel So Alone?
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What Is Life Like For Children With OCD?
What is Obsessive Compulsive Disorder?
Obsessive Compulsive Disorder is an anxiety disorder in which sufferers experience repetitive, and often distressing, thoughts and/or patterns of behaviour. The sufferers obsessions around the house can take on a horrifying intensity, leaving them mentally and physically drained.
Carers are often left bewildered and desperate for help, feeling they have nowhere to go, and no one to turn to for advice.
OCD is mostly centered around types of behaviour that are brought on by anxiety and fear. Sufferers can have the illness for so long (40 years is not unheard of, or unusual) that, for the most part, they can have forgotten the original trigger, or the event that is the underlying reason for the OCD.
Apart from the unavailability of treatment, people sometimes do not get help because they do not seek it, fearful of the stigma of mental ill health. Stigma is the main cause of discrimination and exclusion: it affects people’s self-esteem, contributes to disrupting their family relationships, and limits their ability to socialize, obtain housing and get jobs. It is a major obstacle to the prevention of mental health disorders, the promotion of mental well-being, and the provision of effective treatment and care. For example, in western Europe alone, evidence indicates that 45.4% of people suffering from depression get no treatment, neither do 24.6% of obsessive-compulsive disorder sufferers. (WHO statistics) Both conditions are closely associated with one another.
How Many Types of Obsessive Compulsive Disorder are There?
There are many types of OCD symptoms, which can be subdivided into 2 groups: Obsessions and Compulsions, though they are close allies, and together affect every aspect of a sufferers life.
These include obsessive and compulsive washing, cleaning, tidying, checking and re-checking, repeating action sequences, hoarding, the arrangement or symmetry of things, measuring, exactness and orderliness.
Obsessions about germs, dirt or contamination. Repeatedly counting up to a pre-determined number, or repeating tasks a certain number of times. Obsessive thoughts about doing harm to themselves or others, the obsession comprising preventative measures. Indecision or decisions that take a huge amount of ritualistic behaviour and time before any deed or action can begin. The obsessive need to feel safe and to ensure the safety of others.
What causes Obsessive Compulsive Disorder?
The exact causes of the condition are not known to science, but as a therapist I'm more than happy to offer a suggestion of my own. It is true that everyone is different and what triggers the behaviour in one person, will have little effect on another. Indeed for the greater proportion of the population any display of OCD symptoms is quickly rationalized and we can easily set them aside, at the same time hoping that nobody saw us. The trigger is usually expected to be some hugely traumatic event, such as an accident, a burglary, physical violence or the death of a close friend or relative. But actually that's not always true at all. I've treated cases where the trigger was parental disapproval of an untidy bedroom, or the sight of mouldy dishes and cups in the sink at a students residence. It's not a requirement that the trigger be big and dramatic, but has more to do with how we respond to it over a long period of time.
Recently I treated a farmer with OCD who had a compulsion to wash his hands, clothes, boots, land rover seat, door handles, keys, just about everything he touched between the cow shed and home, over and over and over again. The only time he stopped cleaning was at milking time, and then he started on the milking shed. The rituals, by this time, took up every waking moment and he seemed to be on a permanent high. He had gotten so bad that he avoided cooking as he felt it could be contaminated and had started to eat pre-packaged sandwiches, his rationale being that they were sealed. By the time he presented for treatment he was in a state of depression, anxiety and frustration. It turned out that about 10 years previously the milking herd went down with some bacterial infection and despite having taken all normal precautions to prevent this, he almost lost the herd.
Stepping up the disinfecting regime and treatment did the trick, and with vetinary supervision the herd quickly returned to production. It takes little imagination to see how this event could have been the trigger for the subsequent OCD. There is no doubt the farmer blamed himself and this anxiety led to the fear of it happening again. He couldn't ignore the nagging doubts and worry about cleanliness and over time those thoughts and fears became more frequent and distressing.
How Common is Obsessive Compulsive Disorder?
It is now known that between 1-3% of the UK population (over 1 million people) and 1 in 50 adults in the United States currently has OCD. However, twice that many have had it at some point in their lives. Increasing awareness has helped many to seek the advice and help they need to tackle this debilitating illness. Sufferers become increasingly isolated from society and their families, performing their rituals in secret, for it is fear of other people's judgements that is often the driver. Fear of ridicule, feeling embarrassed, in disgrace, rejected, guilty or ashamed, are all powerful, even crippling emotional responses for which we may in some way become obsessive or compulsive. Race, creed or class are no shield and OCD can affect anyone. Males as frequently as females.
Without doubt, most sufferers are aware of their obsessions and compulsions, know they are irrational, yet feel powerless to stop or control them.
Am I Going Mad? ... No, Of Course Not!
