OBSESSIVE-COMPULSIVE DISORDER: the Secret Illness

A well known Hollywood director-producer, Howard Hughes was described by his co-workers as “eccentric” because he was so concern that he would get sick by touching materials contaminated with germs. David Beckham was recently admitted because of his unusual behavior. He constantly feels that there is a need to arrange everything in a straight line.

What do Howard Hughes and David Beckham have in common? They share a condition called OBSESSIVE-COMPULSIVE DISORDER (OCD).

OCD is a kind of psychiatric disorder specifically anxiety disorder that causes people to have unwanted thoughts (OBSESSIONS) and to repeat certain behaviors (COMPULSIONS) over and over again. Most people observe their routines in their lives, such as brushing their teeth or checking whether doors are locked before going to work. However, brushing may be as much as twenty times a day in response to a fear that they might get sick from germs in their mouth. Doors have to be checked not just twice but ten or more times because they worry that they have not checked enough. Clearly, people with OCD have abnormal and often rigid patterns of behavior that get in the way of their lives. What is interesting is that most people with OCD are aware that their obsessions and compulsions make no sense. However, they can’t ignore or stop them.

Being a disorder, OCD is a clinical concern that needs to be addressed because this disorder is more common than other psychiatric disorders such as schizophrenia, bipolar disorder and manic disorder. However, OCD or also known as the “secret illness” often remains unrecognized and undiagnosed. As the term implies, this condition has two major components: obsession and compulsion. Obsessions are nagging or even present thoughts that cause distress and intrude into a person’s daily activities. Much like when you are obsessed with someone, people with OCD have high levels of distress from worrying about disease, death and other distressing behaviors. In order to address these concerns, they develop compulsions that are repetitive tasks or rituals that attempt to neutralize the obsession. For example, a person may be obsessed that his hands have germs. Having these germs can cause him to get sick and eventually die. Because he is so worried about the possible negative consequences, he may develop a ritual of washing his hands thoroughly every 10 minutes. In some OCD cases, the soap may only be used once, as previously-used soaps may be “contaminated”. Washing the hands often makes the nervous feelings go away but only for the short time. When the fear and nervousness return, the person who has OCD repeats the routine all over again.

Current research still does not have a definite answer. There are therapists who claim that OCD is primarily a psychological disorder, implying that it is caused by life events such as traumatic childhood experiences or unresolved conflicts during a person’s development. Education seems to be a factor, as the complex thinking patterns observed among those with OCD require above average intelligence. There are some researchers who claim that symptoms associated with OCD are caused by abnormalities in the brain itself or how the chemicals in the brain system functions. For example, researchers have discovered that people with OCD have abnormally-sized structures in the brain. Some discovered that this disorder is caused by abnormality in the levels of a chemical called serotonin which leads to faulty communication between different brain structures. Advanced brain studies using imaging technique have suggested that those with OCD have different levels of brain activity from those without. Because of these researches, many practitioners are now convinced that there is a valid biological brain-based cause for OCD are further studying how medications and therapies can help those suffering from it. The course of OCD is quite varied. Symptoms may come and go, ease over time, or get worst.

Symptoms may include the following:

  • Repeated hand washing. This is related to the fear of contaminated by germs or infection with body secretion.
  • Rearranging objects in a rigid manner.
  • Having to “cancel out” bad thoughts with good thought like replacing sexual thoughts with non-sexual thoughts.
  • Specific and unusual counting systems such as counting in groups of 5, stopping every 12 steps, making sure that everything comes in pair, etc.
  • Repeatedly clearing throat, although nothing may need to be cleared.
  • Continuous worry about specific activities such as sleeping and eating without the “specific items”, such as inability to sleep without specific blanket.
  • An obsession with numbers. For example, some OCD sufferers are obsessed with even numbers while loathing to odd numbers.

There are many other symptoms, and one does not need to display the behaviors found on the above list to be diagnosed with an OCD. A formal diagnosis has to be made by a mental health professional such as a psychiatrist, using the DMS-IV TR as a guide.

There is no definite treatment for OCD. However, professionals often help people with OCD through behavioral therapy and cognitive therapy. In these interventions, therapists assist the patients by providing them strategies to address their fears and limit their compulsive behaviors. In behavioral therapy, patients are guided to face situations that cause or trigger their obsessions and anxiety. Then they are encouraged not to perform the rituals that usually help control their nervous feelings. For example, if a person is obsessed with germs might be encouraged to use a public toilet without washing his or her hands more than once. To use this method, a person ma person who has OCD must be able to tolerate the high levels of anxiety that can result from the experience. Medications are also used in treatment including drugs that affect the brain chemical serotonin, as well as medications for depression. Generally, research has shown that medications combined with psychological interventions work better than drugs alone.

The effective management of OCD starts with consulting a mental health professional when symptoms are first noted. With the proper interventions, people with COD can be helped to cope well with their condition and like Howard Hughes and David Beckham, live productive lives.

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