Overview
When someone brings up Obsessive Compulsive Disorder usually people envision a person washing their hands incessantly, turning on and off the lights a certain number of times, or checking the stove knobs to the point that they miss out on important appointments. Although these are definitely signs of Obsessive Compulsive Disorder, there is much more to a person than repetitious behaviors, that most people are not aware of.
This disorder is driven by anxiety and usually becomes apparent after a traumatic event or a great or unexpected loss in their life. In children, a type of Obsessive Compulsive Disorder can be brought on by complications from strep throat. Both children and adults develop Obsessive Compulsive Disorder, but children may not have the ability to realize the irrationality of the behavior. Those with this disorder may be obsessively clean or may be hoarders, or they may repeat actions or count things. There is no limit to the uniqueness of compulsions of each individual with Obsessive Compulsive Disorder. The only commonality is the obsessive thoughts, compulsive acts, and a fear or anxiety of something bad happening if those acts are not carried out.
Diagnosis
To be diagnosed with Obsessive Compulsive Disorder it is not necessary to have both obsessions and compulsions but for most sufferers the behaviors go hand in hand. Obsessions are the fixation on thoughts that intrude into the mind of the sufferer. These thoughts are not about normal life stressors but about irrational, unlikely, or made up scenarios. The thoughts are not under the control of the person with Obsessive Compulsive Disorder and some thoughts may not go away without completing a certain act. Those acts are called compulsions. The compulsions are rituals that will usually calm down the obsessive thoughts and allow the person to feel less fearful or anxious in the moment. Compulsions are not directly related to the anxiety or feared event. An example is a compulsion to tap each foot five times to make sure a close friend or relative does not die. The rituals are very specific and if interrupted, or not done perfectly, will have to be repeated until it is correct. The time that it takes to deal with obsessions and/or compulsions will greatly interfere with life. For children with Obsessive Compulsive Disorder, the school day will be extremely difficult. Without the opportunity to complete rituals or with the distraction of obsessions, the anxiety may make it difficult to function in school.
Treatment
Early treatment is very important for the success of the client. The sooner the obsessions and/or compulsions are redirected, the higher probability of full, and long term, remission. Treatment will consist of some talk therapy but will likely also include experiential therapy. Experiential therapy allows the client to verbalize obsessions and analyze them to determine the cause. It will also allow the person to have the anxiety and fear without being allowed to perform the ritual to show that the feared event will not happen. The irrational relationship between the obsessions and compulsions to an unrelated event will eventually be broken. During therapy, the client will also learn relaxation techniques such as deep breathing, muscle relaxation, and visualization. At times, medication may be used to reduce the anxiety so that progress can be made. Some people may be resistant to therapy because some obsessions may make them feel more productive or in control. The family might enjoy the compulsion of one person to clean incessantly or to save money. While these may be desirable traits, therapy can help the person reduce the behavior to acceptable levels. Overall, Obsessive Compulsive Disorder is very treatable but motivation to change and intensive therapy is often required.
