We all have heard the term OCD at some point in our lives, may be in different contexts. If a person is very orderly or a person is very particular about cleanliness, we say that the person has OCD, but this may not alway be the case. Through this post, let us try to explore this disorder and try to understand how one can take care of oneself or a person having OCD. Let me remind you of one phrase which is very important to all:
ASKING FOR HELP IS NOT A SIGN OF WEAKNESS.
If your OCD is disrupting your normal life, it signals that you need professional help. But what exactly is OCD?
OCD or Obsessive-Compulsive Disorder is an anxiety disorder in which a person has uncontrollable, repetitive thoughts that produce uneasiness, fear or worry, better known as obsession and in order to reduce the anxiety the person may perform a repetitive behaviour called rituals or compulsions.
Although the ritual may temporarily reduce anxiety, the person must perform the ritual again when the obsessive thoughts return. This OCD cycle can progress to the point of taking hours of the person’s day and significantly interfere with normal activity. Persons with OCD may be aware that their obsessions and compulsions are senseless or unrealistic, but they cannot stop them.
Persons with OCD may have symptoms of obsessions, compulsions or both. These thoughts and behaviours cause tremendous distress, take up a lot of time and interfere with daily life and relationships.
First, let us try to understand what is an obsession and a compulsion.
These are involuntary, seemingly uncontrollable thoughts, images or impulses that occur over and over in your mind. You don’t want to have these ideas but you can’t stop them. Some of these thoughts are:
- Fear of being contaminated by germs or dirt or fear of contaminating others.
- Fear of losing control and harming others.
- Sexually explicit or violent thoughts.
- Excessive focus on religious or moral ideas.
- Fear of losing or not having things you might need.
- Order and symmetry: The idea that everything must line up ‘just right’.
- Superstitions, excessive attention to something considered lucky or unlucky.
These are behaviours or rituals that you feel driven to act out again and again to relieve anxiety caused by obsessive thoughts. Some of the compulsive behaviours are:
- Spending a lot of time washing or cleaning.
- Repeatedly checking in on loved ones to make sure they are safe.
- Counting, tapping or repeating certain words to reduce anxiety.
- Praying excessively or engaging in rituals triggered by religious fear.
- Accumulating “junk” such as old newspapers or empty food containers.
- Ordering or arranging things in a particular order.
- Eating foods in a specific order.
- Excessive double-checking of things such as locks, appliances, and switches.
The medications used to treat OCD are the same drugs used to treat most anxiety disorders. They work by increasing the level of serotonin (the feel good chemical) in your brain, which is generally low in people having OCD. These are prescribed by a qualified psychiatrist.
If you are prescribed a medication then be sure you consult your doctor to understand the benefits as well as the risks of the prescribed medications. You should report any side effects to your doctor right away as you may need a change in the dose or a different medication. Some of the side effects are vomiting, diarrhoea, loss of coordination, shaking, abnormal urination, vision changes, appetite changes, extreme confusion, stiff muscles, loss of sex drive.
The most important thing to remember when on medications is: “do not stop taking medicines without talking with your doctor first”. Suddenly stopping a medication may lead to ‘rebound’ or worsening of OCD symptoms.
2. Medication Overdose
Another reason to strictly adhere to your doctor’s recommendations is to prevent overdose. Rapid heartbeat, breathing problems, vomiting, nausea, shakiness, seizure, extreme drowsiness and low blood pressure can all occur if you overdose on an anti-anxiety medication.
Cognitive Behaviour therapy or CBT is the most effective form of psychotherapy in treating OCD. In 75% of people with OCD, CBT significantly helps but for some people, CBT along with medication is more effective as medication helps to reduce anxiety enough for a person to start, and eventually succeed, in therapy.
Everyone has intrusive thoughts, you can’t block the thoughts popping into your head, in fact, no one can. But one can control or modify one’s reaction to these thoughts. CBT is a type of talk therapy that aims to help a person learn to change the way they think and act when having an obsessive thought.
The most important point to be kept in mind is that CBT helps you to learn a new behaviour, to tackle your obsessive thoughts, and like any learning process, it takes time, commitment, patience, motivation and above all practice to work on learning the behaviour.
When you are receiving CBT, the most important ingredient is the homework that must be done between sessions. The therapist can only act as a guide or teacher and the more you practice on your own, the sooner you will get better. When you have completed a successful course of treatment for OCD, most experts recommend follow-up visits for at least six months to a year.
Some of the techniques in CBT are:
- Use thought blocking: If you have an urge to wash your hands pinch yourself hard on your arm this will take your mind off your anxiety of washing your hands.
- Postponement: if you have an urge to wash your hands just postpone the thought. Tell yourself “I will wash my hands after 10 minutes.” And gradually increase the time to take action.
- Deep breathing: Whenever you feel anxious and compelled to wash your hands do this deep breathing exercise 20 times:
- Sit or lie in a quiet room in a comfortable position with one hand on your chest and the other on your stomach.
- Begin by breathing in through your nose. When you breathe in, you should only feel your stomach expand. You will know that you are doing this correctly if the hand on your chest is almost motionless while the hand on your stomach moves outward.
- Once you have taken a deep breath in, blow the air out slowly through pursed lips (similar to the face you would make blowing up a balloon) and feel your stomach fall back towards your spine. Again only the hand on your stomach should be moving. Exhaling should take two to three times as long as inhalation.
4. Exposure Response Prevention Therapy (ERP)
ERP requires that the sufferer confronts the fears directly and without any kind of protection. The initial phase of ERP can be very uncomfortable but in the long run, helps in eliminating or decreasing the compulsions. But a word of caution-ERP should be carried out under the guidance of a trained therapist.
