Sunday, February 10, 2008

Today's lesson--OCD

As I mentioned earlier, my daughter was over again today. We went shopping for a bit and as usual we talked about a myriad of subjects. Today was obsessive-compulsive disorder. Now I am certainly no doc and I wouldn't dare to try to diagnose anyone ever, but I find these topics very interesting.
I see a little of OCD in my life but nothing alarming. SO, I googled OCD and this is what I came up with from the Mayo Clinic site. It's an interesting read. Enjoy.

Introduction
Do you wipe off the doorknobs in your home each time someone touches them? Do you go to great lengths to avoid stepping on cracks in the sidewalk? Or do you feel compelled to wash your hands so often that they've become raw and chapped?

Feeling driven to perform such rituals over and over may indicate that you have obsessive-compulsive disorder (OCD). If you have obsessive-compulsive disorder, ritualistic behaviors may literally take over your life. You have distressing, unwanted thoughts or images that don't make sense to you. These thoughts or images keep coming back despite your efforts to ignore them. You may strive to hide OCD from friends and co-workers for fear of being labeled "crazy."

But obsessive-compulsive disorder, a type of anxiety disorder, is probably more common than you think. And it can affect both adults and children. Because the obsessions and compulsions can be so hard to disregard, OCD can become disabling and chronic. But the good news is that treatment can help bring obsessive-compulsive disorder under control.

Signs and symptoms
Obsessive-compulsive disorder symptoms include both obsessions and compulsions. OCD symptoms can be severe and time-consuming. For instance, someone who feels that his or her hands have become contaminated by germs — an obsession — may spend hours washing them each day — a compulsion. The focus on hand washing may be so great that he or she can accomplish little else.

Obsessions
OCD obsessions are repeated, persistent, unwanted ideas, thoughts, images or impulses that you experience involuntarily and that appear to be senseless. These obsessions typically intrude when you're trying to think of or do other things.

Typical OCD obsessions revolve around:
*Fear of contamination or dirt
*Repeated doubts
*Having things orderly and symmetrical
*Aggressive or horrific impulses
*Sexual images

OCD symptoms involving obsessions may include:
*Fear of being contaminated by shaking hands or by touching objects others have touched
*Doubts that you've locked the door or turned off the stove
*Repeated thoughts that you've hurt someone in a traffic accident
*Intense distress when objects aren't orderly, lined up properly or facing the right way
*Images of hurting your child
*Impulses to shout obscenities in inappropriate situations
*Avoidance of situations that can trigger obsessions, such as shaking hands
*Replaying pornographic images in your mind
*Dermatitis because of frequent hand washing
*Skin lesions because of picking at the skin
*Hair loss or bald spots because of hair pulling

Compulsions
Compulsions are repetitive behaviors that you feel driven to perform. These repetitive behaviors are meant to prevent or reduce anxiety or distress related to your obsessions. For instance, if you believe you ran over someone in your car, you may return to the scene over and over because you just can't shake your doubts. You may even make up rules or rituals to follow that help control the anxiety you feel when having obsessive thoughts.

Typical compulsions revolve around:
*Washing and cleaning
*Counting
*Checking
*Demanding reassurances
*Repeating actions over and over
*Arranging and making items appear orderly

OCD symptoms involving compulsions may include:

*Washing hands until the skin becomes raw
*Checking doors repeatedly to make sure they're locked
*Checking the stove repeatedly to make sure it's off
*Counting in certain patterns

Causes
What causes obsessive-compulsive disorder isn't fully understood. Main theories include:

*Biology.
Some researchers believe OCD is a result of changes in your body's own natural chemistry.
*Environment.
Some researchers believe that OCD stems from behavior habits that you learn over time.
*Insufficient serotonin.
An insufficient level of serotonin, one of your brain's chemical messengers, may contribute to obsessive-compulsive disorder. Some studies that compare images of the brains of people who have obsessive-compulsive disorder with the brains of those who don't show differences in brain-activity patterns. In addition, people with obsessive-compulsive disorder who take medications that enhance the action of serotonin often have fewer symptoms.
*Strep throat.
Some studies suggest that some children develop OCD after infection with group A beta-hemolytic streptococcal pharyngitis — strep throat. Some research suggests that an antibody against strep throat bacteria sometimes mistakenly acts like a brain enzyme. This disrupts communication between neurons in the brain and may trigger OCD. However, these studies are controversial and more evidence is needed before strep throat can be blamed.

Risk factors
It was once thought that obsessive-compulsive disorder was a rare condition. But it's now known to be more common than many other mental illnesses. In fact, about 2.2 million Americans have obsessive-compulsive disorder, according to the National Institute of Mental Health.

Obsessive-compulsive disorder doesn't affect just adults. The disorder often begins during adolescence or early childhood, usually around age 10. In adults, OCD typically begins around age 21.

