OCD: Plain & Simple

 

A woman visits her dermatologist, complaining of extremely  dry skin and seldom feeling clean. She showers for two hours every day.

A lawyer insists on making coffee several times each day. His colleagues do not realize that he lives in fear that the coffee will be poisoned, and he feels compelled to pour most of it down the drain. The lawyer is so obsessed with these thoughts that he spends 12 hours a day at work — four of them worrying about contaminated coffee.

A man cannot bear to throw anything away. Junk mail, old newspapers, empty milk cartons all “could contain something valuable that might be useful someday.” If he throws things away, “something terrible will happen.” He hoards so much clutter that he can no longer walk through his house. Insisting that nothing be thrown away, he moves to another house where he continues to hoard.

A 10 year old girl keeps apologizing for “disturbing” her class. She feels that she is too restless and is clearing her throat too loudly. Her teachers are puzzled and over time become annoyed at her repeated apologies since they did not notice any sounds or movements. She is also preoccupied with “being good all the time”.

These people suffer Obsessive-Compulsive Disorder (OCD). The National Institute of Mental Health estimates that more than 2 percent of the U.S. population, or nearly one out of every 40 people, will suffer from OCD at some point in their lives. The disorder is two to three times more common than schizophrenia and bipolar disorder.

What is Obsessive-Compulsive Disorder? 

Obsessions are intrusive, irrational thoughts — unwanted ideas or impulses that repeatedly well up in a person’s mind. Again and again, the person experiences disturbing thoughts, such as “My hands must be contaminated; I must wash them”; “I may have left the gas stove on”; “I am going to injure my child.” On one level, the sufferer knows these obsessive thoughts are irrational. But on another level, he or she fears these thoughts might be true. Trying to avoid such thoughts creates great anxiety.

Compulsions are repetitive rituals such as handwashing, counting, checking, hoarding, or arranging. An individual repeats these actions, perhaps feeling momentary relief, but without feeling satisfaction or a sense of completion. People with OCD feel they must perform these compulsions. Heredity appears to be a strong factor. If you have OCD, there’s a 25-percent chance that one of your immediate family members will have it. It definitely seems to run in families.

 

Can OCD be effectively treated? Yes, with medication and behavior therapy. Both affect brain chemistry, which in turn affects behavior. Medication can regulate serotonin, reducing obsessive thoughts and compulsive behaviors. Anafranil (clomipramine): A tricyclic antidepressant, Anafranil has been shown to be effective in treating obsessions and compulsions. The most commonly reported side effects of this medication are dry mouth, constipation, nausea, increased appetite, weight gain, sleepiness, fatigue, tremor, dizziness, nervousness, sweating, visual changes, and sexual dysfunction. There is also a risk of seizures, thought to be dose-related. People with a history of seizures should not take this medication. Anafranil should also not be taken at the same time as a monoamine oxidase inhibitor (MAOI).

Many of the antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs) have also proven effective in treating the symptoms associated with OCD. The SSRIs most commonly prescribed for OCD are Luvox (fluvoxamine), Paxil (paroxetine), Prozac (fluoxetine), and Zoloft (sertraline). Luvox (fluvoxamine): Common side effects of this medication include dry mouth, constipation, nausea, sleepiness, insomnia, nervousness, dizziness, headache, agitation, weakness, and delayed ejaculation. Paxil (paroxetine): Side effects most associated with this medication include dry mouth, constipation, nausea, decreased appetite, sleepiness, insomnia, tremor, dizziness, nervousness, weakness, sweating, and sexual dysfunction. Prozac (fluoxetine): Dry mouth, nausea, diarrhea, sleepiness, insomnia, tremor, nervousness, headache, weakness, sweating, rash, and sexual dysfunction are among the more common side effects associated with this drug. Zoloft (sertraline): Among the side effects most commonly reported while taking Zoloft are dry mouth, nausea, diarrhea, constipation, sleepiness, insomnia, tremor, dizziness, agitation, sweating, and sexual dysfunction. Celexa (Citalopram) side effects may include dry mouth, nausea, or drowsiness . SSRIs should never be taken at the same time as MAOIs.

 

How long should an individual take medication before judging its effectiveness?

Some physicians make the mistake of prescribing a medication for only three or four weeks. That really isn’t long enough. Medication should be tried consistently for 10 to 12 weeks before its effectiveness can be judged.

What is behavior therapy, and can it effectively relieve symptoms of OCD?

