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Obsessive-Compulsive Disorder The Line Between Habits and Illness What is Obsessive Compulsive Disorder?

? Obsessive-compulsive disorder (OCD) is a type of anxiety disorder that traps people in endless cycles of repetitive thoughts and behaviors. OCD is characterized by: intrusive ideas, feelings, sensations (obsessions) that produce uneasiness, apprehension, fear, or worry; repetitive behaviors (compulsions) aimed at reducing the associated anxiety, by a combination of such obsessions and compulsions. Often the person carries out the behaviors to get rid of the obsessive thoughts, but this only provides temporary relief. Not performing the obsessive rituals can cause great anxiety. OCD: is the 4th most common mental disorder is diagnosed nearly as often as asthma and diabetes mellitus. in the United States, 1 in 50 adults suffers from OCD. affects children and adolescents as well as adults (roughly one third (1/3) to one half (1/2) of adults with OCD report a childhood onset of the disorder, suggesting the continuum of anxiety disorders across the life span. The phrase obsessivecompulsive has become part of the English lexicon, and is often used in an informal or caricatured manner to describe someone who is excessively meticulous, perfectionist, absorbed, or otherwise fixated. Although these signs are present in OCD, a person who exhibits them does not necessarily have OCD, and may instead have obsessivecompulsive personality disorder (OCPD) OCPD is a personality disorder characterized by preoccupation with: -order, -perfectionism, -mental and interpersonal control OCPD can include preoccupation with: -remembering and paying attention to minute details and facts -following rules and regulations -compulsion to make lists and schedules -rigidity/inflexibility of beliefs - and/or exhibition of perfectionism that interferes with task-completion

So, OCPD has some of the same symptoms as obsessive-compulsive disorder (OCD). But people with OCD have unwanted thoughts, while people with OCPD believe that their thoughts are correct. OCD Symptoms OCD has two primary types of symptoms: Obsessions Compulsions Obsessions Obsessions are recurrent, intrusive, distressing thoughts and images that persist despite efforts to ignore or confront them. An obsession could be: -a preoccupation with the thought or image of someone close dying. -concern with the possibility that someone or something other than oneself - such as God, the Devil, or disease - will harm either the person with OCD, or the people that the person cares about. - the sensation of invisible protrusions emanating from their bodies - feeling that inanimate objects are ensouled. - sexual obsessions that may involve intrusive thoughts or images related with sex experience. People with OCD understand that their notions do not correspond with reality; however, they feel that they must act as though their notions are correct. For example, a person who engages in compulsive hoarding might be inclined to treat inorganic matter as if it had the sentience or rights of living organisms, while accepting that such behavior is irrational on a more intellectual level. In severe OCD, obsessions can shift into delusions when resistance to the obsession is abandoned and insight into its senselessness is lost. Compulsions Compulsions are acts, rituals, that OCD people do because they inexplicably feel they have to. The person might feel that these actions somehow either will prevent a dreaded event from occurring, or will push the event from their thoughts. excessive skin picking excessive hair plucking nail biting counting specific things (such as footsteps) doing things in specific ways (for instance, by intervals of two) doing repetitive actions (often with atypical sensitivity to numbers or patterns)

People might repeatedly wash their hands or clear their throats, make sure certain items are in a straight line, repeatedly check that their parked cars have been locked before leaving them, constantly organize in a certain way, turn lights on and off, keep doors closed at all times, touch objects a certain number of times before exiting a room, walk in a certain routine way ( like only stepping on a certain color of tile) have a routine for using stairs (such as always finishing a flight on the same foot)

People rely on compulsions as an escape from their obsessive thoughts; however, they are aware that the relief is only temporary, that the intrusive thoughts will soon return. Some people use compulsions to avoid situations that may trigger their obsessions. Although some people do certain things over and over again, they do not necessarily perform these actions compulsively. For example, bedtime routines, learning a new skill, and religious practices are not compulsions. Whether or not behaviors are compulsions or mere habit depends on the context in which the behaviors are performed. For example, arranging and ordering DVDs for eight hours a day would be expected of one who works in a video store, but would seem abnormal in other situations. In other words, habits tend to bring efficiency to one's life, while compulsions tend to disrupt it. In addition to the anxiety and fear that typically accompanies OCD, sufferers may spend hours performing such compulsions every day. In such situations, it can be hard for the person to fulfill their work, family, or social roles. In some cases, these behaviors can also cause adverse physical symptoms. For example, people who obsessively wash their hands with antibacterial soap and hot water can make their skin red and raw with dermatitis. OCD Causes It is not completely known why people get OCD, but it was discovered there are some reasons that increase the chances of someone getting OCD. - For example, children and teenagers who develop OCD often feel very 'responsible' for causing or stopping harm happening to themselves or other people like their mum or dad. This feeling of being 'very responsible' can increase the chances of OCD. - awful things that go on for a long time (like being bullied) or awful things that happen all of a sudden (such as someone dying). - feeling depressed for a long time can also increase the chances.

-some reports have linked OCD to head injury and infections. -several studies have shown that there are brain abnormalities in patients with OCD, but more research is needed. -other possible reasons include the idea that the brain works differently in people with OCD and the idea that chances of getting OCD increase if other family members have it too. - about 20% of people with OCD have tics, which suggests the condition may be related to Tourette syndrome. However, this link is not clear. Manifestations of OCD in Children In many cases children try to contain or mask their obsessions and rituals. For this reason, parents often dont realize for some time that their child has OCD or may think the few odd behaviors they do see are just a passing phase. As OCD usually comes on gradually, these behaviors may come on so slowly, that they seem normal to the parent. A child may ask the parent to participate in some of the rituals at first, seeking reassurance that everything is OK. "I touched dirt, am I ok?" to which the parent responds "Youre fine." Failure to respond in this routine way may result in tantrums, or acting-out behavior. Very young children may ask parents to repeat a word or phrase till it sounds right. If these behaviors are observed, parents can gently ask their children why they feel the need to do these things. Useful prompts include: Are you afraid something bad will happen if you dont do that? or Do you have thoughts that scare you that you wish you didnt have? Parents who are concerned that OCD might be an issue for their child should contact their pediatrician or a mental health professional for an evaluation.

OCD Treatment OCD is treated using medications and therapy. Cognitive behavioral therapy (CBT) has been shown to be the most effective type of psychotherapy for this disorder. The patient is exposed many times to a situation that triggers the obsessive thoughts, and learns gradually to tolerate the anxiety and resist the urge to perform the compulsion. Medication and CBT together are considered to be better than either treatment alone at reducing symptoms. Psychotherapy can also be used to: - Provide effective ways of reducing stress - Reduce anxiety - Resolve inner conflicts Paradoxical intention is the deliberate practice of a neurotic habit or thought, undertaken in order to identify and remove it. Used as a counseling technique in which the counselor intensifies the client's emotional state in order to help the client understand the irrationality of the emotional reaction. It is a technique used by Viktor Frankl, the founder of logotherapy.

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