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A woman visits her dermatologist, complaining of extremely dry skin and seldom feeling clean. She showers for two hours every day. A lawyer insists on making coffee several times each day. His colleagues do not realize that he lives in fear that the coffee will be poisoned, and he feels compelled to pour most of it down the drain. The lawyer is so obsessed with these thoughts that he spends 12 hours a day a work -- four of them worrying about contaminated coffee. A man cannot bear to throw anything away. Junk mail, old newspapers, empty milk cartons, all could contain something valuable that might be useful someday. If he throws things away, something terrible will happen. He hoards so much clutter that he can no longer walk through his house. These people suffer from Obsessive Compulsive Disorder or OCD. The National Institute of Mental Health estimates that more than 2% of the United States population, or nearly one out of every 40 people, will suffer from OCD at some point in their lives. What is Obsessive Compulsive Disorder? Obsessions are intrusive, irrational thoughts -- unwanted ideas or impulses that repeatedly well up in the victim's mind. Again and again, the person experiences disturbing thoughts, such as my hands must be contaminated; I must wash them or I may have left the gas stove on. Trying to avoid such thoughts creates great anxiety. Compulsions are repetitive rituals such as hand washing, counting, checking, hoarding, or arranging. An individual repeats these actions, perhaps feeling momentary relief but without feeling satisfaction or a sense of completion. OCD victims feel they must perform these compulsive rituals or something bad will happen. Who gets OCD? People of all ages and from all walks of life. It strikes people in all ethnic groups, and both males and females. Symptoms typically begin during the teenage years or young adulthood. What causes OCD? Obsessive Compulsive Disorders remain among the more baffling mental illnesses. Scientific evidence suggests that OCD results from a chemical imbalance in the brain. Researchers have identified the part of the brain that causes OCD and they have discovered a strong link between OCD and a brain chemical called serotonin. Serotonin is a neurotransmitter that helps nerve cells communicate. Scientists have also observed that people with OCD have increased metabolism in the basal ganglia and in the frontal lobes of the brain. This, scientists believe, causes repetitive movements, rigid thinking and a lack of spontaneity. Can OCD be effectively treated? Yes, with medication and behavior therapy. Medication can regulate serotonin, reduce obsessive thoughts and compulsive behavior. In the last few years, several medications have been developed that relieve many of the symptoms of OCD. Three are particularly recommended as serotonin selectors: Clomipramine: This medication has been used in Europe for more than 20 years, and is now available in the United States. There is little evidence that Clomipramine has adverse long-term negative effects, particularly no increased long-term birth-defects. But it can produce side effects: dry mouth, constipation, tiredness, fatigue, slight hand trembling, sexual dysfunction, severe weight gain. There is also the possibility of seizures in high dosages. Fluoxetine and Sertraline: These medications are viewed as effective in some OCD patients but with far fewer side-effects for most patients. Fluoxetine occasionally causes nausea, weight loss, insomnia. Behavior therapy is not traditional psychotherapy. It is exposure and response prevention and has been found to be effective for many people with OCD. Patients are deliberately exposed to a feared object or idea, either directly or by imagination, and are then discouraged or prevented from carrying out the usual compulsive response. When treatment works well, the patient gradually experiences less anxiety from the obsessive thoughts and becomes able to refrain from the compulsive actions for extended periods of time. Will OCD symptoms go away completely with medication and behavior therapy? Response to treatment varies from person to person. Most people treated with effective medications find their symptoms are reduced by about 40 percent or 50 percent. That can often be enough to change their lives, to transform them into functioning individuals. Unfortunately, some people find neither medication nor behavior therapy has positive effects. However, some people are fortunate enough to go into total remission when treated with effective medication and/or behavior therapy. ############ |
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