by Noor Farihah binti Rozali
Have you ever seen people wash their hand roughly and keep repeating the same thing all over again? Or take a long shower due to fear of germs and contamination? Do you have friends who constantly check all doors to make sure they are locked or who check their items for many times to ensure that everything is put in the correct order according to their size and colour? If yes, you don’t have to feel worried because they are not dangerous, and they can be treated.
All situations mentioned above are symptoms associated with Obsessive Compulsive Disorder or in short, we can call it OCD. OCD is an anxiety and mental health disorder caused by an imbalance in neurotransmitters that can cause extra discomfort to those who experience it. OCD is a common, chronic (long-lasting) disorder in which a person has uncontrollable, reoccurring thoughts (obsessions) and behaviours (compulsions) that he or she feels the urge to repeat over and over in response to the obsession (NIMH, 2016).
Those who live with OCD can be categorised as washers (they are afraid of contamination so they tend to wash things over and over again), checkers (as they repeatedly check things to make sure all are locked, off and so on because they are afraid of danger), doubters (having doubt if everything is not perfect or done just right, something terrible will happen, sinners (think that they will be punished if they did something wrong, counters (they may have delusions about certain numbers, colours or arrangements) and arrangers (obsessed with order and symmetry) (Pietrabissa, et al., 2015).
Back then, when I was a journalist, I did a special news report about OCD and interviewed one patient with a very bad OCD to the extent that she had to seek treatment from Kuala Lumpur Hospital. She told me that she first experienced OCD-related symptoms when she was 13, but she never knew that she had it back then. Her family members started to sense something was wrong with her when she started spending almost five hours a day just to shower. Can you imagine how hard is that situation? Her OCD got worse when she entered college because whenever she went for her classes, she would go back to her hostel just to make sure that she had all her doors locked. This then caused her depression. She said no one wanted to be her friend as her OCD was disturbing. Then her parents took her out from college for a while to give her special treatment and now she is getting better.
Sometimes, we may think that situation is somewhat normal, but OCD patients really need help and treatment. We may think that it is good to have OCD because our house will remain clean, tidy and everything will be in order, but it is not easy to live with those who have OCD. Can you imagine if you are married to someone with OCD? You would have to face his or her frustration and anger each time you make a mess? You might even have to wait for hours just for your partner to get ready whenever you want to go out. This could affect your relationship. Yes, I am married to an OCD person and I know how it feels.
The most important thing is that we need to support those with OCD and help them. In my situation, for example, I always remind my partner not to take his shower for too long or not to wash his hand roughly as they are already clean. We need to distract them from doing something repeatedly. But if things are getting worse, we need to take them to get special treatment like cognitive behaviour therapy (CBT) or medication.
OCD can affect both adults and children. However, there is nothing to be worried about as OCD can be treated even it takes time. In general, CBT teaches OCD patients with different ways of thinking, behaving, and reacting to the obsessions and compulsions (NIMH, 2016). Exposure and Response Prevention (EX/RP) is a specific form of CBT which has been shown to help many patients recover from OCD. EX/RP involves gradually exposing OCD patients to their fears or obsessions and teaching them healthy ways to deal with the anxiety they cause (Rajashekharaiah & Verma, 2016). Other therapies, such as habit reversal training, can also help to overcome this compulsion.
Besides that, doctors may prescribe different types of medications to help treat OCD patients, including selective serotonin reuptake inhibitors (SSRIs) and a type of serotonin reuptake inhibitor (SRI) called clomipramine (Stein, 2013). SSRIs and SRIs are commonly used to treat depression, but they are also helpful for the symptoms of OCD. SSRIs and SRIs may take 10–12 weeks to start working, longer than required for the treatment of depression. But one needs to remember that these medications may cause side effects, such as headaches, nausea, or difficulty sleeping. People taking clomipramine, which is in a different class of medication from the SSRIs, sometimes may experience dry mouth, constipation, rapid heartbeat and dizziness. These side effects are usually not severe for most people and improve as treatment continues, especially if the dose starts off low and is increased slowly over time.
In addition, another thing that OCD patients can do to overcome their conditions are first, learn triggers that worsen the symptoms to come out with effective coping strategies. Secondly, get enough sleep as it is good to have relaxing time and resting mind. Thirdly, one must consume nutritious food to have a good physical health. Fourthly, break big problems down into small chunks to get everything in a good order and ensure that things are manageable. Next, deal with issues immediately and keep calm. Lastly, address the emotion where OCD patients can find a trusted and comfortable person to share their feelings with. Talk to a friend if one is feeling sad, depressed, or angry about. Invite friends to go somewhere or do something to remove self from the situation.
In a nutshell, those with OCD are not dangerous, but they need to get help and treatment for them to have a better life. We must try to help them, support them, understand their situation and encourage them to get better. For those who are living with OCD, no need to worry because they will get better soon if support is given to them. It just takes time and do not give up.
NIMH. (2016). OBSESSIVE COMPULSIVE DISORDER: When Unwanted Thoughts or Irresistible Actions Take Over. National Institute of Mental Health.
Pietrabissa, G., Manzoni, G. M., Gibson, P., Boardman, D., Gori, A., & Castelnuovo, G. (16 Deecember, 2015). Brief strategic therapy for obsessive–compulsive disorder: a clinical and research protocol of a one-group observational study. BMJ Open.
Rajashekharaiah, M., & Verma, P. (2016). Phenomenology of Obsessions and Compulsions in Indian Patients. International Journal of Contemporary Medical Research.
Stein, D. J. (2013). Obsessive compulsive disorder. South African Journal of Psychiatry .