OCD sufferers often face an intolerable lack of understanding by the general public, and such misunderstandings only go to alienate the OCD sufferer more and more. Many OCD sufferers think they must be crazy and it is clear that through accusation and personal criticism, other people also assume this to be true.
Obsessive compulsives aren't mad or insane, and most will eventually recognize that their obsessions and compulsions come from an over active response to thoughts, rather than any real-life events. Their lives may be excessive and unreasonable to most of us, and this often leaves them fragile and alone, however, they are unlikely to ever harm anyone, as the obsessions and rituals they perform are almost always meant to benefit themselves or another, not to harm others. No specific genes for OCD have yet been identified, but that is not to say that a person's upbringing may not have contibuted to the onset of OCD.
How Is OCD Treated?
The good news is that OCD sufferers and their carers can now find relief as the symptoms can be controlled and treated.
The first thing to do when seeking treatment of any kind is always consult your GP.
Even if your GP has little or no knowledge of OCD, they will be the route by which you can get to a specialist who will have more experience of it. It's important to explain your symptoms thoroughly and not be reluctant due to embarrassment or shame. OCD is often misdiagnosed as depression in the absence of all the facts.
The treatment of choice at the moment appears to be CBT (Cognitive Behavioural Therapy) and SSRI's (Serotonin Reuptake Inhibitor Medications), either in combination or as seperate therapies. Medication is primarily used to take the edge off the OCD symptoms and then any trauma associated with the CBT. The majority of the drugs that can help OCD are classified as anti-depressants. Depression commonly results from the disability produced by OCD, which is largely due to the constant state of anxiety and the 'mental chatter' of overbearing thoughts that can completely overwhelm the OCD'ers life. Doctors can treat both the OCD and depression with the same medication.
What are some signs of depression?
Loss of appetite. Rapid weight gain or loss.
Early morning awakenings and difficulty getting back to sleep
Nightmares, and disrupted sleep
Exhaustion on waking. Lack of energy generally
Too much sleep, or too little (insomnia)
Lack of interest in things which were formerly pleasurable
Thoughts or expressions about death or suicide
Shortness of temper, or irritability
Crying, especially without knowing why
Low self-esteem. Can't be bothered with things.
Becoming emotional or upset for no particular reason
Lack of enjoyment of life
The condition is progressive in that the longer a person has OCD the worse it can become. OCD can affect children and young people of all ages and at least half of the adults who seek help for OCD already had the condition as children. Even now, for every 100 children in a school, at lease one of them will have OCD. If a child's education is taken away, or lost through 'illness', for the most part so are his/her life chances. It's therefore important to diagnose OCD early.
Sertraline and Fluvoxamine are currently licensed for use in children. Anti-OCD medications work because they affect the brain chemical serotonin. Serotonin is used by certain nerve cells in the brain to communicate with other brain cells. It is possible that people who get OCD have an imbalance in serotonin levels.
The BT in CBT stands for behavior therapy. The idea is to help people learn to change their thoughts and feelings by first changing their behavior. Behavior therapy involves exposure and response prevention. Gain prolonged exposure to the trigger, then deny the ritualized response. Cognitive therapy, or CT, is the other component of CBT. The aim of CT is to help reduce the catastrophic thinking and exaggerated sense of responsibility of individuals. CT is the logic side, and when the mind accepts the logic of something being unnecessary, it is easier to switch off the usual responses.
So what about Alternative Therapies? One OCD charity website stated that; "there is no medical evidence to suggest how effective ... alternative treatments are, so at the present time such alternatives can't be specifically recommended." It goes on to say; "Nonetheless, it should be noted that such methods can help some individuals where all other options have failed."
This is where I have to speak up, because it is just this type of statement that feds me right up. It also affects my english. As a Spiritual Healer and Alternative/Emotional Therapist I just have ONE QUESTION. If such methods can help when all other options have failed, WHY ARE THEY NOT USED INSTEAD?
I only add this here because my farmer friend was cured of his OCD with nothing more than the therapy I use for all types of anxiety disorder, Emotional Freedom Technique, or EFT. It didn't take 3 months of intensive 2 or 3 hour a day sessions. By addressing the original trigger, which appeared to be the problems with the herd, we removed the reason for the worry. The behaviour issues were then rapidly dealt with, one at a time, and if I might say so, rather routinely.
I hate using this site as a soap box, but I've read over 500 pages of blurb about OCD in the last few days, hoping that somewhere in those pages there would be mention about something other than CBT and prozac. But I didn't find any.
Something really isn't right! OCD has been in the news and TV a lot recently, and so is gaining in profile. It seems to me; and all the information I come back with on this issue, seems to suggest that the CBT Therapists have effectively cornered the market with this condition.
