| Obsessive Compulsive Disorder (OCD) is more common than we think. It is present in about 1-2% of the population affecting men, women and even children. It typically begins during teenage years or young adulthood. Surprisingly it is the more educated and those from the higher social classes who are particularly vulnerable to it.
But what causes OCD? Why is it these useless repetitive thoughts and actions can’t be controlled? From an entire family, why should one person develop OCD, under similar conditions of stress? These are some of the puzzling questions that crop up in our minds when we come across a patient of OCD. There are also various types of thoughts/actions and severity of the problem ranging from where others are not even aware of it to when it is completely debilitating personally, socially and professionally.
It is important to realise that these problems are not the person’s own fault, nor can the family be blamed. People do not cause this disease. It is a combination of several chance factors coming together—an interaction of neurobiological factors and environmental influences. Recent research into brain-behaviour relationships has established that people who develop OCD have a biological disposition to react strongly to stress, that this reaction takes the form of distressing thoughts and compulsive actions which lead to more anxiety, creating an inescapable vicious cycle. This also explains why some people with a neurological disorder of the brain display obsessive compulsive symptoms. It is an interaction of personality, family influences, biological vulnerability and stress which eventually create the symptoms.
When to seek help
It would be best to consult a professional if you find that:-
- There are signs of having repeated, unwanted thoughts which interfere with daily functioning.
- There are repeated acts that are unnecessary, producing great anxiety if an attempt is made to stop these actions.
- Day to day activities take a long time, because they have become complicated with rituals and patterns of
behaviour.
- There are constant doubts about simple events.
- Presence of depression or suicidal thoughts along with thoughts/action.
Treatment of OCD
Many people think of OCD not as a mental disorder, but as a sort of superstitious behaviour. This is not so. No superstition by itself can disrupt daily functioning to the extent that OCD does. The symptoms sometimes become more, sometimes less and sometimes even disappear altogether on their own. Usually they become intense if the person is under some stress.
Medication: Psychiatrists have successfully used a combination of anti-anxiety and anti-depressant medication to control the severe anxiety and accompanying depressive symptoms in OCD, some specifically targeting the obsessive thoughts.
Behaviour therapy: An approach called ‘Exposure and Response prevention’ can be employed wherein a patient is deliberately exposed to the feared object or idea, either directly or by imagination and is then discouraged or prevented from carrying out the compulsive response. The OCD patient thus gradually experiences less anxiety and learns to overcome obsessive thoughts and compulsive actions for longer and longer periods of time. ‘Thought stopping’ technique is also useful in dealing with obsessions. However, these need the expert guidance and supervision of a trained behaviour therapist/psychologist. There are many other techniques based on similar principles including techniques of relaxation to reduce anxiety.
Family Counselling: Family support, both in understanding the complex nature of the patient’s symptoms and helping them to get rid of the problem are crucial to progress and recovery. The psychiatrist/psychologist may enlist the family members active cooperation in the program for changing the person’s behaviour. Merely ignoring the problem, pretending it doesn’t exist and ‘giving in’ to his or her rituals will only make matters worse.
Getting professional help and seeking a long term treatment plan at the earliest will ensure that these sensitive, intelligent and otherwise productive individuals will come out of their closets to live life to the fullest.
—Dr. Avdesh Sharma is a celebrated mental health expert and Heads 'Media and Public Education Committee' of 'Psychiatry in Developing Countries Section' of World Psychiatric Association.
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