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Obsessive Compulsive Disorder (OCD) Cesar Antonio Soto Dr. Justin E. Tomasino Ph.D. Psychology May 9th, 2011 The human brain is a very powerful piece of structure; it is truly limitless when speaking about its potential. With a functional organ comes a dysfunctional possibility. Obsessive Compulsive Disorder, (OCD), for instance, is nervousness in the mind. OCD is an anxiety disorder caused by repetitive intrusive thoughts and behaviors. It is a mental disorder marked by the involvement of a devotion to an idea or routine. Essentially, it is a false core belief which is believing that there is something wrong, causing the mind to overpower the body in order to better itself. The act, the compulsion, is performed in order to reduce the amount of anxiety the host experiences in his thoughts, the obsession. Obsessive Compulsive Disorders can be anything from excessively washing your hands, not stepping on cracks, and even excessively having your possessions clean such as your house, office, car, etc. These compulsions can be treated to an extent. Through observations, it is simple to conclude that everyone has a form of an obsession, very much like OCD, that can benefit bright and new concepts throughout the world. According to the history books, the anxiety disorder of OCD is said to originate in Europe during the 14th and 16th century. During that time, it was believed that people who experienced and had obsessive thoughts, specifically sexual, were possessed by the Devil. Exorcism was the treatment used for people of this manner to “cure” them. Nevertheless, in the early 1910s, Austrian born neurologist Sigmund Freud, who was the founder of psychoanalysis, attributed obsessive- compulsive behavior to unconscious conflicts that manifest as symptoms. He believed that in early childhood life, humans have and attain a “touching phobia”. Contributing to this disorder, Freud explains throughout his work, that the human mind has strong desires. With these desires occur an “external prohibition” against the desires. However, the desire is never diminished it simply forces itself to the unconscious mind. Essentially, the human mind is capable of reaching immense heights due to its desires and it is almost impossible to avoid such feature. Obsessive Compulsive Disorder is the fourth most common mental disorder. Statistics show that “one in 50 adults” in the United States have OCD. People with OCD frequently seek the pleasure or relief of performing actions that are related to the anxiety. Additionally, they may recognize the thoughts and behaviors to be irrational; even so, it can be difficult for people to resist them and break free. In general, studies show that the average person with Obsessive Compulsive Disorder will develop this condition before the age of 25. Daily activities are altered. Behavior within a person with OCD includes: tardiness, perfectionism, procrastination, indecision, discouragement and family problems. Moreover, around 80% of all OCD sufferers are diagnosed with depression. Therefore, not only does man feel isolated and helpless, but he can convince himself that he is not good enough for the world and withdraw from others and life itself. Obsessive Compulsive Disorder deals with two sources: Obsessions, thoughts, and compulsions, behaviors. Melinda Smith and Ellen Jaffe- Gill elaborate on the differences and the relationship that obsessions and compulsions have while having OCD. They state that: Obsessions are involuntary, seemingly uncontrollable thoughts, images, or impulses that occur over and over again in your mind. You don’t want to have these ideas – in fact, you know that they don’t make any sense. But you can’t stop them. Unfortunately, these obsessive thoughts are usually disturbing and distracting. Compulsions are behaviors or rituals that you feel driven to act out again and again. Usually, compulsions are performed in an attempt to make obsessions go away. For example, if you’re afraid of contamination, you might develop elaborate cleaning rituals. However, the relief never lasts. In fact, the obsessive thoughts usually come back stronger. And the compulsive behaviors often end up causing anxiety themselves as they become more demanding and time-consuming. Continuing, an article online describes the differences between obsessions and compulsions. Obsessions are ideas, images and impulses that run through the person's mind over and over again. A person with OCD doesn't want to have these thoughts and finds them disturbing, but he or she can't control them. Sometimes these thoughts come just once in a while and are only mildly annoying. Other times, a person who has OCD will have obsessive thoughts all the