 Behavior therapy is not traditional psychotherapy. It is “exposure and response prevention,” and it is effective for many people with OCD. Consumers are deliberately exposed to a feared object or idea, either directly or by imagination, and are then discouraged or prevented from carrying out the usual compulsive response. For example, a compulsive hand-washer may be urged to touch an object he or she believes is contaminated and denied the opportunity to wash for several hours. When the treatment works well, the consumer gradually experiences less anxiety from the obsessive thoughts and becomes able to refrain from the compulsive actions for extended periods of time. Several studies suggest that medication and behavior therapy are equally effective in alleviating symptoms of OCD. About half of the consumers with this disorder improve substantially with behavior therapy; the rest improve moderately.

 

Will OCD symptoms go away completely with medication and behavior therapy?

Response to treatment varies from person to person. Most people treated with effective medications find their symptoms reduced by about 40 percent to 50 percent. That can often be enough to change their lives, to transform them into functioning individuals. A few consumers find that neither treatment produces significant change, and a small number of people are fortunate to go into total remission when treated with effective medication and/or behavior therapy.

 

Reviewed by Judith Rapoport, MD May 2003

 

Read about Treatments and Supports for Mental Illness Related Resources Living with Obsessive-Compulsive Disorder Welcome to NAMI’s Living with Obsessive-Compulsive Disorder community. Here you will find support, get targeted information and connect with people who understand. Find Support Learn more about the full spectrum of programs and services that NAMI provides across the country for people living with mental illnesses, and their families and loved ones.

Online Discussion Living with OCD.  Find support, share knowledge, ask questions and meet people who’ve been there. Mental Illness Discussion Groups Dozens of online groups for consumers, parents, spouses, siblings, teens and more. Get connected and find support. Related Links Anxiety Disorders Association of America (ADAA).  

Information Helpline: (800) 950-NAMI

Sunday Funnies 3

 Humor_1Bumper Stickers

 

– Back Up My Hard Drive? How do I Put it in Reverse? . . . )

– I just got lost in thought. It was unfamiliar territory.

– Everyone has a photographic memory. Some just don’t have film.

– When the chips are down, the buffalo is empty.

– Seen it all, done it all, can’t remember most of it.

– Those who live by the sword get shot by those who don’t.

– I feel like I’m diagonally parked in a parallel universe.

– He’s not dead. He’s electroencephalographically challenged.

– You have the right to remain silent. Anything you say will
be misquoted, then used against you.

– Honk if you love peace and quiet.

– Pardon my driving, I am reloading.

– Despite the cost of living, it remains very popular.

– Nothing is fool-proof to a sufficiently talented fool.

– Diplomacy is saying “nice doggy” until you find a rock.

– A day without sunshine is like, you know, night.

– Save the whales. Collect the whole set.

– Atheism is a non-prophet organization.

– On the other hand, you have different fingers.

– Change is inevitable. Except from a vending machine.

Just One Step Ahead

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“Life here feels like you were just left off here one day, with no instruction manual, and no idea of what you were supposed to do; how to fit in; how to find a day’s relief from the anxiety, how to keep your beloved alive; how to stay one step ahead of abyss.”

Anne Lamott

The reality is this: so much happens that we’re not in control of. Many deluded souls think they have it by the handle; that they have it figured out. But not me. They say that some circus performers are routinely automatic when walking the tightrope. All though I can recognize the skill, I am terribly afraid of heights.

Life comes at us so fast, racing at us relentlessly. And it is never linear or methodical, there are bumps and curves that must be navigated.

I believe that the Bible– God’s very word, has impressive, supernatural power. It guides me when all other ‘influences’ fail and falter.

“Your word is a lamp to guide my feet
    and a light for my path.”

Psalm 119:105

I live for, and love, the guidance He gives. There is so much adventure to it all. To be in harmony with  Him (and His Will) is a wonderful thing. I don’t pretend that I’m walking alone. A solitary mouse moving through the intricate maze. Rather, I seek the direction of the One who is my Companion. (He knows the way.) And He loves me!

“Who is that coming up from the wilderness,
    leaning on her beloved?”

Song of Solomon 8:5

He is with you in this wilderness.

Being mentally disabled isn’t easy, but who says it should be? Whatever wilderness we find ourselves in is punctuated by His presence. He is there, and He can be leaned on. There are no quick fixes; there is only His strong presence. He is with you in this wilderness.

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