The first step in ERP is to prepare a hierarchy of your fears and then gradually each fear has to be eliminated, starting from the easiest one or lower one in the hierarchy. A sufferer with obsession related to contamination and infection, for instance, might start with touching the door handles of public toilets and then not washing their hands for a considerable period of time. Over time exposure to obsessional cues and not giving in to the compulsive behaviour leads to less and less anxiety and the person is eventually able to stop engaging in these behaviours. Then the next difficult situation is tackled, like touching the taps of a public toilet and so on.
Or a sufferer with obsessions of harming others has to go out and interact with other people, friends and strangers, at home and in shops and coffee houses instead of hiding in your room avoiding human contact.
Some Tips For Self-Help
1. Invest in self-care
It will help you to manage your anxiety and function better. For this:
- Exercise regularly: This is a natural and highly anti-anxiety treatment. It helps to control OCD symptoms by strengthening the nervous system helping to refocus the mind when obsessive thoughts and compulsions arise. For maximum benefit, you should do a 30 minute or more of aerobic activity on most days.
- Stay connected to family and friends: OCD leads to social isolation as OCD takes most of your time which in turn will aggravate your OCD symptoms. Invest in relating to family and friends. Talking face to face about your worries and urges can make them feel less real and less threatening.
- Get enough sleep: Lack of sleep can increase anxious thoughts and feelings. When you are well rested, it’s much easier to keep your emotional balance, a key factor in coping with anxiety disorders like OCD.
- Practice relaxation techniques: practising relaxation techniques like yoga, deep breathing, and mindful meditation regularly.
- Indulge in your favourite hobby: It gives you intense pleasure and relaxes your mind.
2. Learn how to resist OCD rituals
This can be achieved by the following ways:
- Don’t avoid your fears: The more you try to avoid the situations that trigger your obsessive thoughts, the scarier they feel. Instead, expose yourself to your trigger, then try to resist or delay the urge to complete your relief-seeking compulsive needs. If resistance gets too hard, try to reduce the amount of time you spend on your ritual.
- Refocus your attention: When you are experiencing OCD thoughts and urges, try shifting your attention to something else. Exercise, jog, walk, listen to music, read, surf the web, play a video game, make a phone call or knit. The important thing is to do something you enjoy for at least 15 minutes, in order to delay your response to the obsessive thought or compulsion.
- Anticipate OCD urges: By anticipating your compulsive urges before they arise, you can help to erase them. E.g. if your compulsive behaviour involves checking that doors are locked, windows are closed or appliances are turned off, try to lock the door or turn off the appliances with extra attention the first time. Create a solid mental picture and then make a mental note. Tell yourself “the window is now closed” or “I can see the oven is turned off”. When the urge to check arises later, you will find it easier to re-label it as an obsessive thought.
3. Challenge obsessive thoughts
OCD causes the brain o get stuck on a particular anxiety provoking thought. The following strategies can help to get unstuck
- Write down your obsessive thoughts or worries: Keep a pad pencil or type on a laptop, smartphone or a tablet. When you begin to obsess, write down all your thoughts or compulsions. Keep writing as the OCD urges continue, aiming to record exactly what you are thinking, even if you are repeating the same phrase or the same urge over and over. Writing it all down will help you see just how repetitive your obsessions are. Writing down the same phrase hundreds of times will help lose its power. And also writing thoughts down is much hard work than simply thinking them, so your obsessive thoughts are likely to disappear sooner.
- Create an OCD worry period: Rather than trying to suppress obsessions and compulsions, develop the habit of rescheduling them. Choose one or two 10 minutes “worry periods” each day, time you can devote to obsessing. Choose a set time and place (e.g. in the living room from 8.00a.m to 8.10 am and 5.00 p.m. to 5.10 p.m.). That’s early enough so it won’t make you anxious before bedtime. During the worry period, focus only on negative thoughts or urges. Don’t try to correct them. At the end of the worry period, take a few deep breaths and return to your normal activities.
What can families and friends do to help?
Many family members feel frustrated and confused by the symptoms of OCD. They don’t know how to help their loved one. But you can help the person by:
- Learning as much as you can about the disorder, its causes, and treatment.
- Must make sure that the person with OCD also has access to information about the disorder.
- When a person with OCD denies that there is a problem or refuses to go for treatment, this can be very difficult for family members. Continue to offer educational materials to the person.
- Negative comments or criticism from family members often makes OCD worse, while a calm supportive family can help improve the outcome of the treatment.
- Telling someone with OCD to simply stop their compulsive behaviours usually doesn’t help and can make the person feel worse since he or she is not able to comply.Instead, praise any successful attempts to resist OCD.
- Treat people normally once they have recovered, but be alert for telltale signs of relapse. If the illness is starting to come back, you may notice it before the person does. Point out the early symptoms in a caring manner and suggest a discussion with the doctor.
- Encourage the person to stick with the medication and/or CBT.
- When children or adolescents have OCD, it is important to work with schools and teachers to be sure that they understand the disorder.
- Take advantage of the help available from support groups. Sharing your worries and experiences with others who have gone through the same things can be a big help. Support groups are a good way to feel less alone and to learn new strategies for coping and helping the person with OCD.
- Most importantly be sure to make time for yourself and your own life. It is important to continue to lead your own life and not let yourself a prisoner of your loved one’s rituals. You will then be better able to provide support for your loved one.
I hope this post helped you better understand the ways in which you can deal with OCD in daily life. Share the post with your family and friends who might find this information valuable.