By Richmond Natural Medicine

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August 2, 2018

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Obsessive compulsive disorder encompasses far more than a desire to have things in a particular order, wash your hands or be tidy. The “D” (disorder) in “O-C-D” is what defines this as an often debilitating condition.

“I’m so OCD about that” is becoming an increasingly popular phrase in which individuals are referring to their quirks, pet peeves and preferences as “their OCD.” While more than likely an innocent misuse of the term, referring to your alphabetical DVD collection or the way you prefer your laundry be folded as “your OCD” grossly misrepresents the seriousness of true obsessive compulsive disorder.  Individuals with OCD experience recurrent thoughts and/or actions that they can’t let go of or stop; even if they’re aware they are excessive or irrational. These obsessions and compulsions cause significant distress and can take up a large portion of the sufferer’s day, interfering with common daily responsibilities and functioning.

Obsessions and compulsions can present themselves in a variety of ways (see below) and may even go undetected by family, friends, and medical personnel for years due to the secret nature and drastic attempts of the sufferer to hide them out of fear, shame or embarrassment.

Common Misperceptions:

1. Everyone with OCD frequently washes their hands and cleans their house

False.

While hand washing, bathing and other cleaning rituals are common among OCD sufferers, (generally performed in response to exaggerated contamination fears), these are only a handful of the many common compulsions associated with OCD.

Examples of other common obsessions include:

• Fear of losing control
• Fear of harming someone
• Fear that something will happen
• Fear of forgetting or losing something
• Preoccupation with minute details and exactness

Compulsions that may be performed in response to these obsessions include:

• Repeatedly checking that nothing awful has happened
• Repeatedly checking that you didn’t harm someone or act “out of character”
• Continuously asking for reassurance
• Hoarding to be sure you do not dispose of something you might need at a later date
• Repeating activities to make sure you didn’t make a mistake such as recounting or rewriting
• Repeating certain tasks until they are done a “safe” number of times or until they “feel right”

2. If I don’t have clearly observable compulsions I don’t have OCD

False.

In addition to observable compulsions such as those listed above, a common yet less discussed form of compulsion is a mental compulsion. Some patients struggle with “Pure O” OCD, where they experience continuous doubting or “what-if’s”. They may also experience unwanted thoughts, impulses or mental images that are frequently violent, sexual, blasphemous or unethical in nature. These are particularly terrifying and distressing as they directly oppose the person’s morals or values, leaving them feeling confused and guilty. The individual may ruminate on these thoughts trying to make sense of them. They may continuously replay positive thoughts in their mind designed to counteract the negative ones, silently repeat ritualistic sayings or prayers to ensure they don’t act upon these thoughts or impulses, and often will avoid situations that may trigger these thoughts. For example, a person with OCD afraid of harming someone may avoid the use of knives in the kitchen. Someone who fears molesting a child may avoid situations where children are likely to be present.

3. OCD will go away as I get older without receiving treatment

False.

In general, OCD begins in childhood and worsens with age. Obsessions cause anxiety levels to rise. Acting on compulsions serves to decrease this level of anxiety, bringing temporary relief and reinforcing the compulsion. The problem is that this decline in anxiety is short-lived and once the obsession resurfaces, maybe seconds or days later, the compulsion must be carried out once more to decrease the anxiety. Over time this obsession and compulsion cycle becomes a deeply ingrained part of the daily routine, making it more difficult to identify and break.

4. I’ve tried medication and therapy without much improvement. I can’t be helped

False.

Roughly 40-60% of individuals do not respond to pharmacological management of OCD (often treated with selective serotonin reuptake inhibitors [SSRIs]). According to Stanford University School of Medicine, of those who do respond to treatment, only about half report a significant reduction of their symptoms.

“Exposure and Response Prevention” (ERP), a type of Cognitive Behavioral Therapy, has high potential to be a helpful treatment option, however several factors influence how successful the therapy actually is. ERP requires that individuals confront their worst fears and endure the associated anxiety. Since this is often too difficult, many people discontinue treatment.

OCD is a complex condition and one that often takes a multi-disciplinary approach to deal with but there is hope, there is help, there are other ways to live.  If you or someone you love is seeking naturopathic support for OCD, please contact our office at (804) 977-2634.