Can you imagine walking down the street passing a building, and not being able to go on your way until you have counted every window in the building? How about trying to leave your house, but it takes you about one and a half to two hours to leave because you keep checking and checking to make sure the windows and doors are locked? These are just a few instances of how people act that have Obsessive Compulsive Disorder (OCD).
People that have OCD find it hard to lead normal lives. They tend to suffer from recurrent, unwanted thoughts (obsessions) and perform the same rituals (compulsions) that they feel that they cannot control. The rituals or compulsions they have can be anything from washing their hands over and over, to counting, or even cleaning. People who suffer from OCD can only ease their anxiety by performing these rituals. The obsessive or intrusive thoughts are what cause people to behave in this manner. OCD is a very real, chronic, often severe condition unless treated that can result in considerable long-term suffering.
What causes OCD? It was thought in the past that OCD was caused by some kind of biological or psychological vulnerability. (Durand and Barlow 2000.) Psychologists are now starting to lean towards the growing evidence that OCD represents abnormal functioning of brain circuitry, probably involving a part of the brain called the striatum. (NIMH 2000.) OCD is not caused by family problems or attitudes learned in childhood or by a belief that certain thoughts are dangerous and unacceptable. Doctors have been experimenting with clients that have OCD and clients that don’t have it. They have been using positron emission tomography (PET) to compare people with and without OCD. Clients that have OCD tend to have patterns of brain activity that differ from people who have another mental illness or people with no mental illness. The PET scans show that patients that have OCD show a change in the striatum area of the brain when behavioral therapy and medication are given. Maybe with this new information on the cause of OCD, physicians may be able to treat it easier and with greater success.
Commonality of OCD among the population of the United States does not seem substantial when compared to other illnesses. About 3.3 million people in the U.S. between the ages of 18-54 have OCD in a given year. (NIMH 2000.) This translates into roughly 2.3 percent of the population. Studies show that OCD affects women and men about equally. The ratio of men to women with OCD not being that significant in either direction to give it solely to one gender. This is unusual because most illnesses tend to favor one gender or the other. Typically OCD starts in early adolescence, but is written of by parents as abnormal or unusual behavior and the thought that the child will grow out of it. At least one-third of the cases of adult OCD began in childhood. This shows if caught soon enough and treated OCD might not have been a life long battle for some clients. In 1990 the U.S. paid out a total of 8.4 million dollars for treatment of clients with OCD. This was nearly 6 percent of the total mental health bill of 148 billion dollars. (NIMH 2000.)
OCD doesn’t just affect the adult population either. Approximately one million children and adolescents in the United States suffer from OCD. (OCD Resource Center 2000.) This is about three to five children in an averaged size elementary school and about twenty teenagers in a large high school. In fact OCD is more prevalent than any other better know childhood ailments, this includes juvenile diabetes which affects 100,000 children per year. Some of the common obsessions in children and adolescents include fear of contamination, serious illness, fixation on lucky and unlucky numbers, fear of intruders, need for symmetry or exactness, and excessive doubt. Some of the common compulsions include cleaning, washing, touching, counting/repeating, arranging/organizing, checking/ questioning, and hoarding. (OCD Resource Center 2000.) The onset of symptoms related to OCD can occur as early as three or four years of age, but some children may not express them or parents may not recognize them. If the symptoms are not recognized OCD could have a great affect on children’s schoolwork and the child’s family. Unlike adults, children tend to involve their families in their obsessions or compulsivity. When ever possible the child’s teacher should be aware of the condition. Teachers are sometimes very helpful in supporting a child’s treatment
There is a wide range of treatments for OCD, but two of the most common are behavioral therapy and medication. Studies done by the National Institute Of Mental Health (NIMH) show these to be the most effective treatments. Some of the common medications that are prescribed are clomipramine, fluoxetine, fluvoxamine maleate, sertraline, and paroxetine. The medication that has had the greatest effect on the symptoms of OCD is fluvoxamine maleate. People who have OCD tend to have low levels of seratonin. Fluvoxamine maleate is a reuptake inhibitor that helps in the reuptake of the substance seratonin. This reduces the symptoms of OCD and has been found to be safe and effective in adults and children. (OCD Resource Center.) A type of behavior therapy called “exposure and response prevention” has been quite effective in treating OCD. In this approach the patient is deliberately and voluntarily exposed to whatever triggers the obsessive thoughts, and is then taught by the therapist techniques to keep from performing the compulsive rituals and to deal with the anxiety. Studies have shown that with the use of medication and behavioral therapy, the symptoms from OCD are greatly reduced. (NIMH 2000.) OCD is like any other illness, without treatment the patients tend to get worse but if treated most patients tend to go on and lead very productive lives.
If you are living with someone that has OCD, you can play an important role in helping them. Adults and especially children need help in manageing their illness. One thing that you can do to help is reinforce the good behaviors and help the person resist the inappropriate ones. Along with reinforcement, you should be working with your loved ones mental health professional to establish some specific guidelines to follow at home. There are three things you should do if you do anything at all. The first one, be supportive, without support who else will your loved one turn too. The second, be consistent, if you set rules stick with them. The last, be positive, your loved one needs a positive environment without that they could suffer from other issues such as low self esteem. Doing the above three things should and will make life a little easier for everybody involved. Remember it’s not the persons fault that suffers from OCD and anything you can do to help makes life a little bit easier on that person.