Fear for the safety of loved ones and satisfaction with a clean house are both common, everyday emotions. But as Jennifer Paterson discovered, they become symptoms of something much more disturbing - Obsessive Compulsive Disorder.
An obsession is not as sensational a trauma as the word is commonly used to imply. It can be any repeated or ongoing thought. Using the above two examples, common obsessions may be the worry we have for the wellbeing of our nearest and dearest, or perhaps a fixation with a fresh body and spotless house.
Sounds like me! Does this mean I have OCD?
Not necessarily. An OCD sufferer takes these passions to another level. Moreover, the obsession becomes unwanted. It becomes less of an affected worry for something and more of an unavoidable anxiety. People with the disorder are symptomatically plagued by repetitive, traumatic thoughts.
In addition, these obsessions are often far removed from real-life situations. They are not simply excessive worries based on the goings-on in the sufferer's life. Many sufferers are possessed by ideas or imagery that are, to a large extent, created by themselves and not reflective of their tangible experience.
And these obsessions lead to compulsive behaviour?
Exactly. The compulsions exhibited by more than 90 per cent of OCD sufferers are subconscious behaviours designed to relieve the distress caused by the person's obsessions.
Suppose the cleaner from the earlier examples becomes obsessed with neat and precise order within their house. Their obsession begins to disturb them to the point they are devoured by thoughts of having everything categorised and in line.
As a response, to curb their discomforting fixation, they begin to methodically arrange and rearrange their house; for example, ordering objects on a shelf to a precise size series. They are now devoured by the inclination to align everything. The urge, or compulsion, is overwhelming.
Compulsive behaviour is not just in direct response to an obsession, and can also manifest itself with other indicators:
Repetitive behaviour defined by rigid rules - checking things constantly, repeating a mantra, a ritualistic process when, say, cleaning oneself Irrational behaviour - such that although it is in response to an obsession, it will not allay the sufferer's stress; like a mother who fears for her children's health praying for them fervently whilst deigning to solve simply-fixed compromises to their safety. Excessive behaviour - even though it may help quell one's fears, it is to an extreme level; such as barricading oneself in a house because of a fixation with hygiene.
They all sound like copybook cinematographical stereotypes, but in reality OCD is anything but humourous. OCD is a serious mental illness that is often overlooked by specialists, even though it is far more prevalent than more recognised and better-treated disorders like schizophrenia, bipolar disorder, and panic disorder.
Admitting you have a problem
It is interesting to note that, unlike other mental illnesses, OCD suffers will generally recognise that they have a problem. This does, not, however, mean that they will seek treatment. Healthanswers consultant psychiatrist, Jeremy Butler, notes that OCD is a disorder which has traditionally been underdiagnosed, "due to patient reticence and failure of clinicians to adequately screen for symptoms."
As obsessions develop, they become recognised as such, and the sufferer seeks to banish the ever-troubling thoughts from their mind. Compulsive behaviour is typically borne of this realisation, as an attempt to neutralise the thoughts with action.
More importantly, the sufferer will typically realise their obsession is not founded from any external influences. Dr Butler adds that these symptoms are regarded as causing a clinically significant disorder if they cause distress and disruption to daily activity patterns.
So what causes OCD ?
Many sufferers and non-sufferers alike mistakenly believe OCD is a product of psychological shortcomings. Not true. The causes of the disorder are varied and complex; a mixture of genetics, biology, and personality development - how a person develops to view the world surrounding them. Science is yet to fully understand how all these factors intertwine to bring about the condition.
Today's research, however, can confirm what OCD is not caused by weaknesses in one's character and personal flaws.
Ditching the disorder
OCD is treated effectively with a mixture of both medicinal and psychological therapy. Dr Butler comments that prior to treatment initiation "patients require education, reassurance and self-monitoring of symptoms."
Antidepressants are used to combat the disorder, but a sufferer may need up to four times the dose used against depression for the medication to be of any consequence. Dr Butler notes that preferred drugs for treatment in severely depressed OCD sufferers are the SSRI's (Serotonin Reuptake Inhibitors) such as fluoxetine, sertraline and paroxetine.
A solid treatment uses pharmaceuticals in tandem with behavioural therapy. This approach is particularly effective when tailored to the individual's specific obsessions and compulsions.
Psychotherapy techniques should be approached with great caution as they may have a negative effect if applied without due preparation. Unless a patient is able to sufficiently relax, their trauma may become direfully aggravated.
Sadly, even after treatment, OCD is in most cases incurable. Therapy normally reduces symptoms by 50-80%, and is judged as being highly successful if more productive. But OCD is a cyclic beast, and can unfortunately return, worsening with stress.
Safety in numbers
One of the most invaluable forms of care, however, can be found within support groups. There exists a number of forums where people with the disorder can find solace amongst each other, discussing the adversities they face as a result of their trauma.
The internet is host to many such groups. A list of some of these and other OCD help-related sites can be found at Mental Health Net.
OCD is a devastating disorder, and may affect every facet of a victim's life. But with support and therapy, it can be alleviated.
Date written: October 25, 2000
Date reviewed: February 27, 2005