OCD: Plain & Simple

The OCD Cloud

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).

Meds that may help.

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

 

All in Your Head? [Depression]

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Depression is a Mental Disorder, not a Disease

There are plausible arguments for the non-existence of mental illness. But there are still people who declare themselves to have a mental illness. After all, being sick mentally has no physical symptoms; it’s not like a kidney stone or an inflamed appendix. One can only hope it was this simple.

Yet depression is a progressive and debilitating disorder. It is like having a ‘bruised brain’ that refuses to heal. There is an substantial list of psychological disorders. Technically depression is a mood disorder that has a series of symptoms. These symptoms are the evidence that something is definitely wrong.

  • Depressed mood (such as feelings of sadness or emptiness).
  • Reduced interest in activities that used to be enjoyed.
  • Change in appetite or weight increase/decrease.
  • Sleep disturbances (either not being able to sleep well or sleeping too much).
  • Feeling agitated or slowed down.
  • Fatigue or loss of energy.
  • Feeling worthless or excessive guilt.
  • Difficulty thinking, concentrating or troubles making decisions.
  • Suicidal thoughts or intentions.
http://www.nami.org/

The above list is a summary of something called the DSM-IV which doctors use to diagnose the mental disorder of depression. Having five or six of these may indicate a problem. Spinning off this, you will discover some other disorders, like:

  • Generalized anxiety disorder (GAD)
  • Panic disorder
  • Depersonalization/derealization
  • OCD (obsessive compulsive disorder)
  • Psychosis and paranoia
  • PTSD (post traumatic stress syndrome)
  • Specific Phobias (fears of something)
  • SAD (social anxiety disorder)
  • Schizophrenia
  • Eating disorders (bulimia, anorexia)

Even though mental illness is widespread in the population, the main burden of illness is concentrated in a much smaller proportion-about 6 percent, or 1 in 17 Americans-who live with a serious mental illness. The National Institute of Mental Health reports that one in four adults–approximately 57.7 million Americans–experience a mental health disorder in a given year.

Unfortunately, there is a great deal of misunderstanding and stigma for those who have these disorders. I suppose it is akin to having VD (venereal disease) or AIDS. It seems that our culture is pretty quick at labeling people as deviant or undesirable.

I hope this post helps. I can see a 100 holes in it, and alas, it is a meager attempt. But perhaps it will be of some value. Both NAMI.org, Psychcentral.com, and WebMD.com all have excellent info on Mental Illness. aabryscript

Killing My Sin, Before It Kills Me

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We are for the most part anyway, eager to please God. We are Jesus’ people with the occasional brush with sin. But hey, who doesn’t? But that attitude must be questioned.

“My little children, these things I write to you, so that you may not sin.”

1 John 2:1

John hopes that his readers would make a choice— not to commit sin. After all, what soldier goes into battle with the intent of getting just a little wounded? Often we will sin just because it seems so inevitable, and we feel we can’t help ourselves. (But the reality is that we can.)

But the Holy Spirit now lives inside. Cooperation with Him is needed. Often we will work ourselves into a ‘no win scenario’ where we believe that sin rules. We can’t beat it, so we stop trying. That is common, and sad.

‘Passivity’ is defined as not participating readily or actively; inactive. When we are passive spiritually, we disengage ourselves from any effort of living holy and pure lives. Not being ‘hot’, but content to be lukewarm. At this point sin becomes, reluctantly, tolerated. “After all, I’m a sinner, what else can I do?”

Mentally ill people are often passive. We are told that we have an uncontrolled illness which dictates that we act ‘irresponsible.’ Our depression often escalates and we feel victimized by it. My experience has taught me that there are three kinds of depression:

  • organic depression, or the ‘biochemistry’ of the disease,
  • guilty depression, the kind that feels bad because of what we’ve done (or didn’t do),
  • reactionary depression, the type we feel when experiencing a loss, a loved one, or a job

Depression will almost always fall in these three categories. And passivity plays a part in all three. We  frequently feel victimized and ‘acted upon.’ When it comes to our discipleship we don’t act, we react. We are utterly convinced of the Bible— God’s truth, but we are so sporadic we can’t seem to get it to work for any length of time.

