Obsessive-Compulsive Disorder – G.T.Health Newsletter 7

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Obsessive-Compulsive Disorder

“You don’t have to learn how to control your thoughts; you just have to stop letting them control you.”

 

– Unknown 🧠

December 2021, Volume 7

The G.T.Health Letter

~Adding a dose of mental health awareness to our community~ 

Obsessive-Compulsive Disorder

What’s Inside: 

  • Mental Health Spotlight – Obsessive-Compulsive Disorder (OCD)
  • Literature Spotlight 
  • Xtra Scoop of the Week – OCD and COVID-19
  • Weekly Testimonial – Using “OCD” as a non-clinical term

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Obsessive-Compulsive Disorder

Mental Health Spotlight – Obsessive-Compulsive Disorder (OCD)

What is OCD? 

Obsessive-compulsive disorder, or OCD, is an anxiety disorder characterized by unwanted obsessions and compulsions followed by feelings of anxiety or panic. Obsessions are recurrent thoughts, and compulsions are repetitive behaviors. To illustrate, one might be unable to stop thinking about death (obsession), and to ward it away might feel the need to cross themselves every 3 minutes to keep Death at bay (compulsion). Not everyone with OCD experiences both obsessions and compulsions all the time, but at least one is present pretty much daily, and symptoms can be triggered by the most mundane experiences. The thoughts and desires experienced in the course of OCD are intrusive, psychologically taxing, and usually known by the sufferer to be overdramatic or untrue; however, this does not stop such symptoms from creating great anxiety and stress, almost as if one’s brain is split into the irrational and rational hemispheres and the two are at war. Some of the common obsessions (intrusive thoughts) that occur in people with OCD are about: contamination (illness), losing control, harm, perfection, sex, and religion. The perfectionism obsession is especially interesting, because it usually stems from an attempt to reduce life’s uncertainty, not from a desire for perfection itself; for example, to rid myself of the stress of losing my keys I might become obsessed with making sure they’re in exactly the same place every day. This isn’t me trying to make my keys look perfect, it’s about the anxiety I feel when I lose them. Some common types of compulsions, on the other hand, surround: checking (the lock on the door, the temperature, etc), repeating (a prayer, a dance, etc), washing and cleaning (your hands, your bathroom floor, etc), and mental rituals (repeatedly replaying an event, saying a good word to counteract a bad one, etc). Symptoms can be exacerbated when interrupted, or can stem from trauma earlier in life. But why are the symptoms, especially compulsive behaviors, so persistent? Think of it this way: the compulsion exists as a temporary alleviator of the core symptom, which is the anxiety-induced obsession. Here’s an example. I have a fear of losing things; I therefore become obsessed with the perfect placement of my keys. I develop a compulsion that involves checking my keys in their place, a compulsion which is exacerbated when some other variable I can’t control is present in my life. For the moments I am checking my keys, I feel better about the world. I begin to repeat this behavior, and it makes the relief stretch for longer. It becomes so necessary to my functionality that I can’t leave the house because if I do, I won’t be able to check my keys in their perfect place anymore. I stay in the house, keep checking, and keep chasing relief.

How can you help someone with OCD?

Telltale signs that a person actually has OCD consist of obsessions and compulsions intruding in the following ways: taking up at least an hour a day, interfering with daily function, being uncontrollable even when controlling them would make life more bearable, being a source of relief but not pleasure (in the case of compulsions). This last one is especially poignant to remember; a person with OCD could even be crying as they run back to check the lights for the fortieth time, but they’ll continue to do so regardless. OCD is not merely a disorder of rituals: it’s a disorder of unwanted, often harmful rituals meant to temporarily relieve anxiety. Many things can affect the presentation of OCD, such as age, substance abuse, and the presence or absence of significant life stressors. Being a good friend to someone with OCD is a lot like being a good friend to someone with any other disorder; you should try your best to be understanding, non-judgmental, and non-enabling of symptoms. It is probably all too easy to become exasperated by the compulsive behaviors of someone with OCD, but if you begin to wonder why your friend can’t just stop, remind yourself that, without the disorder, you don’t even know how to comprehend a mindset wherein stopping a behavior means, for lack of a better phrase, the end of the world. We without OCD have no conception of the true depth of obsession and compulsion, so it isn’t our place to try and tell a disordered person how how to live her life. What we can do, though, is encourage, provide support, and refrain from doing things that permit compulsions, like buying soap for hand-washing. If your friend is nervous about seeking therapy, you can certainly try and reassure them that they’re making the right choice, or if therapy is getting tough you can try to empower them, but beyond that it isn’t too helpful to over-insert ourselves into the lives of those experiencing disorder. Trying to get someone to change before they are ready will only make the change process slower, and make change itself seem much less benevolent than if it was stumbled upon autonomously. 

