Aug 2 2010

What Is Obsessive Compulsive Disorder (OCD)?

I don't remember if I did that or not...

I don't remember if I did that or not...

OCD is a type of anxiety disorder that involves intrusive, uncontrollable thoughts and fears that can eventually take over the person’s life. Although to others the OCD sufferer may seem paranoid or even psychotic, in most cases the person realizes their thoughts and actions are irrational, making them feel even more alienated from those around them. It’s one of the more common mental illnesses, diagnosed nearly as often as asthma and diabetes. It’s important to note that OCD is different from other compulsive behaviors like overeating, gambling or sex addiction, where the person derives at least some short-term pleasure from the behavior. OCD sufferers get no pleasure or satisfaction from their behavior, yet they find it impossible to stop. OCD sufferers may also be diagnosed with conditions like Asperger syndrome, bulimia, social anxiety disorder, Tourette syndrome or major depressive disorder, among others.

It’s believed to have biological roots, and has been associated with abnormalities with the neurotransmitter serotonin, which is thought to have a role in how the brain regulates anxiety. This sort of imbalance of serotonin may be related to abnormal brain development; it’s suspected that children who have had a Group A streptococcal infection may be more prone to OCD later in life.

What Are OCD’s Symptoms?

OCD manifests itself in a set of compulsive behaviors that give the person “relief” from their anxieties. A typical person with OCD might be preoccupied with disease, God, the Devil or germs, all things that can cause tension and give the person the feeling that their life can never proceed as normal. Other obsessions might involve dirt and contamination; the person may be frightened or apprehensive about things like household chemicals, pets, newsprint, radioactivity, and of course their own bodily secretions or excrement.

Others have sexual obsessions that they can never be rid of, or may be extremely averse to sex. An OCD sufferer knows that their thoughts, behaviors and habits are out of step with the rest of the world, which just feeds their anxieties and doubts even more.

Typical obsessive behaviors or rituals might include:

· Skin picking

· Hair plucking

· Counting, which can come into play by counting specific things (such as footsteps or floor tiles) or counting specific ways (odd or even numbers, for instance)

· Hand washing or showering

· Throat clearing or verbal tics

· Behaviors that are preoccupied with order, such as putting items in a straight line, touching objects a set number of times, turning lights on and off, stepping on only a certain color of floor tile, checking that their car is locked several times over before leaving it, or only walking up or down a flight of stairs in a certain fashion (i.e. always starting and ending on the same foot)

How did it come to this?

How did it come to this?

Hoarding

Hoarding is an offshoot of OCD that has come to the public eye in recent months with hoarding-related TV shows. Hoarders might think that inanimate objects (teddy bears, documents, electronic devices, anything) are sentient beings with thoughts and emotions. In other cases, hoarders might never be able to break associations between those objects and a person or a past phase of their lives, and hang onto them as “mementos” or “keepsakes.” Often this might be linked to the trauma of a death or divorce. Nonetheless, hoarding can be just as destructive and just as crippling as any other form of OCD.

Management And Treatment

The first line of treatment for OCD has always been psychotherapy (and in some cases, dynamic psychotherapy). Newer therapies, though, have involved behavioral modification and medication. Behavioral modification for OCD might involve “exposure and ritual prevention,” where the person gradually is conditioned to let go of the anxiety associated with neglecting to go through their ritual behavior. The person might touch something only mildly “contaminated,” or might check the lock on their house only once when leaving, rather than going back and rechecking it. From there, the person is habituated to tolerate their anxiety in increments (touching something a little more “contaminated,” not checking a lock at all or only washing their hands once instead of repeatedly).

Other behavioral work has concentrated on “associative splitting” to reduce obsessive thoughts. It’s a concept that encourages neutral or positive associations in the network of OCD-related anxieties. For instance, a person who is obsessed with fire meaning “danger” or “destruction” might instead be steered towards thinking of fire as fireworks, fireflies, fireplaces, candlelight dinners, campfires or other pleasant associations.

The brain chemistry involved with OCD suggests using SSRI type drugs (selective serotonin reuptake inhibitors) such as paroxetine, fluoxetine, escitalopram or tricyclic antidepressants such as clomipramine. SSRI’s block excess serotonin from being directed back into the original neuron that released it; instead, they bind serotonin to receptors of nearby neurons, sending chemical signals that can help head off anxiety and obsessive thinking. Some newer-generation antipsychotics have been found useful in treating OCD; paradoxically, some of these drugs have been seen to cause obsessive-compulsive symptoms in patients who didn’t have OCD before.

Some experimental drug treatments have been observed to act on serotonin and neurotransmitters:

· The naturally occurring sugar inositol

· Vitamin and mineral supplements (some believe that nutritional deficiencies contribute to OCD)

· Opioids such as morphine and synthetics such as tramadol. It’s not clear exactly how these work, but they sometimes rapidly alleviate OCD symptoms

· Psychedelics such as LSD and peyote

· Nicotine treatment (again, the jury is still out on this one)

· Anticholinergics, to head off the anti-dopaminergic effects of choline

Will I ever be myself again?

Will I ever be myself again?