It is stated in many places, that CBT is the only truely effective therapy for this condition, usually by CBT therapists, actually. I find this disturbing and totally irresponsible and I'm thoroughly dismayed that such a limitation is put on anybody's source of recovery. (my own feeling on the subject).
Those for whom CBT doesn't work are effectively being told, I'm sorry, but there is no help for you, take these anti-depressants (usually Prozac) instead, or, surprisingly enough, at the same time. Those that give up their medication or therapy, usually very quickly revert back to their OCD behaviour, as you might expect.
But in my opinion, CBT by itself is flawed, in that beneficial results are delayed by not dealing successfully with the original traumatic event first.
I have OCD patients coming through the door at an increasingly alarming rate. I
guess recent news coverage and therefore public education has a lot to do with that. Bringing something out in the open suddenly gives the
sufferer, who probably didn't even know they had a problem, or maybe considered it wasn't treatable, or were in denial, or just thought it was the
way life is, now see how life limiting some of these behaviours can be, and want answers.
One recent TV program interview with a CBT therapist was advocating months of therapy, and I can see why this would appeal. At £70-£200 an hour (yes, that's not a printing error), 12 sessions would rack up the charges. My own feeling is that these people refuse to look at EFT because there is very little money to be made from it. Even the latest NICE (National Institute for Clinical Excellence) guidelines for OCD seem to be produced by the very people who stand to gain the most benefit from them. But, maybe I'm just cynical.
I've had enough successes with EFT now to know that it's not just a question of dealing with the behaviour issues. OCD is an anxiety disorder, and unless you address the anxiety, the emphasis shifts from the behaviour and the obsessions, to something else, perhaps even the physical body, when this anxiety, which now has no outlet, will start to attack the very soul that hosts it.
In all the researching I've done into OCD, the last thing that anybody seems to want to do is treat the anxiety that caused the OCD in the first place. The reason I question this aspect of treatment, can be demonstrated by something much more familiar.
It's my view that smoking is an anxiety disorder as well as a physical addiction. Clients that turn up for addiction therapy have usually been to lots of places and taken lots of preparations previously, in, say, an effort to give up smoking. Some have been to a hypnotherapist to be able to give up smoking, or taken nicotine gum, patches, or some other product and have succeeded in giving up smoking. So why do they come? Because they are drinking. Did they drink excessively before? No, it started when they gave up smoking. Did they quit the addiction? To smoking, yes. But they switched addictions to something else, like alcohol, caffeine, illegal or pharmaceutical drugs.
The driver, the trigger, the original anxiety, was still there. Causing them to look for, and switch to, another kind of tranquilizer. That's not a cure, just a diversion.
I believe OCD is the product of early anxiety or trauma that began a small series of behaviours which became addictive, and yes, quite possibly some people are more predisposed to it than others, either through strength of character or genes. But regardless of how it is acquired, when this behaviour doesn't solve the problem it begins to force the doer into believing they weren't doing it right, or not enough. They then become obsessed and compelled to do the same thing ever more thoroughly, over and over again in an attempt to get it right. Of course, they never can do it right, the behaviour can't resolve the anxiety, and the anxiety gains strength from the failure. When this doesn't work either, more and more ritual is brought into the types of behaviour involved, in an attempt to tranquilize the anxiety, until, at it's worst, the behaviour and thoughts consume every moment of every day.
Visit The Haven Healing Centre
EFT is so easy to learn and painless to do that I would recommend anyone who can't find a practitioner in their area to learn it themselves.
Just go here. Maybe the best people to do this are the carers of OCD sufferers. They've probably got more reason to want this to go away than anybody. Otherwise if you live near the South West of England (I'm near Bristol), I'd be more than happy to try and help you. Just go here to find out how to get in touch.
National groups and internet links for Obsessive Compulsive Disorder - UK
International groups and internet links for Obsessive Compulsive Disorder
22/24 Highbury Grove, Suite 107,
London N5 2EA
Office: 0870 360 OCDA(6232)
Fax: 020 7288 0828
Help and Information Line: 0845 390 OCDA(6232)
Fax: 01727 862550
Visit Website: www.ocdaction.org.uk
Registered Charity No: 1035213
Website: National Institute for Health and Clinical Excellence.
This topic is currently in consultation and pages may be transitory, so visit the page and type "OCD" in the search box.
PO Box 8955
NG10 9AU United Kingdom
Information Line: 0845 120 3778
Office: 0870 126 9506
Visit Website: www.ocduk.org/index.htm
Registered Charity No: 1103210
The Obsessive-Compulsive Foundation (OCF)
676 State Street
New Haven, CT 06511
Visit Website: http://ocfoundation.org/
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Philip Chave © 2004-
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