Obsessive-Compulsive Disorder (OCD) - You might have it!!!!

Obsessive–compulsive disorder (OCD) is an anxiety disorder characterized by intrusive thoughts that produce anxiety, by repetitive behaviors aimed at reducing anxiety, or by a combination of such thoughts (obsessions) and behaviors (compulsions). Symptoms may include repetitive hand-washing; extensive hoarding; preoccupation with sexual or aggressive impulses, or with particular religious beliefs; aversion to odd numbers; and nervous habits, such as opening a door and closing it a certain number of times before one enters or leaves a room. These symptoms can be alienating and time-consuming, and often cause severe emotional and economic loss. The acts of those who have OCD may appear paranoid and come across to others as psychotic. However, OCD sufferers generally recognize their thoughts and subsequent actions as irrational, and they may become further distressed by this realization.

OCD is the fourth-most common mental disorder and is diagnosed nearly as often as asthma and diabetes mellitus.^[1] In the United States, one in 50 adults has OCD.^[2] The phrase "obsessive–compulsive" has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is meticulous, perfectionistic, absorbed in a cause, or otherwise fixated on something or someone.^[3] Although these signs may be present in OCD, a person who exhibits them does not necessarily have OCD, and may instead have obsessive–compulsive personality disorder (OCPD), an autism spectrum disorder, or no clinical condition. Multiple psychological andbiological factors may be involved in causing obsessive–compulsive syndromes.

Signs and symptoms

[edit]

Obsessions

Main article: Intrusive thoughts

A typical person with OCD performs tasks, or compulsions, to seek relief from obsession-related anxiety. Within and among individuals, the initial obsessions, or intrusive thoughts, can vary in their clarity and vividness. A relatively vague obsession could involve a general sense of disarray or tension, accompanied by a belief that life cannot proceed as normal while the imbalance remains. A more articulable obsession could be a preoccupation with the thought or image of someone close to them dying.^[7][8] Other obsessions concern the possibility that someone or something other than oneself—such as God, the Devil, or disease—will harm either the person with OCD or the people or things that the person cares about.

Some people dread entire concepts, fearing their materialization by causes that may seem implausible or indiscriminate to others. For example, a generalized fear of contamination might entail not only wariness of bodily secretions or excretions, but also apprehension toward household chemicals, radioactivity, newsprint, pets, or even soap.^[9] Others may sense that the physical world is qualified by certain immaterial conditions. These people might intuit invisible protrusions from their bodies,^[10] or could feel that inanimate objects areensouled.^[10]

Some people with OCD experience sexual obsessions that may involve intrusive thoughts or images of "kissing, touching, fondling, oral sex,anal sex, intercourse, incest and rape" with "strangers, acquaintances, parents, children, family members, friends, coworkers, animals and religious figures", and can include "heterosexual or homosexual content" with persons of any age.^[11] As with other intrusive, unpleasant thoughts or images, most people have some disquieting sexual thoughts at times, but people with OCD may attach extraordinary significance to the thoughts. For example, obsessive fears about sexual orientation can appear to the person with OCD, and even to those around them, as a crisis of sexual identity.^[12][13] Furthermore, the doubt that accompanies OCD leads to uncertainty regarding whether one might act on the troubling thoughts, resulting in self-criticism or self-loathing.^[11]

The person with OCD understands that their notions do not correspond with the external world; however, they feel that they must act as though their notions were correct. For example, an individual who engages in compulsive hoarding might be inclined to treat inorganic matteras if it had the sentience or rights of living organisms, but such an individual might find their consequent behavior irrational on a more intellectual level. In severe OCD, obsessions can shift into delusions when resistance to the obsession is abandoned and insight into its senselessness is lost. (Insel and Akiskal (1986))

[edit]

Compulsions

Main article: Compulsive behavior

While some with OCD perform compulsive rituals because they inexplicably feel they must, others act compulsively so as to mitigate the anxiety that stems from particular obsessive thoughts. The person with OCD might feel that these actions somehow either will prevent a dreaded event from occurring, or will push the event from their thoughts. In any case, the individual's reasoning is so idiosyncratic or distorted that it results in significant distress for the individual with OCD or for those around them. Excessive skin picking (i.e., dermatillomania) or hair plucking (i.e., trichotillomatia) and nail biting (i.e., onychophagia) are all on the Obsessive-Compulsive Spectrum. Individuals with OCD are aware that their thoughts and behavior are not rational,^[14] but they feel bound to comply with them to fend off feelings of panic or dread.

Some common compulsions include counting specific things (such as footsteps) or in specific ways (for instance, by intervals of two) and doing other repetitive actions, often with atypical sensitivity to numbers or patterns. People might repeatedly wash their hands^[15] or clear their throats, making sure certain items are in a straight line, repeatedly check that their parked cars have been locked before leaving them, constantly organizing in a certain way, turn lights on and off, keep doors closed at all times, touch objects a certain number of times before exiting a room, walk in a certain routine way like only stepping on a certain color of tile, or have a routine for using stairs, such as always finishing a flight on the same foot.

People rely on compulsions as an escape from their obsessive thoughts; however, they are aware that the relief is only temporary, that the intrusive thoughts will soon come back. Some people use compulsions to avoid situations that may trigger their obsessions. Although some people do certain things over and over again, they don't necessarily perform these actions compulsively. For example, bedtime routines, learning a new skill, and religious practices are not compulsions. Whether or not behaviors are compulsions or mere habit depends on the context in which the behaviors are performed. For example, arranging and ordering DVDs or videos for eight hours a day would be expected of one who works in a video store, but would seem abnormal in other situations. Put another way, if the activity helps bring efficiency to one's life, it is probably a habit, if it interferes with one's normal enjoyment of life, it is probably a compulsion.^[16]

In addition to the anxiety and fear that typically accompanies OCD, some people may spend hours performing such tasks (i.e., compulsions) every day. In such situations it can be hard for the person to fulfill their work, family, or social roles. In some cases, these behaviors can also cause adverse physical symptoms. For example, people who obsessively wash their hands with antibacterial soap and hot water to remove what they consider to be contamination can make their skin red and raw with dermatitis.^[17]

People with OCD can use rationalizations to explain their behavior; however these rationalizations do not apply to the overall behavior but to each instance individually; for example, a person compulsively checking the front door may argue that the time taken and stress caused by one more check of the front door is much less than the time and stress associated with being robbed, and thus the check is the better option. In practice, after that check, the person is still not sure and deems it is still better in terms of time and stress to do one more check, and this reasoning can continue as long as necessary.