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Family Behavioral Health Services, LLC
6559-C Wilson Mills Road, #102
Jefferson Park Complex
Mayfield Village, Ohio 44143
"I couldn't do anything without rituals. They transcended every aspect of my life. Counting was big for me. When I set my alarm at night, I had to set it to a number that wouldn't add up to a "bad" number. If my sister was 33 and I was 24, I couldn't leave the TV on Channel 33 or 24. I would wash my hair three times as opposed to once because three was a good luck number and one wasn't. It took me longer to read because I'd count the lines in a paragraph. If I was writing a term paper, I couldn't have a certain number of words on a line if it added up to a bad number. I was always worried that if I didn't do something, my parents were going to die. Or I would worry about harming my parents, which was completely irrational. I couldn't wear anything that said Boston because my parents were from Boston. I couldn't write the word "death" because I was worried that something bad would happen.
Getting dressed in the morning was tough because I had a routine, and if I deviated from that routine, I'd have to get dressed again, but I couldn't seem to overcome them until I had therapy."
People with obsessive-compulsive disorder (OCD) suffer intensely from recurrent, unwanted thoughts (obsessions) or rituals (compulsions), which they feel they cannot control. Rituals such as handwashing, counting, checking, or cleaning are often performed in hope of preventing obsessive thoughts or making them go away. Performing these rituals, however, provides only temporary relief, and not performing them markedly increases anxiety. Left untreated, obsessions and the need to perform rituals can take over a person's life. OCD is often a chronic, relapsing illness.
Fortunately, through research supported by the National Institute of Mental Health (NIMH), effective treatments have been developed to help people with OCD.
How Common Is OCD?
What Causes OCD?
- About 2% of the U.S. population has OCD in a given year.
- OCD typically begins during adolescence or early childhood; at least one-third of the cases of adult OCD began in childhood.
- OCD affects men and women equally.
- OCD cost the U.S. $8.4 billion in 1990 in social and economic losses, nearly 6% of the total mental health bill of $148 billion.
There is growing evidence that OCD has a neurobiological basis. OCD is no longer attributed to family problems or to attitudes learned in childhood - for example, an inordinate emphasis on cleanliness, or a belief that certain thoughts are dangerous or unacceptable. Instead, the search for causes now focuses on the interaction of neurobiological factors and environmental influences. Brain imaging studies using a technique called positron emission tomography (PET) have compared people with and without OCD. Those with OCD have patterns of brain activity that differ from people with other mental illnesses or people with no mental illness at all. In addition, PET scans show that in patients with OCD, both behavioral therapy and medication produce changes in the caudate nucleus, a part of the brain. This is graphic evidence that both psychotherapy and medication affect the brain.
What Treatments Are Available for OCD?
Treatments for OCD have been developed through research supported by the NIMH and other research institutions. These treatments, which combine medications and behavioral therapy (a specific type of psychotherapy), are often effective.
Several medications have been proven effective in helping people with OCD: clomipramine, fluoxetine, fluvoxamine and paroxetine. If one drug is not effective, others should be tried. A number of other medications are currently being studied.
A type of behavioral therapy known as "exposure and response prevention" is very useful for treating OCD. In this approach, a person is deliberately and voluntarily exposed to whatever triggers the obsessive thoughts and then, is taught techniques to avoid performing the compulsive rituals and to deal with the anxiety.
Can People With OCD Also Have Other Physical or Emotional Illnesses?
OCD is sometimes accompanied by depression, eating disorders, substance abuse, attention deficit hyperactivity disorder, or other anxiety disorders. When a person also has other disorders, OCD is often more difficult to diagnose and treat. Symptoms of OCD can also coexist and may even be part of a spectrum of neurological disorders, such as Tourette's syndrome. Appropriate diagnosis and treatment of other disorders are important to successful treatment of OCD.
Source: National Institute for Mental Health
Books About Obsessive-Compulsive Disorder (OCD)
The Boy Who Couldn't Stop Washing: The Experience and Treatment of Obsessive Compulsive Disorder
Judith L. Rapoport, MD
New American Library / 1997 / Paperback
Brain Lock: Free Yourself from Obsessive-Compulsive Behavior: A Four-Step Self-Treatment Method to Change Your Brain Chemistry
Jeffrey M. Schwartz, MD, with Beverly Beyette
HarperCollins / 1997 / Paperback
Getting Control: Overcoming your Obsessions and Compulsions
Lee Bauer, PhD
Plume books / 1992 / Paperback
The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder
Bruce M. Hyman PhD, Cherry Pedrick,
New Harbinger / 1999 / Paperback
Stop Obsessing! How to Overcome your Obsessions and Compulsions.
Edna B. Foa, PhD, Reid Wilson, PhD
Bantam Books / 1991 / Paperback
Triumph Over Fear: A Book of Help and Hope for People with Anxiety, Panic Attacks, and Phobias
Bantam Doubleday Dell / 1995 / Paperback
Anxiety Disorders Association of America
National Alliance for the Mentally Ill (NAMI)
State and Local Affiliates- NAMI
National Institute of Mental Health
Obsessive-Compulsive Disorders newsletters from athealth.com
State Self-Help Groups
Reviewed by AH: 3/3/2000