“Will all great Neptune's ocean wash this blood
Clean from my hand? No; this my hand will rather
The multitudinous seas incarnadine,
Making the green one red”.
- Lady Macbeth from Macbeth
- Jenny suffers from a constant fear that her children have met with terrible accidents
when they are outside home. She even visualizes scenes of these mishaps in vivid
detail. She can’t seem to shake off the thoughts and feels guilty knowing how unreasonable
- Rohit is a successful businessman and a happily married family man. However, since
2 months he is unable to derive pleasures from the regular activities as he is haunted
by images of himself being involved in illicit sexual encounters especially with
female colleagues. He spends hours in the toilet washing and showering and does
not know how to control these ‘gross but untrue’ thoughts. He is unable to talk
to his wife as he knows she will misunderstand him.
- Laila spends hours every night making sure that all the locks in the house are
in place. She would check and recheck the same locks. This long time “habit” of
hers was angering her husband Shakil who felt she was doing this to avoid interacting
with him in their privacy. While Laila understands her husband’s resentment she
is unable to control the urge to indulge in her daily “ritual.”
All these people mentioned who are leading apparently “normal” lives are actually
victims of an exhausting mental condition known as “Obsessive- Compulsive Disorder
Although descriptions of patients with OCD have been reported since the fifteenth
century in religious and psychiatric literature, the condition was widely assumed
to be rare until very recently. Epidemiological research since 1980 has now identified
OCD as the fourth most common psychiatric illness, after phobias, substance use
disorders, and major depressive disorders
How do I know I have OCD?
Obsessive-compulsive disorder (OCD) is an anxiety disorder that affects thoughts
and actions and is believed to be rooted in a biochemical imbalance of the brain.
Its main features are recurrent and disturbing thoughts (called obsessions)
and/or repetitive, ritualized behaviors that the person feels driven to perform
(called compulsions). Obsessions can also take the form of intrusive images or unwanted
impulses. The person attempts to ignore or suppress such thoughts, impulses, or
images, or to neutralize them with some other thought or action. While, in most
cases compulsions alleviate anxiety, they are often known to trigger a fresh attack.
The most painful part of OCD is that the person recognizes that her thoughts or
behaviors are senseless or excessive but caves in to the powerful drive of the compulsions.
While an obsession may or may not result into a compulsion, behind every compulsive
act is a strong obsessive thought.
What are the different types
The most common types of obsessions include concerns with:
-Contamination (e.g., fear of dirt, germs or illness),
-Safety/harm (e.g., being responsible for a fire),
-Unwanted acts of aggression (e.g., unwanted impulse to harm a loved one),
-Unacceptable sexual or religious thoughts (e.g., sacrilegious images of
something or somebody venerable)
- And the need for symmetry or exactness.
Common compulsions include:
Excessive cleaning (e.g., ritualized hand washing);
Checking, ordering and arranging rituals; counting; repeating routine activities
(e.g., going in/out of a doorway) and
Hoarding (e.g., collecting useless items).
While most compulsions are observable behaviors (e.g., hand washing), some are performed
as unobservable mental rituals (e.g., silent recitation of nonsense words
to vanquish a horrific image).
How do we know this
is OCD and not just temporary symptoms of stress?
The obsessions or compulsions cause marked distress, are time consuming (take more
than 1 hour a day), or significantly interfere with the person's normal routine,
occupational (or academic) functioning, or usual social activities or relationships.
Also OCD should not be confused with Obsessive- Compulsive Personality Disorder
which is a lifelong pattern of insistence on control, orderliness, and perfection
that begins no later than the early adult years.
Is it a rare mental health
condition? Why do people have OCD?
About two-thirds of people with OCD have the first symptoms before they are 25 years
old, while only 15% develop symptoms after age 35. There is strong evidence that
the illness has a genetic (inherited) basis, since about 35% of people with OCD
have a close relative who also has the condition. Although 50% to 70% of patients
first develop OCD after a stressful life event such as a pregnancy, a job loss or
a death in the family, scientists still do not understand exactly how or why stress
seems to trigger the symptoms of this illness.It often takes people a long time
to seek out help for OCD, even after they learn it is a treatable illness. When
asked why it took so long, the reason given is usually embarrassment. The symptoms
of OCD can be so disagreeable and so private that they are very difficult to share
with anyone, including loved ones and trained professionals. Most cases of OCD begin
inconspicuously and gradually become more apparent over many months or years. It
is only in retrospect that one looks back and recognizes some of the early signs
of the illness.
Is it true that children
can also experience symptoms of OCD?
Yes. According to Tamar Chansky, the author of Freeing Your Child from Obsessive-Compulsive
Disorder and the director of the Children’s Center for OCD and Anxiety in Philadelphia,
there are more than a million children in the United States today with OCD. Chansky
also reports that the condition affects at least one in 100 American children and
that the average age of onset is 10.2 years. Children are often too embarrassed
to tell their parents or an adult what is going on. Thus parents can watch them
carefully for similar warning signs mentioned before they adopt appropriate steps
Can OCD be cured?
Behavioral therapy with medications seems to offer the best long term
improvement. Although, almost no treatment is curative for OCD most treatment can
be expected to reduce symptoms by 50-80% or more. The illness is cyclic, and worsens
when the individual is under stress.
Behavior therapy has a lot to offer individuals with this disorder. Two common
and popular techniques are systematic desensitization and flooding.
Systematic desensitization techniques involve gradually exposing the client to ever-increasing
anxiety-provoking stimuli. This is coupled with relaxation techniques involving
imagery, breathing skills and muscle relaxation.
Flooding allows the patient to face the most anxiety-provoking situation,
while using the relaxation skills learned.
Saturation, response prevention and thought – stopping techniques
have also found to be useful in varying degrees.
Research has shown that one of the most difficult problems in OCD is in getting
family members to understand that the patient is unable to simply stop the behavior.
Many times relatives become angry and upset when they are forced to deal with the
time-consuming and unrealistic repetitive behaviors.
What can I do to help myself?
Based on the various behaviour therapies mentioned above some techniques can be
followed at home:
1. Practice relaxation techniques and do this daily for 20 minutes in a secluded
area of your house.
2. Jot down your ‘irrational’ or obsessional thoughts in a diary and talk to yourself
about it trying to use rational thinking to analyze them e.g. “I feel as
if germs are there in my hands but I know it is not there.”
3. Delay your compulsions for a time period e.g. 30 seconds or a minute and
do some deep breathing in that time. Keep track of the delay and increase that gap
4. You can also tell yourself “ no, stop it” when you experience mild urges
to indulge in your thoughts or actions.
5. Redirect your compulsions to an opposite activities like calling up a
friend, drawing, writing, knitting as opposed to hand washing.
Do not feel anxious or dejected if you do not succeed in curbing your symptoms.
You probably need a professional’s advice to help you achieve your goals.
Some useful websites on
mental health issues :