For centuries, people thought it to be a demonic act. But today it has come out of the closet and has become a worrying fact for many societies around the world. Hollywood star Cameron Diaz opens doors with her elbows for fear of contamination: Michael Jackson goes through surgeries to look better – Is it madness? Till fifteen years ago, many thought so. But recent studies ad new frontiers in gene research, scanning technologies and treatments have shown that it is a disease known as Obsessive Compulsive Disorder (OCD). “OCD stands as a condition where the brain tries to do something it’s wired to do – warning you of danger – but goes overboard in the process.” According to World Health Organization (WHO) – OCD has become one of the top 10 debilitating diseases in the world.
Actually, it is kind of a “mental hiccup”. OCD throws up persistent, distressing thoughts, images and ritual behaviors that a person is driven to perform. “Everyone has intrusive thoughts, but people can ignore those and move on with their lives. For those with OCD, the thoughts become their lives.’ Says Dr. Ramesh Sagar, associate professor of psychiatry at the All India Institute Of Medical Sciences (AIIMS), Delhi. It is an obsession because the sufferers recognize these as a mental projection and try to ignore those without much success. It’s a compulsion, because the repetitive, seemingly purposeful acts follow rigid rules.
An OCD patient’s life is torn with fear, guilt, doubt, distasteful images, depressions and a sense of defeat and the suffering and anguish is far worse than one normal human being can imagine. Obsessions and compulsions parade as infinitely personalized variations on a number of morbid themes – from aggression, harm avoidance, contamination, unpleasant or excessive sexual ideation, religious concerns, compulsion to collect, need for symmetry or order, to fear of illness. Contamination and fears of harming oneself or others are the most common obsessions, while cleaning and checking are the most common compulsions.
Research shows that, moderate amount of anxiety helps people to complete their assignments more efficiently. So all anxieties are not cases of OCD. Indeed it’s a bit of difficult to diagnose OCD. However, the key to diagnosing authentic cases of OD is how great imact odd behaviors have on people’s lives. The question is – why do some people get over-active internal alarms than most others? The answer lies in a small structure in the brain called the amygdale, where danger is processed. “If this risk centre is overactive, it would keep on alerting you to peril even after you have attended to the problem” points out Sagar. Functional magnetic resonance imaging (fMRI) show that apart from amygdale, there are other anatomical hot spots involved in the disorder: the orbitofrontal cortex, striatum, anterior cingulum and thalamus. Together, this wiring regulates your response to the stimuli around you, including how anxious you are I the face of threatening or frustration.
No other mental disorder hides as stealthly, delays diagnosis, or causes as much embarrassment. But better treatments are breaking its hold. Treatment for OCD is a long process divided into several stages from selective serotonin reuptake inhibitions (SSRI) to cognitive behavioral therapy. Researchers are working on the possibility of using surgery and a technique called deep brain stimulation.(apply low doses of current) to calm the OCD tossed brain.
Some Facts About OCD:
Common Compulsions:
- Washing and cleaning 41%
- Checking 38%
- Repeating 16%
- Ordering 16%
- Counting 5%
- Hoarding 3%
Common Obsessions:
- Contamination 45%
- Pathologic doubt 35%
- Aggression 32%
- Sex 20%
- Religious 17%
- Symmetry/exactness 14%
- Hoarding 3%
Primary Causes for OCD:
- GENES: can run in the family
- STRESS: in about one in 3 cases
- LIFE CHANGES: sudden role change, puberty, child birth, new job etc.
- BRAIN CHANGES: imbalance of a chemical called serotonin
- PERSONALITY: Obsessive, perfectionist, high on morality and responsibility.
Cure Conundrum:
- Routinely mislabeled as other disorders –depression to schizophrenia
- Underdiagnosed and undertreated due to stigma and lack of awareness
- OCD striking a young person mean an entire childhood lost.
- The disease often leads to breakdown of family life and causes job-related problems
Rethinking Remedies:
- New research has revealed genetic links, one in four children with OCD has a first-degree relative with a similar condition
- Modern scans can show up the landscape of OCD
- New treatments with anti-depressants (selective serotonin reuptake inhibitors) are in force
- Cognitive behavioral therapy is proving effective.
FactFile:
- Just 20 years ago OCD was considered a rare disorder, affecting only 0.5% people.
- Now it is believed to affect 2-3% of the total population and 1% children
- Who says- OCD is one of the top 10 causes of disability
- Over 12 million Indians suffer from it in one form or another
- 58% patients seeking treatment come from urban background
- Average timelag between onset and a proper diagnosis is 17 years.
- 40% patients recover completely
- 30% show good improvement
This writing is inspired by a report on India Today magazine, issued on March3, 2008.
