Obsessive-Compulsive Disorder (OCD)
1 Inservice Hour
OBJECTIVES:
At the end of this class, you will be able to:
1. discuss the signs of OCD;
2. list the treatments of OCD; and
3. care for patients with OCD
INTRODUCTION
Obsessive-Compulsive Disorder (OCD) is a mental health problem that causes the person to have thoughts and/or behavior that is repeated over and over again. Some of the things that the person may do over and over again can include counting, washing one’s hands, clearning and other rituals. The person does these things in hopes that doing these things will make these thoughts go away. The person is driven to do these things. They cannot control themself.
Many times these behaviors have strict rules that must be stuck to in order to prevent some harm to someone or something that has nothing to do with the act. For example, an old saying that you may have repeated over and over again when you were a child was “Step on a crack and break your mother’s back”. Stepping on a crack in the sideway while walking, as you know, has nothing at all to do with breaking your mother’s back.
OCD is seen quite often. It is the 4th most common mental health problem. It is seen as often as diabetes and asthma is seen in the United States. About 1 in every 50 adults has it.
OCD, when severe, stops the person from being able to function in their everyday life. Some have to do their acts several times a day and for several hours. The person may no longer be able to work and to support themself. They may not be able to keep friends and family members. It is very painful, especially when the person knows that the acts and the thoughts are not sound and rational.
WHAT CAUSES OCD?
In the past, some thought that people with OCD were possessed by the devil. Today, most people think that OCD is the result of both physical and emotional factors. Many state that OCD comes as a result of the lack of a normal brain chemical called serotonin. The brain cannot filter out thoughts that are not necessary when this chemical is lacking. As a result, the brain dwells on these thoughts and fears. These acts end up controlling the person’s whole life.
Some think that it may have emotional causes. The compulsive acts are carried out to decrease anxiety and, because the anxiety is reduced after the act, the person learns that doing the act will make them feel better. They must, therefore, do the act over and over again.
Others say that OCD may happen with children because of a response to a Group A strep infection. Still others say that it may be in the genes and that it runs in families or that it is problem with the brain that fails to communicate with the body to produce a complete act in a smooth manner. The person then breaks each part of the process up into smaller and repeated bits of movement to accomplish the goal. The brain is never happy with the person’s starting of the movement. It is always sending a worry signal to the person. Anxiety rises and the only way that it can stop is if the person does their act over and over again.
Some people have noticed that the intake of caffeine makes their symptoms worse. The rate of OCD appears to be higher among those that have not completed high school and higher for those who have graduated from college. Males tend to get OCD at an earlier age than girls. It usually begins during the late teens and the early 20s. Some say that those of above average intelligence get it more.
Research into the causes of OCD continues to be done todday. We may find new causes and new treatments as time goes on.
THE SIGNS OF OCD
The signs of OCD are the thoughts that occur over and over again and the acts, or rituals, that are performed over and over again.
For example, if a person has thoughts of germs over and over again, they may feel the need to wash their hands over and over again (the act) even when it is not necessary. Some people will wash their hands until they are raw and bleeding and they still cannot stop. If a person has ongoing thoughts about a robbery in their home, they may have the need to constanting check and lock their doors and windows in their home. Some other acts can include constant counting, touching things in oder over and over again, constantly cleaning and organizing and collecting lots of items, and junk, that the person does not need.
The person feels better for a short time after doing the acts but, soon thereafter, the thoughts and the need to do the act come up again, and again, and again. It haunts the person every day. Many people with OCD know that what is happening is not normal. Others, like children, may not know that what they are doing is not normal. People that know may avoid their triggers and they may use alcohol or drugs to stop their thoughts. They may also feel shame and embarassment about it. They are not happy about having to do these acts over and over again.
Even though these acts are not normal and not necessary, they are necessary to the person. If the act is not done, stress in the person will build up and build up. Doing the act decreases the stress and the distress that the person is having.Some of the physical effects of OCD are nervous tics or twitches, jerking and not voluntary arm or leg movements, tremors and rigid muscles.
The thoughts of the person with OCD can be:
· violent or aggressive thoughts;
· bad sex thoughts; or
· thought about religion that are not good.
The person is constanting thinking, “Can I harm myself or other people if I suddenly snap and lose control and do something, not even knowing that I am doing it, that is not at all like anything I could ever do if I had control?” Even though very few people lose control and perform the thought, these thoughts are very upsetting to the person. They feel guilt, shame, anger and anxiety about them.
Violent thoughts
Some possible violent thoughts are thoughts of:
· hurting a child,
· jumping off a bridge or jumping in front of a speeding car,
· pushing another person off the top of a mountain, and
· killing an animal,
· shouting out bad words in public, and
· hurting a family member.
Sexual thoughts
Some of these thoughts can include thoughts about:
· rape,
· sex with family members,
· sex with animals
· sex with religious leaders,
· fondling or touching another without their consent, and
· homosexual contact when the person is not.
THE TREATMENT OF OCD
Although OCD can NOT be cured, it can be treated with:
· medicines,
· therapy,
· support groups,
· stress management and
· the support of others.
Some people are helped with medicines and therapy. During therapy, the person learns how to face the things that may them fearful. As they does this over time, they will become less fearful and no longer forced to do the repeated acts. Brain stimulation may also be used. Because many people with OCD also have depression, this too must be treated.
Many people with OCD and other disorders, like depression, get a lot of help and support with support groups in their home town. These groups meet in different places at different times, mostly one time a week. People with OCD can freely share their feelings, problems and solutions with other OCD patients during these meetings.
Stress management can also help. The person may want to do yoga, meditate, pray, and/or do deep breathing or progressive relaxation to decrease their anxiety. Exercise is also helpful. Caffeine, illegal drugs and alcohol should be avoided.
Lastly, families, clergy, friends and others can support the person with OCD.
REFERENCES
National Institute of Mental Health Obessive-Compulsive Disorder
http://www.nimh.nih.gov/health/publications/anxiety-disorders/obsessive-compulsive-disorder.shtml
Copyright © 2009 Alene Burke