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Tuesday, January 17, 2017

Do I have OCD?

Obsessive Compulsive Disorder (OCD)

What do we know about OCD?
Obsessive Compulsive disorder (OCD) is classified with anxiety disorders in the Diagnostic and Statistical Manual of Mental Disorders (2013) because one of the main aspects of this disorder is an overwhelming feeling of anxiety.  This anxiety can come in the form of fear, doubts, and sometimes, various forms of panic.  The hallmark of OCD is overwhelming and intrusive thoughts and compulsions to act in a certain ritualistic manner.  Most compulsive acts are not directly related to the obsessive thoughts and provide temporary and little relief.  For example, checking the door locks on one’s home multiple times per day may reduce the risk of home intrusion, but cannot prevent it completely.  Handwashing can also reduce the risk of certain illnesses, but many feared illnesses are airborne. 
OCD is two-fold, and most individuals who suffer from OCD have both obsessive thoughts and compulsive behaviors.  OCD manifests itself in many ways that time nor space allows us to explore here in depth.  OCD can involve a strong tendency to be overly responsible, perfectionistic, uncontaminated, and a large percentage (30) have a co-occurring tic disorder (more about this later).
Because OCD is chronic, it does not show itself only in one situation for a temporary period of time.  It is quite common for most everyone to claim OCD in an effort to get their way, or to make a joke about a habit they have.  However, Obsessive Compulsive disorder is much more serious than this as it lasts a lifetime and most individuals who meet the criteria for diagnosis are not likely to be so open about discussing how they suffer from this disorder.
Obsessive Compulsive disorder is time-consuming.  Depending on the severity of the symptoms and the intrusive thoughts, an individual with this disorder can spend hours each day acting on the compulsions that they believe will reduce the anxiety associated with the obsession.
About 2% of the general population meet the requirements to receive a diagnosis of OCD.
How is this anxiety exhibited?
For the most part, the obsessive thoughts the individual with OCD feels are not directly shared with others.  These thoughts are acted upon in what can be thought of as unusual or pointless ways.  What happens when an individual is overwrought with a compulsion to act in a certain way and they are unable to do so?  As previously mentioned, there is significant anxiety.  This anxiety can be exhibited in several forms.  The person can appear panicked, exhibit anger, and can even become violent, depending on the severity of the disorder and the intrusive thoughts.
How does OCD happen?
Unfortunately, like many illnesses and mental disorders, there is no clear pathway for the development of OCD.  However, much is known about who is at risk for developing Obsessive Compulsive disorder.  What we believe is that OCD is caused by environmental (culture, upbringing), neurological, and genetic factors.
About ¼ of the diagnosed cases of OCD begin before the age of 14, and onset after the age of 35 is rare, but can happen.  The onset is usually gradual, and OCD is chronic, not temporary.
Males typically have an earlier onset than females.  Recent research does show that children as young as six can be diagnosed with OCD, but this is not as common as adult diagnosis.
Children who have a great deal of undesirable emotionality, and fretful signs are believed to be at risk.  Also, children who have been physically or sexually abused appear to be at a higher risk for OCD.  Furthermore, we do know that individuals who have a first-degree relative (parent or sibling) with OCD may also be more susceptible.
What other problems can be associated with OCD?
There is such a long list of what can happen to an individual with Obsessive Compulsive disorder that it would be impossible to list them all here.  Individuals with OCD are often so rigid, they have problems with relationships (family and marriage).  These sufferers are more susceptible to suicide risks at some time in their life.  In fact, about half of the individuals with OCD experience suicidal thoughts in their lifetime, and about ¼ of sufferers will act on these thoughts.
OCD is associated with a poorer quality of life than for those who are unaffected.  After all, it’s more difficult to enjoy life when one is inundated with fear and anxiety.  Therefore, Major depressive disorder is also associated with Obsessive Compulsive disorder.
Because of the high tendency to be perfectionistic in some respect, some of these sufferers can develop eating disorders as well.  OCD is often accompanied by TIC disorder, which are abrupt, and repetitive actions that involve motor movements or vocalizations.  These can include (but not limited to) Tourette’s disorder, repeated eye blinking, shoulder shrugging, throat clearing, finger snapping, sniffing, or grunting.
Is there a cure for Obsessive Compulsive disorder?
To answer this truthfully, no, there is no “cure” for OCD.  However, there is hope in that years of research shows how certain therapy approaches and medications can provide the sufferer with a great deal of relief.  Regardless of the severity of the disorder, a combination of Cognitive Behavioral therapy (especially involving couples and families) and Selective Serotonin-Reuptake Inhibitors (SSRI) medications are the most beneficial. 
How do I know if I have or someone I love has OCD?  Where can I get help?
If you have a family member or spouse who has OCD, you are well aware of this.  It may be the source of a joke or two on occasion, but the majority of the time, it affects a fair amount of your life as well.   This is particularly so if you live in the same home with the sufferer.  OCD has been the cause of many disagreements between couples and can result in significant marital problems if not properly managed. 
Dr. Potter offers empirically-proven assessments as well as online couples and family counseling specifically targeted to reduce the symptoms of OCD.


Diagnostic and Statistical Manual of Mental Disorders (2013) American Psychiatric Association. VA. American Psychiatric Publishing.