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Tuesday, November 17, 2015

OCD and what it looks like

I want to get a little technical and talk about the clinical definition of OCD. I think this is an important conversation, not only because i suffer from it, but because many people suffer from it and it is very misunderstood. Have you ever found yourself saying "Im a little OCD when it comes to cleaning"? Or "I am so OCD, i hate when things aren't in order"? Many people make these comments and i'm here to tell you, it doesn't offend me, because i understand what you are trying to say, however, I think its important to put out there what OCD truly is and why its misunderstood. Conversations about this need to happen more because when your going through it, you can feel utterly alone, and when you try to explain it, you sound utterly crazy.

OCD. This is, as Paul would put it, the thorn in my flesh. I was diagnosed with OCD several years ago but looking back i have always shown symptoms of it. OCD is a form of an anxiety disorder. It is by far one of the hardest, if not the hardest of the anxiety disorders to treat.  OCD stands for obsessive compulsive disorder. OCD can take on many forms and look many different ways. It would take a very long time to explain each sub-type of OCD within these four categories. There are some forms that  don't fit these categories, typically though, most peoples OCD will fall into one of these categories.

  • Checking
  • Contamination
  • Hoarding
  • Intrusive Thoughts 

  • Checking
    Checking is the compulsion, the Obsessive fear could be the fear of harm coming to a loved one or ones self. A person with a checking compulsion may repeatedly check that their car is locked, that the fire alarm works, repeatedly checking with loved ones to make sure they are ok, repeatedly googling symptoms of illness.

    Contamination 
    The fear is that the person will become contaminated or infected by illness. The compulsion is typically obsessive washing, avoiding, or cleaning. Someone with this fear may feel a sudden panic at the thought of going out in germ infested public. To help lesson the panic, they may repeatedly clean their house, use far to much hand sanitizer, or avoid going to the grocery store, a public park, or anywhere with crowds of people.

    Hoarding
    Many people are aware of this category of OCD because of the many shows and documentaries on it. People with the Hoarding compulsion have a fear of separating from their possessions. It could be due to a sentimental attachment. Their compulsion is they will store up these possessions or collections to the point where it fills their whole house.

    Intrusive Thoughts
    This is where a person suffers from obsessional thoughts. These thoughts are typically repetitive, Horrific, and disturbing. For example they may have a thought of violently harming a loved one or themselves. This thought then causes so much distress that the person will develop a compulsion to help "disprove"or "Prevent" the thought.  Say for example their thought was triggered when they looked at a knife. In response to the feeling of panic the thought brings, they may put their knives out of reach and repeatedly seek re-assurance from their loved one that they are not going to harm anyone.
    *Its important to note here that intrusive thoughts happen to everyone. For most people the thoughts come and go with no issue, much like a "thought train" passing through a station, its in one ear and out the other. You may not even notice it. For someone with OCD the thought captures their anxiety and becomes an obsession. The train, in essence, goes in one ear, circles around a bit, and may or may not leave out the other ear. The sort of sad irony of people who suffer this kind of OCD,  for all the anxiety they go through, they actually are proven to be one of the least likely people to act on thoughts like these.

    For me, I suffer from intrusive thoughts. I also suffer from generalized anxiety disorder (GAD). Sometimes the intrusive thoughts come first and cause the anxiety, other times the anxiety comes first and causes the intrusive thoughts. My compulsions tend to fall into the checking category. I will seek re-assurance from my husband or my mom. Mostly i have the "figure it out" compulsion, as my therapist calls it. If i let my anxiety gain control i can spend literally hours online researching. For example, when Ethan was a newborn i was terrified he had developmental delays that his Doctor was not picking up. I spent days researching every type of infant developmental delay i could think of, as if by me somehow knowing all the signs id be able to identify and stop the delays. So you see, my fear was harm coming to Ethan and i did everything i could think of to prevent it.

    How Its Treated

    There are 3 main ways people go about treating OCD. Some (like myself) try multiple ways of treating OCD.

    1. Therapy
    This (in my opinion) is pivotal in treating OCD (or any other mental disorder). There are two types of therapy that benefit OCD. These therapies can be done out patient or inpatient depending on the mental state of the person.The two types are as follows:

    *Cognitive Behavioral Therapy (CBT)- CBT is basically "Talk Therapy". In CBT you talk with your Therapist about your issues (real or imagined) and the aim is that they would be able to help you identify and change unhelpful thinking or behavior regarding your problems. I happen to think all of America could use some CBT.

    *Exposure Response Prevention Therapy (ERP)- ERP is a very specific type of therapy used to treat OCD. The Exposure part of ERP is where you force yourself to confront the images, thoughts, objects, and situations that make you anxious thereby triggering the anxiety. The Response Prevention part is where at one point you would have done a compulsion to alleviate the anxiety but instead you actively choose not to do the compulsive behavior once the anxiety has been triggered. Example: If i am afraid of heights then the way to conquer that fear is by standing on a balcony. If you trigger the fear enough, eventually your body will essentially become "bored" of that fear. you will get to a point where you can stand on the balcony and your body wont respond in fear.

    2. Medication
    This one is pretty simple to explain. There are medications that can help OCD. The main class of medication used are selective serotonin re-uptake inhibitors, more commonly known as SSRI's. SSRI's are a type of anti-depressant. Anti-depressants have been proven to not only help depression but also help with anxiety disorders like OCD. Medication can be a really good option for people with severe anxiety. There are actual anti-anxiety medications called benzodiazepines that are used as needed for anxiety disorders. OCD is different because it requires levels of serotonin to be kept at a constant level. OCD also typically requires very high doses of SSRI's and even still, 30% of people with OCD will not respond to medication. In this case the person with OCD would be considered treatment resistant. People with treatment resistant OCD do have a couple other options, but they are much more invasive i.e. brain surgery, deep brain stimulation and gamma knife.

    3. Natural Remedies
    Some people might not consider this a treatment option, but, i do. There are multiple ways you can go about this. Homeopathic doctors can be a great resource with supplements and remedies that can help alleviate symptoms. Acupuncture, therapeutic massage, and chiropractics have all also been known to help with anxiety.

    Personally, I use all 3 of these methods. I have an amazing therapist, i take an SSRI, and i also see a homeopathic doctor. OCD is a life long struggle. There are ways to manage it though so you never give up hope. If you made it this far, thanks for reading. I hope this gives you a little more information than maybe you previously knew about OCD.

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