Although there is still a lot of research to be done on OCD, the last several years have seen significant advances. Medical science has gone a long way towards understanding the biological roots of OCD; between treating the root causes and readjusting the behaviors of the OCD sufferer, many with OCD (and many with related anxiety disorders) have been able to go back to leading a fairly normal, routine life again.


Jan 4 2010

Top 10 Weirdest Mental Conditions

Crazy comes in many different flavors. And let’s face it, some forms are funnier than others. Thankfully, some of the strangest mental conditions are the ones that don’t seem to occur too often.

Below are a few of the craziest of crazy―10 of the weirdest, most unique mental disorders.

Objectum Sexuality. Folks with this disorder develop serious emotional attachments to inanimate objects. These feelings may even include sexual arousal brought on by certain objects. So you might want to keep people suffering from objectum sexuality away from your favorite teddy bear, lest your stuffed pal become the object of a very one-sided love affair. The size of the item being emoted upon isn’t always practical, either. One woman who suffers from this condition believes she is married to the Eiffel Tower. So perhaps it’s time to start worrying about your friend who talks incessantly about the love he has for his 50-inch plasma screen television.

Gamomania. If you’ve ever had a random stranger walk up to you and ask you to marry her, then it sounds like you’ve probably met someone suffering from gamomania, a mental disorder that causes people to make sudden, outrageous marriage proposals. If you accepted, then hopefully you two are happy. Although it’s unlikely, as your spouse undoubtedly brings home a new fiancé every day. Gamomaniacs have such an intense desire for marriage, they usually tend to lean towards a polygamous lifestyle.

Aboulomania. You know that conversation you have sometimes that goes like, “What do you want to have for dinner?” “I don’t know, what do you want to have?” Multiply that times a thousand, and you can imagine what living with someone who suffers from aboulomania could feel like. This mental disorder causes extreme indecisiveness, which must be really annoying for not only the sufferers, but for their friends and loved ones. It does make you wonder how an aboulomaniac can ever leave the house in the morning, since such a severe inability to make a decision on anything must make picking out the day’s outfit even more challenging than it already seems to be for so many non-sufferers.

Doromania. If you don’t have a friend who has been diagnosed with doromania, perhaps you should hop on down to your local psychiatric ward and find one. Doromania in an obsession with giving gifts, which really makes the illness sound less like a horrible disorder and more like a characteristic of a wonderful friend or a favorite aunt. This is assuming, of course, that your favorite doromaniac actually gives good gifts, and not just random items from the dollar store or cans of cat food wrapped up with a bow.

Alien Hand Syndrome. Folks with alien hand syndrome apparently lose control over the actions of one of their own hands. But the hand doesn’t just hang there limply. It takes on a life of its own, seemingly under its own power, regardless of what the hand’s owner wills it to do. While alien hand syndrome allows you to feel all sensations in your hand like normal, you just can’t tell it what to do anymore. It seems like having this bizarre particular mental illness could come in handy if you ever need an excuse for slapping someone in the face or shoplifting.

Cotard Syndrome. People with Cotard syndrome take hypochondria to the next level. Rather than just think they are sick, people with this illness believe they are dead. Well, sometimes they just believe they have lost some of their major organs, but it seems like that would quickly lead to death anyway. If you know someone who is still walking around looking like a zombie months after Halloween is over, your friend may be suffering from this sickness. It’s best to just ignore him, rather than shattering his belief that he has ceased to exist.

Capgras Delusion. If you travel home to visit family and it feels like your mother has been replaced by an entirely new person, you may be right. Or you may have been stricken by the Capgras delusion. This form of schizophrenia causes people to think their loved ones have been replaced by imposters. You could seek help from a medical professional, or you could just go with the flow, enjoy making a new friend and welcome the influx of a fresh presence at family dinners.

Synesthesia. People with synesthesia basically attribute unique characteristics to words. They may associate certain colors with letters and numbers, or think of a map or calendar page as a three-dimensional image. For some people, this mental illness can bring about more creativity and artistic inspiration. Others just use it to annoy their friends. Two people with synesthesia won’t always agree. One may think the letter “B” is green, while another may call it red. Putting the two in a locked room to duke it out would be cruel and also hilarious.

The Jumping Frenchmen of Maine. If you suffer from this wonderfully named illness, it means that you are likely to jump up and obey any command instantly, even if the command asks you to hit your mother in the face. Essentially a physical form of Tourette’s, Jumping Frenchmen is a rare but useful illness. If you’re looking for an always willing participant who will react quickly to your every command without question or hesitation, then seek out someone with this affliction. Just remember, with great power comes great responsibility … and enjoyment.

Body Integrity Identity Disorder. Ever felt the strong desire to cut off one of your own limbs? Of course not. That would be crazy. Or more specifically, that would be body integrity identity disorder. People with BIID truly believe that removing one of their healthy body parts would make their lives better. Luckily, most BIID sufferers do not remove their own limbs or have luck finding doctors who will do so for them. Instead, they often just pretend they are missing a leg or an arm, which seems difficult to do, and they should be applauded for sticking to their disorders with such dedication.