time. Obsessive thoughts make people who have OCD feel nervous and afraid. They try to get rid of these feelings by performing certain behaviors according to "rules" that they make up for themselves. These behaviors are called compulsions. (Compulsive behaviors are sometimes also called rituals.) For example, a person who has OCD may have obsessive thoughts about germs. Because of these thoughts, the person may wash his or her hands repeatedly. Performing these behaviors usually only makes the nervous feelings go away for a short time. When the fear and nervousness return, the person who has OCD repeats the routine all over again. Compulsions are the effect of the obsessions. The host first experiences the intrusive thoughts, which are the obsessions. Second, man receives behaviors or actions that are a result from the thoughts. As a result, an anxiety disorder is in place of the mind. Moreover, throughout the span of a long- term period of time, the host has realized that the obsessions or compulsions are excessive or unreasonable. At this specific point in time with OCD, the patient must attain medical or psychological attention for treatment. The causes of Obsessive Compulsive Disorder, to this day, are still unknown. OCD’s causes aren’t fully understood, however, psychological doctors believe that there are three main factors to the cause of Obsessive Compulsive Disorder. The theories and possibilities of the causes of OCD are: biological, environment and insufficient serotonin. Scientists and doctors believe that OCD may be a result of changes in the human body. In addition, it may have a genetic component. Yet, to this day in history, these specific genes have not been identified nor clarified. When it comes to environment, practitioners think, over time and throughout life, human beings have obtained OCD through every day activities. Behavior- related habits learned and attained in life have a huge cause in OCD. Serotonin is a chemical messenger in the human brain. With low levels of this chemical, psychologists believe that this has a high cause of OCD. Several factors lead to the possession of OCD. Obsessive Compulsive Disorder has symptoms that include the following: order and symmetry with the idea that everything must line up “just right”, superstitions, double- checking of things, counting, tapping, repeating certain words to reduce anxiety, ordering, evening out things, and accumulating “junk”. Symptoms are both thoughts and behaviors; they are repetitive thoughts to reduce any form of anxiety. In order to identify OCD in man, man must have mental obsessions that lead to intrusive compulsions in everyday activities. In times of stress, symptoms can get worse as the symptoms wax and wane over time. There are many different ways to treat OCD. The general idea of the treatment is to resist the urge of the patient to perform the mental or physical act. This treatment manages the person to expose the underlying anxiety. Essentially, a neutralization of the thought is produced by the action. Furthermore, effective treatment for OCD varies from therapy to self help to medication. With the variety and diverse of treatments, there is only one treatment that has high research supporting its effectiveness. Cognitive- Behavioral Therapy works extremely well with the diagnosis of Obsessive Compulsive Disorder. The following statements are from mayoclinic.com, a website for diseases, and for medical attention. Here, they describe the Cognitive- Behavioral Therapy treatments and its significance. A type of therapy called cognitive behavioral therapy (CBT) can be effective. Cognitive behavioral therapy involves retraining your thought patterns and routines so that compulsive behaviors are no longer necessary. One CBT approach in particular is called exposure and response prevention. This therapy involves gradually exposing you to a feared object or obsession, such as dirt, and teaching you healthy ways to cope with your anxiety. Learning the techniques and new thought patterns takes effort and practice. But you may enjoy a better quality of life once you learn to manage your obsessions and compulsions. Therapy may take place in individual, family or group sessions. Furthermore, Cognitive- Behavioral Therapy has two key components; as stated by Melinda Smith and Ellen Jaffe-Gill. Exposure and response prevention involves repeated exposure to the source of your obsession. Then you are asked to refrain from the compulsive behavior you’d usually perform to reduce your anxiety. For example, if you are a compulsive hand washer, you might be asked to touch the door handle in a public restroom and then be prevented from washing up. As you sit with the anxiety, the urge to wash your hands will gradually begin