Sufferers from O.C.D. and their families know that the obsessive compulsions are not only time consuming – they make it virtually impossible to live normally. So it’s alarming to hear that a University of Chicago Psychiatrist has published an article in The New England Journal of Medicine, saying that
“Only approximately one third of patients with O.C.D. receive appropriate pharmacotherapy, and fewer than 10 percent receive evidence-based psychotherapy.”
The article says that the common misdiagnosis of depression or anxiety delays or even prevents effective therapy. Patients with O.C.D. may suffer from both but if the O.C.D. itself isn’t diagnosed and treated, the anxiety and depression will continue.
What is O.C.D.?
It stands for Obsessive Compulsive Disorder. The main symptoms are disturbing thoughts and fears that the sufferer cannot ignore. These thoughts force the person to repeat rituals and to behave irrationally to relieve the fears.
How Does it Affect Someone?
In his article, Dr. Jon E. Grant, psychiatrist at the Pritzker School of medicine, reported on a 19 year old man who
Washed his hands up to 100 times a day,
Couldn’t touch anything if someone had touched it first – unless he scrubbed it ‘clean’
Had such a severe fear of germs that he became reduced to living in his bedroom, couldn’t eat and felt suicidal.
It took two years for his O.C.D. to reach the point where he was completely disabled by it.
An Exhausting Life
Sufferers from O.C.D. are aware that what they are thinking and doing is not rational but they are unable to stop. The compulsive rituals only relieve their anxiety for a short time and then they need to do them all over again and so the cycle repeats.
Who Gets It?
1 to 3% of people with start developing O.C.D. in childhood or when they are young adults. The condition can be inherited although it can vary in how crippling it is from one family member to another.
What Causes It?
This is still not properly understood although in his study, Dr.Grant noted that there were abnormalities in some areas of the brain. There were also some failures in cognitive abilities such as not being able to change behaviours when given new information.
What About Treatment?
O.C.D. is not likely to spontaneously resolve without relevant treatment. The sooner it is diagnosed and treatment started, the better the outlook. This is why the misdiagnosis mentioned earlier is such a problem.
Just 30 hours of Cognitive behavioural therapy spread over once or twice weekly sessions can be most effective. In a type of CBT called ‘exposure and response prevention’ the sufferer undergoes anxiety provoking stimuli. They begin with the least provoking and learn to avoid their usual responses. They keep going until they can face their most frightening stimulus without reacting.
Medications such as the antidepressants clomipramine (Anafranil) or Zoloft or Paxil (selective serotonin reuptake inhibitors) may be helpful, although cognitive behavioural therapy remains the most effective treatment.
The Good News
Treatment does work in 60 – 80% of sufferers – even if given over the phone or via the internet. Booster sessions may be necessary to keep the person maintained.