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"Checking" out Obsessive Compulsive Disorder

All of us double check things. For example, we double check to make sure the stove or iron is turned off before leaving the house. However, people with Obsessive Compulsive Disorder (OCD) feel compelled to check things repeatedly, or they have recurrent thoughts, or they perform routines and rituals repeatedly. These thoughts and rituals cause significant distress and can impair their ability to function normally in daily life.

The distressing recurrent thoughts are called obsessions. To try to control the anxiety and distress caused by these obsessions, the person will feel an overwhelming urge to repeat certain rituals or routine behaviors called compulsions. People with OCD try with little success to control these obsessions and compulsions.  Ignoring these symptoms of OCD only increases the distress and anxiety- yet giving into these obsessions and compulsions gives only temporary relief.

For many people, OCD starts during childhood or the teen years (boys earlier than girls).  Most cases are diagnosed by early adulthood (by 29 years of age). Most of the time the symptoms of OCD fluctuate and be can better or worse at different times; however, a completely symptom-free period is unusual.

OCD

Obsessions often have themes to them, such as

  • Fear of contamination or dirt
  • Having things orderly and symmetrical
  • Aggressive or horrific impulses
  • Sexual images or thoughts

Obsession symptoms and signs may include

  • Fear of being contaminated by shaking hands or by touching objects others have touched
  • Doubts that you've locked the door or turned off the stove
  • Thoughts that you've hurt someone in a traffic accident
  • Intense stress when objects aren't orderly or facing the right way
  • Images of hurting your child
  • Impulses to shout obscenities in inappropriate situations
  • Avoidance of situations that can trigger obsessions, such as shaking hands
  • Replaying pornographic images in your mind
  • Dermatitis because of frequent hand washing
  • Skin lesions because of picking at your skin
  • Hair loss or bald spots because of hair pulling

As with obsessions, compulsions typically have themes, such as

  • Washing and cleaning
  • Counting
  • Checking
  • Demanding reassurances
  • Performing the same action repeatedly
  • Orderliness

Compulsion symptoms and signs may include

  • Hand washing until your skin becomes raw
  • Checking doors repeatedly to make sure they're locked
  • Checking the stove repeatedly to make sure it's off
  • Counting in certain patterns
  • Arranging your canned goods to face the same way

There is no known cause or prevention for OCD but having parents or other family members with the disorder can increase your risk of developing OCD.

Treatment should start by seeing a psychiatrist or your family doctor to determine youe diagnosis.  OCD is generally treated with psychotherapy, medication, or both- AFTER a physical exam rules out physical causes and a psychiatric evaluation rules out other mental disorders.

A type of psychotherapy called cognitive behavior therapy is especially useful for treating OCD. It teaches a person different ways of thinking, behaving, and reacting to the obsessive thoughts or compulsions. Another type of therapy called exposure and response prevention is especially helpful in reducing compulsive behaviors in OCD.

There are several types of medication that is often used in conjunction with psychotherapy.  Your doctor would determine the best medication to use for your treatment.  Also, questionnaires, such as the Yale-Brown Obsessive Compulsive Scale (YBOCS), are used to track the progress of treatment.

Treatment options which have been studied and have shown success

  • Electroconvulsive therapy (ECT)
  • Transcranial magnetic stimulation (TMS)
  • Deep brain stimulation (DBS)
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Bradley T. Wajda, D.O. PC
1312 W Herndon Ave, Suite 102
Fresno, CA 93711
Phone: (559) 493-5544
Fax: (559) 493-5166

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