to go away on its own. In this way, you learn that you don’t need the ritual to get rid of your anxiety – that you have some control over your obsessive thoughts and compulsive behaviors. Studies show that exposure and response prevention can actually “retrain” the brain, permanently reducing the occurrence of obsessive-compulsive disorder symptoms. This type of OCD therapy can even extinguish compulsive behaviors entirely. The cognitive therapy component for obsessive-compulsive disorder (OCD) focuses on the catastrophic thoughts and exaggerated sense of responsibility you feel. A big part for OCD is teaching you healthy and effective ways of responding to obsessive thoughts, without resorting to compulsive behavior. Treatment for OCD can be very long to cure as well as difficult. As referred, Cognitive Behavioral Therapy can be very effective; additionally so can medication such as: Clomipramine, Fluvoxamine, Fluoxetine, Paroxetine, and Sertraline. These anti-depressant chemicals have been cleared and approved by the Food and Drug Administration, (FDA), to treat OCD. Patients may be lacking levels of serotonin. Anti-depressants have the ability to increase these decreased levels of serotonin, which is highly probable when man has OCD. With the use of medication and psychological treatment, there are many risks and factors that the patient can undergo. The dilemmas for medication are limitless. There are controversies for choosing a medication, continuing the medication and side effects of the medication. The general goal for deciding on a medication is for the patient to pick the medication or treatment that will ultimately affect the signs and symptoms of OCD while maintaining the lowest possible dosage. After the start of medication, it can take weeks and sometimes months for the patient to notice an improvement in the symptoms displayed throughout every day routines. Factors for side effects are continuous and may include the following: upset stomach, sleep disturbance, sweating, and reduced interest in sexual activity. Ultimately, the patient is responsible for his condition before, during, and after medication is taken to properly and legally treat his Obsessive Compulsive Disorder. Obsessive Compulsive Disorder is an anxiety illness marked by repetitive intrusive thoughts and behaviors that affect daily lives throughout people around the world. Michael Maher Ph.D. has done a case sample on a person whose name and personal information has been kept private. This case study is from his website Columbia-ocd.org. This given sample illustrates the generic symptoms, side effects and medication that man can undertake. A 35 year old male, complained of elaborate cleaning and washing rituals. His particular concerns were with bodily waste or secretions (especially urine, feces, saliva, and semen). His specific feared consequences were about contracting HIV disease and/or spreading the HIV virus to others. His rituals included elaborate handwashing routines, prolonged and stereotyped showers, and lengthy wiping and cleaning rituals after using the toilet. The possibility that he might contract HIV disease and/or that he might spread it to others dominated his waking hours, and he only really felt safe when he was at home washing. On initial evaluation, Dan was told about the two proven treatments for OCD: pharmacotherapy with a serotonin reuptake inhibitor (SRI) and cognitive-behavioral therapy consisting of exposure and ritual prevention (EX/RP). When Dan learned that EX/RP treatment would require exposure to feared contaminants, he chose SRI treatment instead. After about 6 weeks on fluoxetine 60 mg per day, Dan reported that he was much less bothered by his obsessions, and he was more able to delay or stop his rituals. On the other hand, he continued to obsess about 3 hours per day about contaminants and to wash excessively. Thus, he was referred to twice-weekly EX/RP with an experienced therapist. Remaining on the SRI, Dan participated in 17 EX/RP sessions. With the therapist's expert guidance, he confronted feared contaminants in session and at home without ritualizing. He started with situations that he found moderately distressing (e.g., touching the floor in the therapists office), progressed to situations that he found more distressing (e.g., touching the floor in public bathrooms), and finished with situations that were highly distressing (e.g., imagining contracting HIV disease and giving it to his whole family). Although the treatment triggered a lot of anxiety, he persisted, and he became less fearful over time as he repeatedly confronted his fears without ritualizing. By the end, his OCD symptoms were minimal, his work and his social functioning had improved, and he felt optimistic