Obsessive-Compulsive Disorder (OCD)
OCD includes uncontrollable obsessions. These are recurring thoughts or impulses that are intrusive or inappropriate and cause you anxiety; for example, coming into contact with dirt, germs, or “unclean” objects, doubts about locking doors or turning off machines or appliances, extreme orderliness, or aggressive impulses or thoughts (such as to yell “fire” in a crowded theater).
Compulsions can also be involved. Compulsions are repetitive behaviors; for example, cleaning your house constantly, washing your hands repeatedly, or showering many times a day.
In both cases, you realize your actions are excessive and unrea-sonable but you’re unable to stop them. make sure your stove is turned off or your doors are locked. Repeating a name, phrase, or action over and over also qualifies as a compulsion, as does taking an excessively slow and methodical approach to daily activities so that you spend hours organizing and arranging objects, or hoarding them. Hoarders are unable to throw away useless items, such as old newspapers, junk mail, even broken appliances. When hoarding reaches epic proportions, whole rooms can be filled with saved items .
OCD usually starts gradually, most often in adolescence or early adulthood. Unlike adults, children with OCD do not realize that their obsessions and compulsions are excessive.
To be diagnosed with this disorder, your obsessions and/or com-pulsions must take up at least one hour every day and interfere with normal routines (for example, if you can’t make left turns when driving), occupational functioning, social activities, or relationships. You may feel the need to avoid certain situations. If you’re obsessed with cleanliness, you may not be able to use public rest rooms.
Questions your physician may ask to determine whether you have OCD include …
1. Do you have unwanted ideas, images, or impulses that seem silly, nasty, or horrible?
2. Do you worry constantly about dirt, germs, or chemicals?
3. Are you excessively worried that something bad will happen if you forget something important, like turning off appliances or locking the door?
4. Do you keep many things you don’t use because you can’t throw them away?
5. Do you avoid situations or people you worry about hurting by angry words or actions?
Laura, age thirty-one, could not leave her house unless she washed her hands ten times. She’d taken biochemistry in college and knew humans swim in a sea of bacteria and viruses and she feared the dirt and disease-causing organisms in her environment. The hand-washing seemed to help at first, but then her skin became chapped and red, and she knew she had to stop it. But no matter how hard she tried, she couldn’t stop washing. Her primary-care physician diagnosed her with obsessive-compulsive disorder and started to buy xanax regimen.
