OCDOCDOCD want to have these ideas, finds them
OCDOCDOCD is a very common disorder affecting almost everyone in the world, some being affected much more than others. First of all I will give a brief definition of OCD. Obsessive Compulsive Disorder causes the brain to get stuck on one particular urge or thought that can’t easily be let go.
People with OCD often call it a case of, “mental hiccups that won’t go away.” Everyone has this condition in one way or another. For instance, a man might go into a bathroom and flush the toilet with his foot so he won’t have to touch the handle that others have handled after handling themselves.
Someone with a worse case in the same situation might go in the bathroom, use toilet paper to lower or raise the lid, flush with foot before use, flush with foot after use, use paper towel to turn water on, wash his hands for a few minutes to get off all possible germs, and use more paper towels to open door following up with hand sanitizer. OCD usually involves having obsessions and compulsions although having one or the other is not uncommon. First is the obsession, which is thoughts, images, and impulses that occur over and over again that make the person feel out of control. ObsessionsObsessions are thoughts, images, or impulses that occur over and over again and feel out of your control. The person does not want to have these ideas, finds them disturbing and intrusive, and usually recognizes that they don’t really make sense. People with OCD may worry excessively about dirt and germs and be obsessed with the idea that they are contaminated or may contaminate others.
Or they may have obsessive fears of having inadvertently harmed someone else (perhaps while pulling the car out of the driveway), even though they usually know this is not realistic. Obsessions are accompanied by uncomfortable feelings, such as fear, disgust, doubt, or a sensation that things have to be done in a way that is “just so.”CompulsionsPeople with OCD typically try to make their obsessions go away by performing compulsions.
Compulsions are acts the person performs over and over again, often according to certain “rules.” People with an obsession about contamination may wash constantly to the point that their hands become raw and inflamed. A person may repeatedly check that she has turned off the stove or iron because of an obsessive fear of burning the house down. She may have to count certain objects over and over because of an obsession about losing them. Unlike compulsive drinking or gambling, OCD compulsions do not give the person pleasure. Rather, the rituals are performed to obtain relief from the discomfort caused by the obsessions.The following chart was taken from www.
ocd.com and shows typical obsessions and the compulsions that follow.Table 1. Typical OCD SymptomsCommon Obsessions:Common Compulsions:Contamination fears of germs, dirt, etc.WashingImagining having harmed self or othersRepeatingImagining losing control of aggressive urgesCheckingIntrusive sexual thoughts or urgesTouchingExcessive religious or moral doubtCountingForbidden thoughtsOrdering/arrangingA need to have things “just so”Hoarding or savingA need to tell, ask, confessPrayingOCD can start at any time from preschool age to adulthood. One third to one half of adults with OCD report that it started during childhood.
Unfortunately, OCD often goes unrecognized. Studies have also found that it takes an average of 17 years from the time OCD begins for people to obtain appropriate treatment. There is no single, proven cause of OCD.
Research suggests that OCD involves problems in communication between the front part of the brain (the orbital cortex) and deeper structures (the basal ganglia). These brain structures use the chemical messenger serotonin. It is believed that insufficient levels of serotonin are prominently involved in OCD.
Drugs that increase the brain concentration of serotonin often help improve OCD symptoms. Although it seems clear that reduced levels of serotonin play a role in OCD, there is no laboratory test for OCD. Rather, the diagnosis is made based on an assessment of the person’s symptoms.
When OCD starts suddenly in childhood in association with strap throat, an autoimmune mechanism may be involved, and treatment with an antibiotic may prove helpful. Research shows that the serotonin reuptake inhibitors (SRIs) are effective treatments for OCD. These medications increase the concentration of serotonin, a chemical messenger in the brain.
Five SRIs are currently available by prescription in the United States: Clomipramine (Anafranil, manufactured by Novartis) Fluoxetine (Prozac, manufactured by Lilly) Fluvoxamine (Luvox, manufactured by Solvay) Paroxetine (Paxil, manufactured by GlaxoSmithKline) Sertraline (Zoloft, manufactured by Pfizer) Citalopram (Celexa, marketed by Forest Laboratories, Inc.) Fluoxetine, fluvoxamine, paroxetine, citalopram, and sertraline are called selective serotonin reuptake inhibitors (SSRIs) because they primarily affect only serotonin. Clomipramine is a nonselective SRI, which means that it affects many other neurotransmitters besides serotonin. This means that clomipramine has a more complicated set of side effects than the SSRIs. For this reason, the SSRIs are usually tried first since they are usually easier for people to tolerate. My wife worked as an RN at Forsyth Hospitol for two years and has told me of numerous times that people have had a bad side effect from taking Anafranil. One in particular went into a state of severe depression and had to be put on suicide watch for a few days.
So anyone who decides to take meds for OCD should be extremely careful. Work CitedVarcarolis, E. Foundations of Psychiatric Mental Health Nursing Third Edition p. 450 – 465 W.B. Saunders CompanyOCD Foundation www.ocfoundation.org November 16, 2004OCD home page www.ocd.com November 16, 2004