Yes, we are believers. And yes, we have issues. We’re waiting for a miracle, and hope we get a breakthrough soon.

At the base point of our lives, quite often, there is a passive attitude. Passivity aggravates our depression or mental illness. It deepens, spreading through our lives like a contagious illness. Our discipleship sputters and stalls. We no longer act on God’s Word, but we find ourselves fabricating a faith that makes allowances for our situation.

But we must ‘act the miracle.’ Everything God gives… everything… must be received by a convinced faith. We must be persuaded to give up our flawed ideas, and believe God for the real thing. I opened up this with 1 John 2:1. But there’s much more to this verse:

“My little children, these things I write to you, so that you may not sin.  And if anyone sins, we have an Advocate with the Father, Jesus Christ the righteous.”

I don’t want you to sin. Avoid sin. But even if you do— we have someone who will plead our case before God. He stands and argues our plight. He loves us that much.

 

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OCD: Rituals and Obsession

“I couldn’t do anything without rituals. They invaded every aspect of my life. Counting really bogged me down. I would wash my hair three times as opposed to once because three was a good luck number and one wasn’t. It took me longer to read because I’d count the lines in a paragraph. When I set my alarm at night, I had to set it to a number that wouldn’t add up to a ’bad’ number.”

“I knew the rituals didn’t make sense, and I was deeply ashamed of them, but I couldn’t seem to overcome them until I had therapy.”

“Getting dressed in the morning was tough, because I had a routine, and if I didn’t follow the routine, I’d get anxious and would have to get dressed again. I always worried that if I didn’t do something, my parents were going to die. I’d have these terrible thoughts of harming my parents. That was completely irrational, but the thoughts triggered more anxiety and more senseless behavior. Because of the time I spent on rituals, I was unable to do a lot of things that were important to me.”

People with obsessive-compulsive disorder (OCD) have persistent, upsetting thoughts (obsessions) and use rituals (compulsions) to control the anxiety these thoughts produce. Most of the time, the rituals end up controlling them.

For example, if people are obsessed with germs or dirt, they may develop a compulsion to wash their hands over and over again. If they develop an obsession with intruders, they may lock and relock their doors many times before going to bed. Being afraid of social embarrassment may prompt people with OCD to comb their hair compulsively in front of a mirror-sometimes they get “caught” in the mirror and can’t move away from it. Performing such rituals is not pleasurable. At best, it produces temporary relief from the anxiety created by obsessive thoughts.

Other common rituals are a need to repeatedly check things, touch things (especially in a particular sequence), or count things. Some common obsessions include having frequent thoughts of violence and harming loved ones, persistently thinking about performing sexual acts the person dislikes, or having thoughts that are prohibited by religious beliefs. People with OCD may also be preoccupied with order and symmetry, have difficulty throwing things out (so they accumulate), or hoard unneeded items.

Healthy people also have rituals, such as checking to see if the stove is off several times before leaving the house. The difference is that people with OCD perform their rituals even though doing so interferes with daily life and they find the repetition distressing. Although most adults with OCD recognize that what they are doing is senseless, some adults and most children may not realize that their behavior is out of the ordinary.

OCD affects about 2.2 million American adults, and the problem can be accompanied by eating disorders, other anxiety disorders, or depression.  It strikes men and women in roughly equal numbers and usually appears in childhood, adolescence, or early adulthood. One-third of adults with OCD develop symptoms as children, and research indicates that OCD might run in families.

The course of the disease is quite varied. Symptoms may come and go, ease over time, or get worse. If OCD becomes severe, it can keep a person from working or carrying out normal responsibilities at home. People with OCD may try to help themselves by avoiding situations that trigger their obsessions, or they may use alcohol or drugs to calm themselves.

OCD usually responds well to treatment with certain medications and/or exposure-based psychotherapy, in which people face situations that cause fear or anxiety and become less sensitive (desensitized) to them.

Source: http://www.nimh.nih.gov/index.shtml

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