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O.C.D. *** Obsessive Compulsive Disorder

Do you have thoughts entering your mind that you'd rather not have?

Are these thoughts distressing?

Do you find it difficult to get rid of these thoughts from your mind? Do you have to check your door-locks and gas taps repeatedly?

Do you have mental rituals that you repeat?

When once is not enough, it may be OCD.   

What is OCD?
OCD is a neurobiological condition causing changes in the brain. The person is unable to resist persistent, irrational and unshakeable thoughts and urges (obsessions) which he/she recognizes as irrational and uncontrollable (compulsions). The anxiety is either reduced after performing the act or builds up on resisting the urge. Do you remember Jack Nicholson in the movie "As good as it gets"? 

History:
OCD usually starts in adolescence and rare after 50. It affects 2% of the population. It occurs in both sexes equally, although symptoms appear in males at an earlier age. There is a family history of OCD in 20% of sufferers and the predominant age is 20. Before the onset of symptoms there may be minor episodes occurring in early childhood that may initially be controllable. The symptoms may change over years. This condition tends to wax and wane, as it becomes chronic, with one in six deteriorating with this disorder. Stresses in the environment, such as a change of school, marital breakdown and pregnancy, or traumatic events such as illness or death in the family, sexual trauma and loss of a job may increase the symptoms. The highest risk is observed in monozygotic twins. It is usually associated with other mental disorders like panic disorder, phobias, Tourett's, eating disorders, and depression (comorbidity) and sometimes with alcohol or drug abuse. 

Symptoms: Over and over again!

1.    Obsessive symptoms are

Repetitive thoughts of disease and death through contamination

Obsession with cleanliness: washing hands repeatedly

Intense need for exactness, orderliness and symmetry

Repeated perverse sexual thoughts and images

Distress by religious thoughts and images;

repetitive religious obsessions

Repetitive doubts with a need to know or remember facts all the time

    Impulse to be aggressive or violent and fears of inability to control those impulses
    2.      Compulsive symptoms may be in their thoughts (covert) or in their behaviour (overt):

(i) Thoughts:

Repeating of words, phrases and numbers

Mentally repeating certain rituals

     Mentally reciting prayer in a set order            

     (ii) Behavior:

     Excessive hand-washing, tooth-brushing, bathing or showering, and grooming

     Compulsion to repeat routine activities at home or at work

     Compulsion to check the locks, gas and electrical appliances repeatedly

     Seeking reassurance with a need to confess, ask or tell 

 

The Way it Repeats itself: 1-2-3-4-5-Do it again 1-2-3-4-5-Do it again!

 When these compulsions persist and are strong, the person develops anxiety and extreme discomfort. To relieve anxiety the compelling task is carried out. However, this relief is short lived and so the action needs to be repeated. Let us consider the thought of contamination. The person feels his hands are dirty and so has to wash his hands. The feeling builds up in his mind, urging him to wash. Then he feels less anxious for a while. Soon the thought of contamination returns and the ritual begins again. Situations like hopping and touching objects or saying prayers in your mind need to be differentiated from OCD. 15% of schizophrenics have obsessive-compulsive symptoms. Delusions of schizophrenics are different from OCD, as with the latter the person is aware of what he is thinking or doing and realizes his inability to control the act. He/she may try to avoid the situations and hence hide their disorder. Other mental conditions may also be associated with OCD. Hence, a physician should always be consulted to diagnose this condition properly. 

Assessment:
Self-assessment can be made following obsess ional and compulsive inventory or Yale Brown OCD checklist. Medical doctors use different obsessive-compulsive scales to evaluate the severity of the disorder. That's why you need a doctor to diagnose correctly. 

Management:

The aim of therapy is to help the person gain control over their obsessive and compulsive behavior. Behavioral and cognitive therapy are main line of management. The psychotherapist will guide the person providing techniques and suggestions to unlearn some behavior and replace them with new behavior. It is necessary to educate the person so that he/she can take control of their management. It is a self-directed behavioral therapy. Graded exposures to the triggers are combined with encouragement not to respond to obsessive-compulsive thoughts. When depression is severe, serotonin-reuptake inhibitors and clomipramine are very effective. Medication needs to be continued for at least 12 months combined with regular assessment of the person. For best results both psychotherapy and pharmacotherapy are combined. Rarely is neurosurgery recommended.

Family support and cooperation are mandatory.

OCD Support Groups are only a phone call away on 1 800 626 055.

 

Behavioural Change:

How Can I Overcome Procrastination ? 
It's time to stop putting things off till the last minute! If you find that others have to remind you to get things done or if you tend to resent others for trying to keep you "on track," then you need to figure out who's driving your bus!

Stop your procrastinating by first recognizing that procrastination is a behavior acted out by your rebellious self. Don't be hard on yourself, which can cause more internal conflicts and more procrastinating behaviors and don't get into power struggles with those who are trying to keep you on track. Instead, call on your Adult ego to help you get back on track. Your Adult ego is responsible, logical, and unemotional; and it's your Adult ego who will help you get to work so that your Child ego can come out later to play.

 

 

 

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