This Side of the Creek

It affects more than 2 million Americans. It can lead to arguments, unemployment, and an overall loss of quality of life. It can swallow its victims and mold them into whatever it wants before spitting them back out to live in this chaotic world…

I’m talking about Obsessive-Compulsive Disorder (OCD).

According to the National Institute of Mental Health, those with OCD may be “plagued by persistent, unwelcome thoughts or images, or by the urgent need to engage in certain rituals. They may be obsessed with germs or dirt, and wash their hands over and over. They may be filled with doubt and feel the need to check things repeatedly.” Unknown to many is the fact that OCD is classified as an anxiety disorder. Not only can this mean that anxiety results when compulsions, also called rituals, are not performed, but the obsessions that lead to the compulsions are most often related to feelings of anxiety. That anxiety can stem from an array of life events or from low self-esteem, self-doubt, etc.

In my lifetime I have heard numerous individuals with good intentions jokingly refer to themselves as “OCD” because they like certain things a certain way. Some men may assume their wives suffer from the disorder because the wives like to keep a clean household. However, most women like to keep a clean household and this could be because the house is a representation of the family to others when company arrives. Not all women have OCD and the disorder affects men as well. Liking things a certain way is OK, but when there is a feeling – an urge – to complete a task because not doing so will create intense anxiety that cannot be ignored without intervention, then we as professionals must look at actual OCD. We also look at the time an individual spends engaging in the rituals on a daily basis. Is it consuming one hour, two hours, 24 hours in a single day?

Although contamination is thought of by most when discussing OCD, this is not always the obsession or compulsion. For some, counting to a particular number, having everything on one side or the other, stepping a certain way through a door or over cracks in the sidewalk are common compulsions. Additional compulsions may include ordering items with all labels facing forward, straightening things to obtain a “balance,” matching underclothes with outerclothes (or being unable to wear certain colors together). There are many ways obsessions (the thoughts) can play out in compulsions (the actions). What is relevant is that the thoughts become overwhelming and life can seem uncontrollable if the actions are not performed. There is a nagging from the inside when trying to ignore a compulsion to, “Go back and do it,” because otherwise it will consume your thinking.

The positive side is that treatment exists for OCD. Sadly, however, many cases go undiagnosed and the thinking and behaviors are thought to be quirks of the individual’s personality. One such treatment utilized for OCD is known as Exposure Response Prevention and involves exposing the person with OCD to the stimuli which cause the anxiety. Once exposed, the individual is then encouraged to not engage in the behavior that would normally follow. In time, the symptoms may reduce to where the individual can be confronted with the anxiety-producing stimuli and not respond with compulsions. This further reduces the level of anxiety associated with the stimuli to a point where the anxiety no longer occurs to begin with. ERP takes time and should be used under the care of a professional trained in utilizing the approach. This is evidenced-based treatment that makes sense because the more urges are given into, the more frequently those urges occur and when we can’t pacify the urge, a negative emotional response such as anxiety, irritability, etc. can result. The International OCD Foundation reports that 7 out of 10 individuals benefit from cogntive behavioral therapies (such as ERP) or from the use of medication.

Other options for those who suffer from OCD may include talk therapy, group therapy/support groups, and medication. Although, these are certainly not the only ways for individuals to overcome the disorder. It may be crucial for an individual to discuss past traumas that may have led to the OCD and this, as many of us know, can further create anxiety until we know it’s OK to talk about and that we are safe from those traumas today.

A life free from obsessions and compulsions can happen with time, work, and support. For more information, visit the National Institute of Mental Health, the OCDCenter.org, or the International OCD Foundation or speak with your healthcare professional today.

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