We all do. It’s natural. Yesterday I turned around about 5 minutes from home because I wasn’t sure I’d closed the garage door. We all want our homes, possessions, family and selves to be safe. But what happens when that drive for safety becomes overwhelming, affecting our everyday lives?
Obsessive Compulsive Disorder is an anxiety disorder characterized by obsession, (ideas, thoughts, impulses or images) which often result in compulsions (the ritual performance of specific activities or mental acts over and over again). The purpose of the rituals is to get rid of the thoughts and protect those at risk, but of course it doesn’t work. These uncontrollable, unwanted thoughts and repetitive, ritualized behaviors control who you are and how you function in the world. And even though the sufferer knows they’re irrational, they are unable to stop the thoughts or behaviors without external help.
For those of you old enough to remember record players (yes I had one), OCD is like a needle getting stuck on a record and the same thought plays over and over again.
These thoughts and behaviors seem to fall into categories:
Cleaners are afraid of contamination. They usually have cleaning or hand-washing compulsions which can leave their skin cracked and bleeding. Usually these activities must be performed in a certain specific, rigid order. For example, one client would come home and stand on a green garbage bag inside the door and in a specific order remove every piece of clothing, put them in the wash and then shower, to ensure that germs from the outside didn’t come inside.
- Worriers repeatedly check things (iron unplugged, washer turned off) that they believe may cause harm to their home. (An unplugged iron will start a fire a burn my house down.) They may also be obsessed with repugnant images (throwing their child into a fire or off the balcony).
- Doubters and sinners are afraid that anything less than perfection will cause something terrible to happen to themselves or a loved one. (If I don’t lock the door, someone will come in and kill my family.) As a result, anything less than perfection will result in a catastrophe.
- Counters and arrangers are obsessed with order and symmetry. Often this includes superstitions about specific numbers, colors, or arrangements. This can include ensuring things happen in threes (or fours) or that phrases and words are ‘finger—typed’.
- Hoarders fear the risk of throwing anything away, so they keep everything, regardless of its usefulness or value. We’ve all seen where this can end up, given reality television.
How do I know my returning home is simply being responsible and not an OCD activity?
- OCD thoughts are intrusive and out of control. If I hadn’t returned home, I would not have spent the day worrying about my garage because I made a decision about the likelihood of the door being open.
- Thoughts are time consuming, chewing up hours of time over a week. If I decided it was unlikely I’d left the door open, I wouldn’t have given it much more thought.
- OCD thoughts cause a lot of anxiety or distress and interfere with life. I might have wondered once or twice during the day, especially on the return home after work, but otherwise I would have focused on work.
- My concern about the garage door would not have led me to create a ritual to ‘protect’ my home, even when I knew the door was closed.
- I wouldn’t (and didn’t) create some ritual to ensure I didn’t leave the door open again (this is not a plan of action to bring to consciousness that I’ve shut the door, but rather an activity (say clapping my hands three times) that is supposed to protect the house, even when I know the door is closed.
OCD usually starts between 18 – 24, although boys seem to get it earlier than girls. Approximately 1 – 2% of the population suffers from this disorder which fluctuates in intensity: when ‘active’ it takes up an inordinate amount of time. But the thoughts and behaviors can recede into the background in certain circumstances.
Treatment is similar to that of any anxiety disorder. Anti-depressives, from the SSRI family (Celeza, Zoloft etc) are commonly prescribed. Cognitive Behavior Therapy has also had some good results with this disorder. There is a myriad of valid and valuable self help treatments as well. One of these, developed by Psychiatrist Jeffrey Schwartz, author of Brain Lock: Free Yourself from Obsessive-Compulsive Behavior, offers a four step program for dealing with OCD. As always, outcomes vary. It is rare to be completely symptom free from this disorder but periods of total incapacitation can be minimized.
As alway, no self-diagnosing allowed. If you worry lots and have rituals to deal with those worries, contact a mental health professional.
I apologize for being late with this post — it’s been that kind of week.