about his future. It is clearly understood the harsh reality of having OCD. However, there are medications out there in the medical and psychological fields. Every year, a large number of people with Obsessive Compulsive Disorder do not get diagnosed nor treatment at all. This can and is very fatal to the human mind and patient with the numerous amounts of symptoms experienced every day. Today, in society and culture, three celebrities and well- known pop idols have said to have Obsessive Compulsive Disorder- like symptoms. David Beckham, an English footballer for Milan, has outspoken regarding his struggles with OCD. He has spoke to the media saying that he must count all his clothing and express his magazines in a straight line. Unfortunately, he has not been diagnosed nor been treated for it. American filmmaker and aviator, Howard Hughes, has been commented on by his companions. They declare that Mr. Hughes has a great fear for germs and minor flaws in clothing. Mr. Marc Summers, who is an American game show host, has written a novel about his life and how it has been affected by OCD. His novel, Everything in Its Place: My Trials and Triumphs with Obsessive Compulsive Disorder depicts his descriptive autobiography with OCD. Summary Obsessive Compulsive Disorder is an anxiety illness marked by repetitive intrusive thoughts and behaviors that affect daily lives throughout people around the world. Psychologists believe that the three main causes of OCD are: biological, environment and insufficient serotonin levels. Symptoms of OCD include the following: order and symmetry with the idea that everything must line up “just right”, superstitions, double- checking of things, counting, tapping, repeating certain words to reduce anxiety, ordering, evening out things, and accumulating “junk”. In order to treat OCD, the patient must partake in one, or both, of two things: take Cognitive- Behavioral Therapy or take medication like Clomipramine, Fluvoxamine, Fluoxetine, Paroxetine, and Sertraline. Obsessive Compulsive Disorder can be lifelong threatening if not diagnosed or treated. Personal Thoughts When it comes to Obsessive Compulsive Disorder, I believe everyone has a role to fill in life and the world. Everything happens for a reason. If life has been made for someone to have and possess OCD, then they should take advantage of that and use that to the best of their ability. For example, if someone is obsessed with cleaning and having everything clean, then they should open up their own business for cleaning houses or something along those lines. If someone has to repeatedly check if the doors are locked or secured, then they should work and possibly manage a service like ADT; keeping people safe would be his/ her passion. If depression is a part of the OCD, then the patient should be treated and put on medication; however, he or she should take advantage of the skill he/ she possess to the extreme. I personally have OCD like symptoms and I take advantage of every possible ability that I can. My room must be all about me, my hands must be washed before eating dinner, my homework must be saved onto my laptop a certain way; it is neither extreme nor harmful to me. Nevertheless, I like have a little bit of OCD because it makes me who I am. I like having the ability to do what I do and how I do that. There is no one on this planet that should judge me for my happiness so why should society to so towards patients with OCD and depression? If the patient wants to be cured, it’s because of his/ her choice. They should have the right to do what they want to do. After all, happiness is a milestone a lot of us try to reach throughout life. Works Cited [Hastings, C. Devin]. “Obsessive- Compulsive Disorder: Can Hypnosis help?” Unknown. April 30th 2011. < http://www.mindbodyhypnosis.com/OCD%20article.htm> [Maher, Michael Ph.D.]. “Obsessive Compulsive Disorder: Research Clinic”. Unknown. May 7th 2011. < http://www.columbia-ocd.org/> [Smith, Melinda M.A., and Jaffe-Gill, Ellen M.A.]. “Obsessive-Compulsive Disorder (OCD)”. Unknown. April 21st 2011. <http://www.helpguide.org/mental/obsessive_compulsive_disorder_ocd.htm> [Unknown]. “Obsessive-Compulsive Disorder, OCD”. Unknown. March 26th 2011. <http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml> [Unknown]. “Anxiety & Panic Disorders Guide”. Unknown. May 1st 2011. <http://www.webmd.com/anxiety-panic/guide/obsessive-compulsive-disorder> [Unknown]. “Obsessive Compulsive Disorder (OCD)”. Unknown. April 29th 2011. < http://health.yahoo.net/channel/obsessive-compulsive-disorder-ocd.html> [Unknown], “Obsessive Compulsive Disorder; What is it? And how to treat it?”. Unknown. May 5th. <<http://familydoctor.org/online/famdocen/home/common/mentalhealth/anxiety/133.html>