The pressure to earn a living was enormous. After the inability to conform to a demanding workplace, Joy (name changed) quit her job. A couple of unsuccessful job interviews later, Joy withdrew from her social circles. In a matter of a month, she found herself obsessed with the ritual of washing her hands. Touching a door knob, picking a newspaper up from the floor, a handshake, touching the gate to her house where a beggar could have stopped over for alms, made her stop and wash for hours. “I knew it was irrational and silly, however, I kept doing it anyway. I was afraid of social ridicule and was hesitant to reach out for any help. My life was coming to a standstill , and the constant washing almost gave a breakdown to the skin on my hands,” she says.
Joy is one of the many suffering from Obsessive Compulsive Disorder (OCD), an anxiety disorder. Here, obsessions and compulsive rituals take over an individual’s psyche. A certain man in his forties takes one step back for every five steps that he takes forward ( even at pedestrian crossings ! ) One particular lady was compelled to offer money to the local church every day to ward off evil at the cost of draining her modest income. And many more.
Epidemiological studies have revealed that roughly 2 per cent of adults suffer from this anxiety disorder. The exact prevalence among children is not accurately known, as few really reach out for medical help, says a study on the disorder by Dr Y C Reddy from NIMHANS.
“OCD can be viewed as a neurobiological disorder. Life events like unemployment, death of a family member, change of job or school, relationship issues etc. can play a part in triggering off OCD, depending on the person’s personality trait. In comparison with normal folks, those who suffer from OCD are found to possess traits like inability to tolerate uncertainty, excessive focus on orderliness and high anxiety levels. To understand this common disorder, one has to have an understanding of the obsessions and compulsions,” says Dr John, consultant psychiatrist at Medical Trust Hospital, Ernakulam.
The Obsessions:
These are thoughts, images, impulses that occur to a person over and over. The person knows that the thoughts are irrational and unwanted, but is powerless to stop it anyway. The common obsessions are contamination from germs and dirt, fear of harm (fire or burglary), aggressive thoughts, sexual obsessions, religious obsessions, concern about evenness and symmetry. The anxiety is developed when trying to fight the obsessions.
The Compulsions:
These are behaviors or rituals that are unnecessary and baseless. The person with OCD is compelled to repeat the rituals over and over again. For example, the person may check repeatedly that the door is locked or wash hands every now and then to prevent contamination.
The compulsive actions are an attempt to make the obsessions go away. “Though they are aimed at reducing the distress, say the fear of contamination, the behavior in itself may not be realistic. It is usually excessive, and potent enough to make life come to a standstill,” Dr John says.
Roughly 60 per cent of those who suffer from OCD are found to have recovered from this debilitating condition. Those who suffer from chronic OCD have been found to fall into depression in some cases. Selective Serotonin Reuptake Inhibitors (SSRIs) are being used clinically to correct this neurobiological disorder. For the best results, cognitive behavioural therapy and medication go hand in hand, Dr John adds.
Cognitive therapy often involves repeated exposure to the source of obsession and the patient is asked to abstain from the compulsions that he would otherwise usually perform.
Actor Cameron Diaz of Charlie’s Angels fame is a celebrity who has gone public about her OCD. After grappling with the anxiety disorder for a couple of years, she has been successful in modifying her compulsion of habitually rubbing the doorknobs clean.
A primer in the field of OCD is 'The Boy who Couldn’t Stop Washing' by Judith Rapoport, written sympathetically and knowledgeably (published by Penguin Books) .
Reaching out to family and supportive friends is essential as OCD victims tend to suffer in silence, out of inhibition to get professional help. Mindful meditation, yoga and refocusing on activities like jogging play a part in the recovery process.
