Sunday, November 14, 2010

Obsessive Compulsive Disorder (OCD)


OCD can be loosely described as a psychiatric anxiety disorder characterized by obsessive thoughts and compulsive actions such as cleaning, checking, counting or hoarding. With OCD this condition can persist throughout a person’s life where the sufferer becomes trapped in a pattern of repetitive thoughts and behaviors that are senseless and distressing, but extremely difficult to overcome.

These obsessions are unwanted ideas or impulses that repeatedly flood the person’s mind. Persistent fears of being contaminated or a need to do things perfectly tend to be a common occurrence as well as experiencing disturbing thoughts associated with not performing the behaviour. These unpleasant thoughts are intrusive and produce a high degree of anxiety.

The most common obsessions lie with the need to have things in a particular order and not performing this act can leave the individual in intense distress. Most common compulsions are washing and cleaning, counting, checking, repeated actions and ordering.

Looking at the history of OCD, it was once believed that the disorder resulted from life experiences, but recent evidence suggests that biological factors are a primary contributor to the disorder. This information is sourced from the fact that OCD patients respond well to specific medications that affect the neurotransmitter serotonin which then implies a neurological basis for the disorder.

Diagnosing OCD can be problematic as this disorder has co-morbidity with depression, eating disorders, substance abuse disorder, personality disorders and other anxiety disorders. The co-existence with these disorders makes OCD more difficult to diagnose and also treat.

The treatment for this disorder is generally a combination of medication and cognitive behavioural therapy (CBT). While the medication combats the symptoms of the obsession and ease the associated anxiety, the treatment options work differently from person to person. Some people find they benefit from therapy alone whereas others also need medication. The most effective and long lasting treatment is through CBT.

Although psychotherapy is the most traditional treatment it is generally not helpful for OCD sufferers. Alternatively, exposure and response prevention therapy has been effective for many people with OCD. This particular therapy involves the individual deliberately and voluntarily confronting the feared object or idea directly or through imagination. In the example of compulsive hand washing, the individual would be encouraged to touch something they believed to be contaminated and then urged to refrain from washing their hands for several hours until the anxiety has greatly subsided. After the first hurdle the treatment proceeds on a step by step basis guided by the patient’s ability to tolerate the anxiety and control the rituals. In time as the treatment progresses most patients gradually experience less anxiety from the obsessive thoughts and are able to resist the compulsive urges. Studies have shown this method to be successful for the majority of patients who complete it but it is very important that your therapist is fully trained in this particular therapy. Positivity, a determined attitude, and high motivation from patients is known to be helpful in this treatment.

By Paulina Pyrchla – September 2010
RMIT Placement Student

References
http://www.medterms.com/script/main/art.asp?articlekey=4610
http://au.reachout.com/find/articles/obsessive-compulsive-disorder-ocd
http://www.anxietyaustralia.com.au/anxiety
_disorders/ocd.shtml

A few important points on Doctors and Medications


Recognise that not all GPs are directly familiar with or have personal knowledge of anxiety except on an academic level.

Medicine is still essentially conservative - there may be other natural options

Regard your doctor as a person with some specialised training in one particular modality, but not a specialist in ALL areas. Therefore they may have SOME knowledge that is helpful to you, but it is not necessarily the ONLY knowledge you can gain.

Doctors, as people, also have different preferences in the way they practice medicine as well as different approaches. Some may not be interested in emotional problems, preferring a more technical approach. Ask to be referred to another more "listening" doctor if you find this is the case.

Don't be afraid to ask WHY?

Recognise that you are paying the doctor to provide a service, which should be delivered to YOUR satisfaction - including providing you with all of the information you require.

There are several doctors now available who have also studied natural therapies. If you would like a more holistic approach, these may be the answer.

SUGGESTED QUESTIONS:
What precisely can I expect the medication to do?
What are the side effects?
How long till the medication takes effect?
How long should I expect to be on medication?
What happens if I choose to come off it?
Are there any precautions I should take? (e.g. avoiding certain foods, operating machinery etc.)


Information provided by Bev Aisbett, Counsellor and Author of LIVING WITH IT and several other anxiety and depression self-help books.