Obsessive-Compulsive Disorder - A Silent Disease

 Vijai P. Sharma, PhD. Clinical Psychologist

This is the fourth article in a series of eight on obsessive-compulsive disorder.

Obsessive-compulsive disorder is a secretive and isolating condition.  The shame of one's inability to control a behavior which in one's own opinion is "silly" or "bizarre" is bound to be painful and disturbing for one's self-esteem.  One feels disgust along with anxiety.

Even though friends and relatives know about the compulsive behaviors, persons with OCD try to hide the full extent and severity of the problem.  The concern about "being caught in the act," that is, of performing an awkward compulsive behavior or ritual, results in further isolation and loneliness.

We know that 25 percent to 30 percent of OCD patients consider psychological treatment but don't actually undertake it.  At most, some may seek medication for anxiety or depression resulting from OCD.  Some may "self-medicate"with alcohol or street drugs to get relief from the distress caused by OCD symptoms.

This is sad beause 60 percent to 70 percent of these people can obtain considerable relief from their symptoms if they get the right treatment.  For example, exposure and response prevention is a highly effective treatment that will be discussed in a future article.  Also, medication can help in 30 percent to 60 percent of the cases.

Why are some people secretive about OCD?  Erroneously, compulsive behaviors, such as hand wahsing, conjure up thoughts about some unresolved guilt or sin.  Lady Macbeth of Shakespeare would get up in the middle of the night and repeatedly wash her hands, laden with guilt about her involvement in the slaying of King Duncan.  These age-old associations lead to an automatic thought that there must be something really bad and undesirable that a compulsive washer or a cleaner can't get rid of.  Due to this connotation, OCD sufferers may feel guilty or bad.

Even up to the 1970s, OCD was regarded as a "rare disorder" because patients hid the problem from everyone and hardly ever came to clinics for help.  Studies from 1980 onward suggest that 2 percent to 3 percent of the people, or about 4 million to 6 million people in the United States, will have or have had an OCD sometime in their lives.  Many people keep their problem effectively concealed until it becomes a severely disabling condition and eventually life routines can't be carried out.  Others struggle with the problem on a daily basis until sever stress or a life event renders OCD out of control.

In  one study, 37 percent of patients who came to the dermatology clinic with non-specific dermatitis had OCD but not even one of them ever had any treatment for OCD.  Non-specific dermatitis was caused by repetitive washing and cleaning or rubbing a particular part of the body over and over again. 

Many mothers obvsessively fear harm coming to their children or they fear they may hurt their children.  They go to extraordinary lengths, taking precautions and performing rituals to prevent that from happening, and yet the anxiety caused by such thougts haunts them day and night.  Out of all thoughts, the thought of harming someone you love creates tremendous distress for the OCD sufferer.

Some sufferers become demoralized and depressed.  About 70 percent of OCD adults have had at least one episode of major depression at some time in their lives.  Feelings of intense anxiety or disgust are common.  They are acutely aware of the irrationality of their behavior and that self-awareness creates the fear of being seen by others as crazy.  About one in four OCD adults has phobias and about 6 percent have panic attacks.  The good news is that anxiety and depression are significantly reduced as the OCD is successfully treated.

The outlook is positive for the future.  Many socially renowned people some of them higly successful doctors, lawyers, engineers, actors, etc., are coming forward and admitting to their obsessions and compulsions in the hopes that it would encourage other people with similar problems to seek treatment.  This would help reduce the fear that OCD victims ultimately lose comtrol of their mind.  These people have gained power over their compulsions and obsessions.

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Copyright 1996, Mind Publications 


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