Obsessive-Compulsive Disorder

How do we combat OCD?

Like other disorders, OCD is treatable with time and therapy. Disorder is not necessarily something that can be cured; it is indicative of the way a person’s brain works and interacts with their environment, so saying that we can cure disorder (without amazingly invasive procedures, medications, etc) would be like saying we can cure Type 1 diabetes. It can be helped, treated, and have its symptoms lessened, but it is a part of one’s identity, not a temporary state of mind or being that was contracted like a virus. But back to treating OCD. Similar to other anxiety disorders, behavioral therapy is a fairly successful approach; the main goal is to reassess how thoughts affect behaviors, and restructure the response to a thought so that it doesn’t get the better of you. Cognitive behavioral therapy (CBT) specifically is highly desirable for helping patients learn to think and behave differently when they experience anxiety. Take my hypothetical example about being afraid of losing things, and my resulting obsession with my keys and checking compulsion. In therapy, I might learn how to experience but not react to that anxiety, reacting with acceptance of imperfection instead of fear, which might in turn reduce my checking behavior so that I only have to go back three times instead of forty. One specific type of CBT referred to as the gold standard for OCD is called exposure and response prevention therapy (ERP), which involves exposing patients to anxiety triggers and teaching them to respond in new, healthy ways. Acceptance and commitment therapy (ACT) is another version wherein people learn to accept the discomfort of their obsessions instead of giving in to the need to scratch the itch and have compulsions. Other forms of treatment are anti-anxiety medication and support groups, which are likely to work best in combination with therapy.

Helpful sources for those looking to learn more about OCD!

https://www.mcleanhospital.org/essential/everything-you-need-know-about-ocd

https://beyondocd.org/information-for-friends-and-family/how-to-support-a-friend

Literature Spotlight 

OCD – Aditi

OCD is not all about remembering the freckles on her cheeks or telling her
I love you repeatedly
OCD is waking up at 2am in the morning after you have spent hours trying
to delude yourself into thinking that your hands are clean only to end up
in your washroom trying to rub your skin off.

(all because a stranger touched me on the sidewalk a month ago)

OCD is being in an abusive relationship with yourself. Your logic won’t let
you give in, but like a desperate lover, your OCD won’t let you go. So you
keep swinging, tick tock, to and fro, like the broken clock in the store
room you can’t get yourself to throw out because it belonged to your
nana.

OCD is not finally finding a peace of moment when he looks at you but it
is biting your teeth into your lips trying to hold in the cringe when he
carelessly wipes his greasy hands on the napkin. “Don’t complain, don’t
complain”
you mutter to yourself as you throw a hand sanitiser his way.

(please don’t leave me)

OCD is rearranging the picture frames on the shelf for the fifteenth time a
day because last time your brother interrupted you and so you might as
well start again. OCD is the worry in your mum’s eyes as she invites the
guests to show them your room while she keeps throwing you cautious
glances as someone touches your books
.

(I’m sorry, ma. I can’t help it)

OCD is reading the same line again and again, a part of your brain asks
you why since you got it right the first time. You don’t know why, but you
keep doing it just to be sure
. Check the door if it’s locked properly before
sleeping. Once, twice, thrice till it’s morning already and it’s time to wake
up.

(another sleepless night, ******* it)

OCD is all these fuzzy voices mixed around with the signals from your
brain telling you that your life will fall apart, if, just for this once, you do
any different. 

https://hellopoetry.com/words/ocd/

Let’s talk about this poem. By far its most important aspect is the comparison to what OCD is not, since OCD is a disorder that’s incredibly misunderstood by the neurotypical public. As this writer so blatantly puts it, OCD isn’t something that can be blown away with the breath of love and repetition; it’s more like being haunted than being reminded. Being someone who has really no OCD symptoms, I can’t imagine what it’s like to be unrelentingly plagued with the surety that you’re missing something, that your world will never be just right because there’s always something out of place, either literally or metaphorically. In all honesty, I have much less to say about OCD than about other disorders, simply because I have so much less of an understanding of what experiencing it is like. I might say that I’m “obsessed” with something like food, that I can’t get something out of my head like that one time I forgot a homework assignment in middle school, that I have to go back once or twice to make sure I bolted and chained my door, but these experiences are nothing like those of people who are actually diagnosable with OCD.

