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September 17, 2012

Obsessive Compulsive Disorder, The Effect of OCD on the Successful Achievement of Erikson's Task during Developmental Stages of the Lifespan

            According to the studies, 28% Americans suffer from mental illness after the age of 18 years. There are numerous amounts of mental illnesses that are discovered all over the world among these illnesses is obsessive-compulsive disorder. Almost everyone in 82 individuals suffer from the obsessive compulsive disorder. The interesting thing about OCD is that many people having it are very mindful of their activities but they dont think that it is out of the ordinary. OCD is real frequent like diabetes or asthma and individuals having this can still enjoy life in a normal way.
OCD is the abbreviation for Obsessive Compulsive Disorder. Yes, that's me. It's exactly as described; I'm both obsessive about things, and I often do these things compulsively. For me, this means doing things "in threes". The number three, you see, is a good number. It feels right, it feels good and everything, in my head at least, is counted or acted out in threes or multiples of threes, or sometimes, its just numbers with the number three in them. It means that when I do things, such as swallow, I have to swallow a minimum of three times. On a bad day, I will feel the need to swallow six, nine, even up to thirty times. It completely takes over my life in ways that most 'normal' people can't even begin to imagine. I am obsessive about switching off and unplugging plug sockets. Generally this means that I have to check every single plug socket in the flat to see that it is switched off, and I do that a minimum of three times otherwise I feel like something bad will happen. That sounded wrong, I know nothing bad will happen, but I feel really, really strongly compelled to do it and it feels very wrong to me if I don't.
Obsessive Compulsive Disorder is an anxiety disorder, that it is characterized by repeated unwanted thoughts or obsessions and repetitive behaviors (Obsessive Compulsive Disorder); in which victims feel that they cannot control. Along with these characteristics there are usually rituals that run jointly with OCD. Rituals such as hand washing, counting, checking, or cleaning are some of the most common. Performing these rituals is the persons way to try and cope with the anxiety; but they usually only offer temporary relief, and when these tasks are not performed it usually increases anxiety. Although the sufferers of OCD know that their anxiety is senseless and embarrassing their obsessions are always popping up without warning. Dr. John March and Christine Benton have a way of describing Obsessive Compulsive Disorder in a different way: OCD is much like the hiccups, it may not seem that bad at first; but as time goes on, they get harder and harder to live with. If you had them and they refused to go away, you naturally would have to fit in breathing, speaking, eating and every other function between hiccups. The unpleasant reality of having OCD is that it has a deteriorating effect; over time it becomes worse and worse until it can fundamentally destroy your life (Hyman& Pedrick, 2005).
Obsessive Compulsive Disorder is believed to be caused by abnormal functioning of the brain circuitry, probably involving a part of the brain called the striatum. Many people usually think, OCD is caused by family problems or attitudes learned in childhood, but this has been proven false; an example of this would be an emphasis on cleanliness in the home, you cannot develop OCD in that way. Scientists have actually done brain-imaging research called Positron emission tomography (PET), which showed that sufferers of OCD brains differ from those that dont have the disease. Although there is no clear genetic proof, OCD tends to run in families  (Waltz, 2000). A person with OCD has a twenty five percent chance of having a blood relative that has the same dysfunction. Much like many other mental diseases, OCD is more predominant in identical twins; if one twin has OCD there is a seventy five percent chance that the other will also have it.
Obsessive Compulsive Disorder has a various amount of treatments; there is no real cure for OCD no matter what people try. One treatment is cognitive behavioral therapy or CBT; this is a combination of cognitive therapy and behavior therapy(Steketee& Pigott, 2006). In behavior therapy people are shown how to change their thoughts and feelings that are causing them trouble by first changing their behavior. Many types of behavior therapy have been proven effective for different problems. Cognitive therapy focuses on what people are thinking, which in turn helps them challenge unhelpful thoughts that are making them feel bad and behave in ways that arent serving them well. This is basically used for kids with OCD, because it helps them replace inaccurate beliefs about life and OCD. Another treatment for OCD is exposure and response prevention, which basically focuses on anxiety and the actual fear; the person is purposely exposed to the trigger that makes them anxious; the trick here is to teach the person to avoid performing the compulsive rituals that helps them to deal with their anxiety. The last treatment for OCD is medication; there have been several that are proven effective in helping people with OCD such as clomipramine, fluoxetine, and sertraline. These are basically anti-depressants that cause drowsiness for you to calm down and decrease anxiousness. These medications are proved to be most effective when used along with behavioral and cognitive therapy.