Several factors can increase the risk of developing obsessive-compulsive disorder, including:

*Family history. Having parents or other family members with the disorder can increase your risk of developing OCD. However, researchers haven't identified any genes responsible for obsessive-compulsive disorder.
*Stressful life events. If you tend to react strongly to stress, your risk may increase. This reaction may, for some reason, trigger the intrusive thoughts, rituals and emotional distress characteristic of obsessive-compulsive disorder.
*Pregnancy. Some studies show that pregnant women and new mothers are at increased risk, but it's not clear why. In these cases, OCD symptoms center mainly on thoughts of harming the baby.

When to seek medical advice
There's a difference between being a perfectionist and having obsessive-compulsive disorder. Perhaps you keep the floors in your house so clean that you could eat off them. Or you like your knickknacks arranged just so. That doesn't necessarily mean that you have obsessive-compulsive disorder.

In OCD, your quality of life can decrease dramatically as the condition dictates most of your days and you become consumed with carrying out compulsive behaviors and rituals. Most adults can recognize that their obsessions and compulsions don't make sense. Children, however, may not understand what's wrong. But the lives of both children and adults can be severely affected by OCD. Children may find it difficult to attend school, and adults may find it difficult to work. Relationships also suffer.

If your obsessions and compulsions are affecting your life, talk to your health care professional, such as your primary care doctor or mental health professional. It's common for people with OCD to be ashamed and embarrassed about the condition. But even if your rituals are deeply ingrained, treatment can help.

Screening and diagnosis
A mental health professional can diagnose obsessive-compulsive disorder after a thorough evaluation. Although there aren't any laboratory tests to diagnose OCD, your doctor may check for physical problems the condition may cause, such as dermatitis from frequent hand washing.

It's sometimes difficult to diagnose obsessive-compulsive disorder because it may resemble generalized anxiety disorder or other mental conditions. To help diagnose obsessive-compulsive disorder, your doctor will ask you questions about your obsessions, compulsions and emotional well-being and may talk to your friends and relatives about your behavior.

To be diagnosed with obsessive-compulsive disorder, someone must meet the criteria spelled out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This manual is published by the American Psychiatric Association and is used by mental health professionals to diagnose mental conditions and by insurance companies to reimburse for treatment.

For OCD to be diagnosed, you must have either obsessions or compulsions, you must realize that these obsessions and compulsions are excessive or unreasonable, and they significantly interfere with your daily routine.

Obsessions must meet these specific criteria:
*Recurrent and persistent thoughts, impulses or images that are intrusive and cause distress
*The thoughts aren't simply excessive worries about real problems in your life
*You attempt to ignore or suppress these thoughts, images or impulses
*You recognize that these thoughts, images and impulses are a product of your own mind

Compulsions must meet these specific criteria:
*Repetitive behavior, such as hand washing, or repetitive mental acts, such as counting silently, that you feel driven to perform
These behaviors or mental acts are meant to prevent or reduce distress about unrealistic obsessions


Treatment
Obsessive-compulsive disorder treatment can sometimes be difficult, and it may not offer a cure. However, OCD treatment can help you bring symptoms under control so that they don't rule your daily life.

OCD treatment has two main components: psychotherapy and medications.

*Psychotherapy
A type of therapy called cognitive behavior therapy has been shown to be the most effective form of therapy for OCD in both children and adults. Cognitive behavior therapy involves retraining your thought patterns and routines so that compulsive behaviors are no longer necessary. One approach in particular is called exposure and response prevention. This therapy involves gradually exposing you to a feared object or obsession, such as dirt, and teaching you healthy ways to deal with it. Learning the techniques and new thought patterns takes effort and practice, but it's worth it. Most people with obsessive-compulsive disorder show improvement of signs and symptoms with cognitive behavior therapy.

*Medications
Most people with OCD benefit from taking certain psychiatric medications. Some medications have been specifically approved by the Food and Drug Administration to treat OCD, such as the antidepressants clomipramine (Anafranil), paroxetine (Paxil), fluvoxamine and sertraline (Zoloft). However, many other antidepressant medications on the market may also be used to treat OCD off-label — that is, even if they haven't been specifically FDA approved for that use. Antidepressants may be helpful for OCD because they may help increase levels of serotonin, which may be deficient in OCD. All of these medications have side effects and safety concerns, and you may need to try several medications before finding one that's both effective and tolerable.

Self-care
Obsessive-compulsive disorder is a chronic condition, which means it may be part of your life for the long term. However, psychotherapy, medications and self-care can help you control OCD symptoms so that you can live a normal life.

Self-care steps you can follow include:
*Sticking to your treatment plan, even if it's sometimes uncomfortable or challenging
*Taking your medications as directed and talking to your health care professionals about side effects or other concerns
*Joining a support group to share experiences with others in a similar situation
*Enlisting support of loved ones who can offer encouragement in tough times
*Learning about your disorder so that you understand the myths and realities
*Avoiding alcohol and illicit drugs as coping mechanisms
*Getting involved in social activities, rather than isolating yourself

1 comment:

Anonymous said...

That was VERY interesting. Now I understand those people who have admitted being OCD a little more. And, I realize my germ-phobia isn't as bad as I thought.