Address that obsessive disorder

I am an 18-year-old student. For the last two years I have been suffering from a peculiar problem which I’m embarrassed to share. I have become a cleanliness freak and wash my hands frequently, almost once every twenty minutes. I know it’s silly to spend so much time on washing hands but I’m unable to control it. My studies are getting affected and I am unable to go out and spend time with my friends. Sometimes I’m afraid to use my mobile if somebody else touches it. It has become a torture, please help me. Vijay, Gouthami Nagar.

You have Obsessive-compulsive disorder (OCD). Feeling bad is a sign of weakness and you need to be strong in your battle with OCD. Vijay, you are one of those many who are suffering from the problem and fail to realize that it is a psychological problem. OCD is a type of mental illness that causes repeated unwanted thoughts. To get rid of the thoughts, a person with OCD does the same tasks repeatedly. For example, you may fear that everything you touch carries germs.

So to ease that fear, you wash your hands over and over again. Generally, obsessive rituals are performed privately because affected people believe that others may not understand their feelings and behaviour. People with OCD also realise that their actions have no real purpose but still find it difficult to stop. OCD affects up to 3 per cent of the population and occurs in all communities. It affects men and women equally.

It is sometimes confused with other anxiety disorders, but in reality, the condition is an illness that requires treatment.Washing and cleaning rituals are the most common and widely recognised symptoms. People with this type of OCD can be described as perpetually engaged in compulsive acts of decontamination. People who compulsively wash and clean can be divided into two groups: (a) those who are trying to prevent themselves from being harmed or spreading harm to others via contamination, and (b) those who feel uncomfortable or contaminated by specific substances.

The first group of patients is usually worried about coming down with an illness or disease from contamination, which in some cases may feel responsible for spreading the contamination to others. Washing rituals are performed as an attempt to prevent this perceived danger. Individuals in the second group, tend to have fewer identifiable obsessions and engage in cleaning compulsions merely to relieve the discomfort associated with feeling dirty. People with this type of OCD typically have very strong disgust reactions.

People with contamination fears typically engage in excessive washing in order to remove dirt or to feel clean. This often involves excessive or repeated washing of hands. Hand-washing may be done in a ritualised manner, where the person cleans each finger individually. Once hands are clean, the person will then carefully turn off the tap with another object, such as a towel or a napkin, to avoid re-contamination of hands. Compulsive hand washers may also engage in excessive use of hand sanitizers.

People may experience suicidal feelings if they have depression along with OCD. They may give warning signs of suicide that include talking about death or giving away possessions.

Symptoms of the disorder include:

Obsessions: These are unwanted thoughts, ideas, and impulses that you have constantly. They won't go away; such thoughts cause anxiety or fear. The thoughts may be sexual or violent, or they make you worry about an illness or an infection. Examples include:

• A fear of harm to yourself or a loved one
• A driving need to do things perfectly
• A fear of getting dirty or invfected

Compulsions: These are behaviours that you repeat to control obsessions. Some people have behaviours that are rigid and structured, while others have very complex behaviours that change. Examples include:

• Washing
• Counting
• Repeating things
• Hoarding
• Constant praying

Causes of OCD:

OCD is caused by a combination of biological, genetic, and environmental factors. Researchers have shown that changes in the level and balance of chemicals in the brain are associated with anxiety and related disorders. Research also indicates that OCD runs in families (i.e., it has a genetic component).

Treatment:

OCD can be treated with psychological therapy, medications, or a combination of both. The main psychological intervention is cognitive behavioural therapy - exposure or response prevention - that can result in a high success rate with very few relapses. Cognitive behaviour therapists deliberately expose you to your obsessions to encourage you to confront the accompanying behaviours. You are then prevented from carrying out the rituals. Don’t hesitate to approach a trained psychologist for effective treatment and management.

Four steps to overcome OCD:

• Relabel: Recognise that the intrusive obsessive thoughts are a result of OCD. For example, train yourself to say, "I don't think or feel that my hands are dirty. I'm having an obsession that my hands are dirty." or, "I don't feel the need to wash my hands.”
• Reattribute: Realise that the intensity and intrusiveness of the thought or urge is caused by OCD; it is probably related to a biochemical imbalance in the brain. Tell yourself, "It's not me—it’s my OCD," to remind you that OCD thoughts and urges are not meaningful, but are false messages from the brain.
• Refocus: Work on the OCD thoughts by focusing your attention on something else, at least for a few minutes. Say to yourself, "I'm experiencing a symptom of OCD. I need to engage in another activity.”
• Revalue: Do not take an OCD thought at face value. It is not significant in itself. Tell yourself, "That's just my stupid obsession. It has no meaning. That's just my brain. There's no need to pay attention to it."
• Remember: You can't make the thought go away by not paying attention to it.
• Some facts about OCD
• OCD is a psychiatric illness recognised by experts throughout the world.
• OCD is an anxiety disorder characterised by symptoms that can include powerful, unwanted, or recurrent thoughts or compulsive, repetitive behavior.
• OCD is the fourth most common mental illness.
• People with OCD are not crazy, although they may sometimes feel that way because they are troubled by thoughts and actions that they know are inappropriate.
• People with OCD are often anxious and depressed.
• People with OCD often believe they are the only ones who have irrational, obsessive thoughts, and are therefore often ashamed and afraid to tell anyone or to seek help. Diagnosis is delayed until these symptoms are "unmasked."

By:N Radhika Acharya