Like with most disorders, a diagnosis occurs when the condition. is so debilitating that it impairs your everyday function and is consistently harmful to you. My own measly comparisons to OCD from above do not really hinder me in a terribly big way; I’m not afraid to go outside for fear of not being able to control what happens to me there. Imagine being so preoccupied with the thought that if you don’t check the dishwasher exactly 16 times, your grandmother will catch tuberculosis. Imagine missing a hand wash and then having to make up for it by washing ten times in a row, even as you’re telling yourself to stop. I know I can’t.

Obsessive-Compulsive Disorder

Obsessive-Compulsive Disorder
Xtra Scoop of the Week – OCD and COVID-19

Imagine having OCD, obsessions and compulsions and anxiety about losing control, and then imagine living through the coronavirus pandemic. For some people, whose symptoms center around fear of contamination or illness, the virus is probably making things much, much worse. Our lives are surrounded by talk of disease, disease prevention debates, and the general lurking fear of getting sick, so it’s easy to see how someone constantly occupied by these thoughts already might react to having their feelings echoed by society at large. All the talk about hygiene might also produce tunnel vision in individuals with OCD, causing them to hyperfocus on cleanliness and overlook some of the other important aspects of self care and health living.

However, it is not necessarily productive to assume that all people with OCD are affected so harshly; the reality of disorder is much more complex. If you have obsessions and compulsions about things that aren’t health, like your body, animals, etc, you might not be affected any more than the average person by COVID. The nature of OCD is such that if a typical life stressor is not the root of the symptoms, it is likely to pale in comparison to other worries, regardless of how threatening a stressor it is. There is also the potential for OCD therapy to have a protective effect against COVID stress, seeing as people with OCD have to deal with fear and uncertainty constantly. OCD therapy is therefore a tool for adapting to live with the exact feelings COVID is surfacing in us now; the only difference is that people who don’t partake in such therapy don’t have any practice dealing with them.

https://www.mcleanhospital.org/essential/living-ocd-during-coronavirus-crisis

Weekly Testimonial – Using “OCD” as a non-clinical term

I think it’s quite safe to assume that most of us have either said or had a friend say: “it’s just my OCD,” or “you’re giving me OCD,” or something along those lines. It seems like something fairly harmless to say, especially when you’re young, but is it alright to just throw around a disorder’s name like that? I personally think somewhat yes, but mostly no. On the one hand, using the names of disorders in everyday discourse is helpful to decreasing the stigma surrounding mental health; if we’re comfortable saying the words and acknowledging the existence of psychopathology, then we’re taking a big step in a larger world of acceptance. However, using OCD to describe why you’re washing your hands, using “seasonal depression” to describe aversion to winter (which is a very valid feeling, by the way), etc also helps to increase misconceptions about what the disorder really is; mostly, it detracts from the severity of the disorder. Analogizing unknowns so that we can understand them in the context of our own lives is natural; most of us can’t imagine the true scope of OCD, so we equate it to the feeling of having to check and make sure we actually turned the oven off after baking. But in trying to understand, we also bring ourselves further from the truth by making disorder into something it’s not. Becoming more confident in our belief of what OCD is with every passing reference we make, we are also becoming less likely to believe someone with OCD when they try to correct our assumptions; our perceived closeness with the disorder might make it harder for us to learn about the true reality of it, since we now think we know what there is to know.

So the next time you hear yourself or someone else call something in your lives a symptom of disorder, think about what you’re implying. Think about whether what you’re experiencing actually compares to disorder, which is by definition terribly impairing. If it’s a disorder that is rarer or whose symptoms are not present in most people, like OCD (as opposed to, for example, ADHD), you might also think about what you can say in that situation instead.

That’s all for this week, folks!
Next week’s topic:
Seasonal Depression

Obsessive-Compulsive Disorder

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