All you need to know about OCD

My son, 17 years old, constantly counts things. He takes two steps in front and three steps behind while walking. He has to spend time in counting the number of movements while soaping his hands.

He counts money given to him sixteen times and he also has to bow down and pray before every deity a certain number of times in a particular way, otherwise, he gets very upset and anxious. Not surprisingly he finds it difficult to study, attend college, socialize, and just have a great time! I know that this is something called OCD but have been just so scared to go to a doctor in the past, but I think his problems are just increasing”.

I looked at the lady in front of me, tears had started rolling down her cheeks as she gesticulated at her sheepish-looking son who was with her sometimes the “not so serious” psychiatric illnesses can actually cause more anguish as the person concerned has “insight” i.e., he knows that his behaviour is irrational but cannot stop himself from doing what he is doing.

Obsessive-compulsive disorder is a psychiatric illness where an individual has intrusive thoughts and
feels the need to perform repetitive actions in a ritualistic way, to the extent that it induces distress, or impairs social, occupational, academic or general functioning.

Obsessions are persistent unwanted thoughts, images and urges, that cause anxiety or discomfort. This causes the performance of certain ritualistic actions, which seem to reduce the anxiety. These are the compulsions…and these are responsible for impairing the quality of one’s life.

There is a very strong genetic component associated with OCD. Risk factors seem to include child abuse.

There is the implication of the prefrontal cortex, basal ganglia, insula and posterior cingulate gyrus, and implication of the glutamate and monoamine neurotransmitters.

The commonest obsessive thoughts in ocd include fear of being contaminated by germs or dirt or
contaminating others, fear of losing self-control and harming others, sexually explicit or violent thoughts and excessive focus on religious or moral ideation. There is also a tendency toward “perfectionism.’

It typically starts between 18 and 25 years but can begin anytime.

Treatment is usually with a combination of medication and therapy. Medications are very effective, provided given in appropriate doses, and for extended periods of time.

Therapies, including CBT, help stop negative habits and replace them with healthier ways to cope.

Comparatively newer therapies, including Trans magnetic stimulation, Gamma-knife ablations, and deep brain stimulation, have also been used to wonderful effect, in the resistant OCDs.

Someone had once described what happens to him in OCD imagine your child getting into an accident over and over again in front of your eyes in a loop. The only way you can stop that event is to keep repeating the action that reduced some of the anxiety a long time ago when it first happened in your life. You feel it excruciatingly necessary to keep repeating it till the thought passes that is what happens in my head every minute.

OCD is never going to go away on its own it needs treatment!! We need to be proactive and deal with it on a war footing, to allow for actualization.

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