Sufferers of OCD have a very challenging life; their anxiety can control their entire existence. There are a numerous amount of common fears sufferers of OCD may have, the most common are:Fear of harming oneself or others, forgetting or loosing things, fear of misunderstanding, fear of anxiety or other uncomfortable feelings resulting from the obsession, fear of constant attention to thoughts or images and constant perception of bodily sensations, fear of contamination and fear of imperfection. Along with these fears there are rituals that people perform, so they wouldnt be anxious about obsessing over these things; a person who has a fear of contamination would constantly wash their hands or anything they would come into contact with. There are also many other compulsions too, such as checking in which you repeatedly check something over like stoves or doors, some people order and arrange different items to cope with their anxiety, another is hoarding different objects in fear of loosing them; the items are usually useless and have no significance to normal people, the most common are mental rituals; in these rituals the person usually counts, repeats words, or tries to prevent or restore something.        
Preventative and restorative rituals share the goal to avoid harm coming to you and others. Preventative rituals are shown in people who are anxious about fires or break-ins into their house; the person may touch the doorknob several times before the open a door. If a person is anxious of a break-in they may check the locks on the doors several times, they are not just a one, two, three check. They may check over twenty times until they are sure and satisfied that their house would be safe. Restorative rituals usually have to do with people who are terrified of germs and contamination. They may have cleaning rituals that are much more than needed for anyone, but they mostly fear that their clothes are so contaminated that they need to return them to a safe state.
OCD is extremely hard to live with and it is even harder for others to deal with, it is hardest in interpersonal relationships. One woman says: ‘I couldn't do anything without rituals. They invaded every aspect of my life. Counting really bogged me down. I would wash my hair three times as opposed to once because three was a good luck number and one wasn't. It took me longer to read because I'd count the lines in a paragraph. When I set my alarm at night, I had to set it to a number that wouldn't add up to a bad number.  I knew the rituals didn't make sense, and I was deeply ashamed of them, but I couldn't seem to overcome them until I had therapy. This woman had a really hard time trying to deal with her compulsions and it affected her life negatively. OCD is very difficult and frustrating to live with daily, and it is even tougher on family members. Families usually have a hard accepting the fact a person with OCD cannot stop their stressful behavior, which in turn actually increases the behavior. The only way a family can help a person with OCD is to encourage the person to go through therapy or have the person think about using pharmaceutical drugs.
            Some of the common repetitive symptoms of OCD are cleaning and washing compulsions such as excessive, ritualized hand washing, showering, bathing or brushing one's teeth. The unshakable feeling that household items, such as dishes, are contaminated or cannot be washed enough to be germ free. An obsessive need for order and to have everything aligned in a certain way or to have appearances be exact. Saving and stashing away useless trash, most people would recognize this behavior and associate with the phrase "pack rat". Repeating routine activities for no logical reason such as repeating questions over and over, rereading or rewriting words, counting objects like windows ceiling tiles and cars. Victims of OCD find themselves asking for reassurance over and over again with feelings of dread if some simple task is not performed or forgotten.
There are two treatment approaches to OCD. The first is the use of Drug therapy. Although, these drugs may get rid of the symptoms of OCD they do not cure the disease. Mainly, SSRI's (Selective Serotonin reuptake inhibitors) and SRI's (Serotonin reuptake inhibitors) are used to increase the levels of Serotonin, which acts as a chemical messenger in the Brain. The other is Cognitive Behavioral Therapy. Serotonin is used by certain nerve cells in the brain to communicate with other brain cells called neurons. Under certain conditions, Serotonin is released into the neurotransmitters, which then affect neighboring cells. After the Serotonin is released, it's taken back up into the cell so that it can be used again. Each of the drugs used to treat OCD interfere with the Serotonin being recycled once it has been released. This allows it to spend more time outside the cell, where it can continue affecting other cells close by. Thus, allowing it to do its job longer. Researchers are still unsure why this works. The main SRI is Anafranil (Clomipramine) an older Trcyclic anti-depressant, which has an effect on other Neurotransmitters beside just Serotonin. Therefore, it's not selective. The main SSRI's are PROZAC (Fluoxatine), LUVOX (Fluvoxamine), ZOLOFT (Sertraline), PAXIL (Paroxatine), and CELEXA (Citalopram). Since OCD can come and go many times during your life, you and your family or others close to you need to learn all about OCD and its treatment. This will help you get the best treatment and keep the illness under control. Read books, attend lectures, talk to your doctor or therapist, and consider joining the Obsessive-Compulsive Foundation. A list of recommended readings and information resources is given at the end of this handout. Being an informed patient is the surest path to success.
How often Should I Talk with my Clinician?
When beginning treatment, most people talk to their clinician at least once a week to develop a CBT treatment plan and to monitor symptoms, medication doses, and side effects. As you get better, you see your clinician less often. Once you are well, you might see your clinician only once a year. Regardless of scheduled appointments or blood tests, call your clinician if you have:
  • Recurrent, severe OCD symptoms that come out of nowhere
  • Worsening OCD symptoms that don't respond to strategies you learned in CBT
  • Changes in medication side effects
  • New symptoms of another disorder (e.g., panic or depression)
  • A crisis (e.g., a job change) that might worsen your OCD
What should I do if I feel like Quitting Treatment?
It is normal to have occasional doubts and discomfort with your treatment. Discuss your concerns and any discomforts with your doctor, therapist, and family. If you feel a medication is not working or is causing unpleasant side effects, tell your doctor. Don't stop or adjust your medication on your own. You and your doctor can work together to find the best and most comfortable medicine for you. Also, don't be shy about asking for a second opinion from another clinician, especially about the wisdom of cognitive-behavior therapy. Consultations with an expert on medication or behavioral psychotherapy can be a great help. Remember it is harder to get OCD under control than to keep it there, so don't risk a relapse by stopping your treatment without first talking to your clinician.
What can Families and Friends do to help?
It is because of OCD, that members of the family feel confused and frustrated. They don't know how to help their loved one. If you are a family member or friend of someone with OCD, your first and most important task is to discover to the extent that one can about the causes and the treatment of the disorder. At the same time, you must be sure the person with OCD has access to information about the disorder. We highly recommend the booklet, "Learning to Live with Obsessive Compulsive Disorder" by Van Noppen et al. (Information on obtaining this and other educational resources is given at the end of this handout.) This booklet gives good advice and practical tips to help family members help their loved ones and learn to cope with OCD.    
Helping the person to understand that there are treatments that can help is a big step toward getting the person into treatment. 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. In some cases it may help to hold a family meeting to discuss the problem, in a similar manner to what is often done when someone with alcohol problems is in denial.
Family problems don't cause OCD, but the way families react to the symptoms can affect the disorder, just as the symptoms can cause a great deal of disruption and many problems for the family. OCD rituals can tangle up family members unmercifully, and it is sometimes necessary for the family to go through therapy with the patient. The therapist can help family members learn how to become gradually disentangled from the rituals in small steps and with the patient's agreement. Abruptly stopping your participation in OCD rituals without the patient's consent is rarely helpful since you and the patient will not know how to manage the distress that results. Your refusal to participate will not help with those symptoms that are hidden and, most important, will not help the patient learn a lifelong strategy for coping with OCD symptoms.
Negative comments or criticism from family members often make OCD worse, while a calm, supportive family can help improve the outcome of treatment. Try to be as kind and patient as possible since this is the best way to help get rid of the OCD symptoms. Praise any successful at tempts to resist OCD, while focusing your attention on positive elements in the person's life. You must avoid expecting too much or too little. Don't push too hard. People perform compulsions by trying to make their obsessions go away. Compulsions are the acts that the person does over and over again. For example, someone with an obsession about being dirty or contaminated might wash their hands over and over again, or someone with an obsession about burning the house down might check if the stove is off repeatedly. Living with OCD can be very hard because compulsions take up a lot of time and energy, making it hard to finish homework, do chores, or have any fun.  Today more people understand OCD, and there is a better treatment for it too. After reading about OCD, I think that it is a very serious disorder. It can affect people’s everyday lives in many harmful ways.
People with OCD can almost always be treated as outpatients
In very rare cases in which the OCD involves severe depression or aggressive impulses, hospitalization may be necessary for safety. When a person has very severe OCD or the OCD is complicated by a medical or Neuropsychiatric illness, hospitalization can sometimes be a useful way to give intensive CBT.
Maintaining Treatment Gains
When patients have completed a successful course of treatment for OCD, most experts recommend monthly follow-up visits for at least 6 months and continued treatment for at least 1 year before trying to stop medications or CBT. Relapse is very common when medication is withdrawn, particularly if the person has not had the benefit of CBT. Therefore, many experts recommend that patients continue medication if they do not have access to CBT. Individuals who have repeated episodes of OCD may need to receive long-term or even lifelong prophylactic medication. The experts recommend such long-term treatment after 2 to 4 severe relapses or 3 to 4 milder relapses.
Support Groups
Support groups are an invaluable part of treatment. These groups provide a forum for mutual acceptance, understanding, and self-discovery. Participants develop a sense of camaraderie with other attendees because they have all lived with OCD. People new to OCD can talk to others who have learned successful strategies for coping with the illness.
Obsessive Compulsive Disorder a disorder of anxiety and almost 1 in 40 adults are affected with this disorder. Not only men but also women are equally affected. Childhood is the time, when most of the disorders take effect. According to the perception of the general public, OCD occurs during adolescence, nevertheless the science decides against it. There are hundreds of obsessions and compulsions that the sufferers may have and it is hard for them to seek help, because they dont think that their behavior is out of the ordinary. Unfortunately there is no cure for OCD but there is help; therapy is the best way to deal with the disorder, but for others theres medication.


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