Durban - All of us, now and then, go back and double-check whether we have unplugged the iron or locked our car doors. That’s normal.
All of us worry about things from time to time. “Did I lock the back door when I left home?” or “Did I switch off the stove plate?” These thoughts might pop up in our minds a few times, bother us for a short period, but we soon settle down and go on with life as usual.
However, in the case of individuals with OCD, obsessive thoughts and compulsive behaviours become excessive.
For example, in a youngster who is obsessive about cleanliness, this habit becomes a disorder when it starts to get in the way of his everyday activities.
His concerns about cleanliness can become so severe that he:
*l Avoids touching certain family members because he is afraid of getting contaminated.
* Washes his hands so often that they become chapped and bleed.
* Avoids going to school for fear of contamination.
* Is not able to turn on the TV because others have touched it.
* Spends hours every day consumed with cleanliness-related rituals.
Besides being washers or checkers, OCD individuals could be:
* Doubters – those who are afraid that if everything isn’t perfect or done just right, something terrible will happen.
* Hoarders who fear that something bad will happen if they throw anything away. They compulsively hoard things, even things that they aren’t likely to need.
* Have persistent thoughts relating to violent actions, such as hurting or killing someone dear to them, eg, a mother who obsesses over throwing her crying infant out of an open window.
* Persistent thoughts of performing repugnant sexual acts or forbidden behaviours.
* Copro-lalia (repeatedly uttering swear words) or copro-praxia (repeatedly making obscene gestures).
* Troubled by thoughts that are against one’s religious beliefs.
* Following rigid rules of order (for example, putting on one’s clothes in the very same sequence every day, keeping belongings in the room in a very particular way and becoming upset if the order becomes changed). They may have superstitions about certain numbers or colours.
* Repeating words spoken by self (pali-lalia) or others (echo-lalia); repeatedly asking the same questions.
* Repeating sounds, words, numbers, or music to themselves.
No matter what the OCD sufferer does, he/she seems unable to shake off these thoughts and behaviours.
Usually, compulsions are performed to try to make the obsessions go away.
When this has been done, the sufferer feels relieved but, sadly, this relief doesn’t last long. In fact, the obsessive thoughts usually come back even stronger.
One of the greatest wishes of parents of an OCD child is to help their child break free of the disruptive, relentless thoughts, actions and bizarre symptoms that appear to enslave the youngster.
In therapy sessions, we often see and hear moms’ and dads’ determination to want to conquer the OCD monster.
What causes obsessive-compulsive disorder?
The cause of OCD is not known. Some researchers believe that OCD happens when people don’t have enough serotonin (a brain chemical). Many other factors could contribute to OCD, including:
* Family history. OCD happens more often when children and teens have family members with OCD.
* Life events. OCD is sometimes triggered by stress. For example, hand-washing can be triggered by media reports about germs or epidemics.
* Infection. In rare cases, OCD may be caused by bacterial infection (streptococcal).
Fortunately, with systematic treatment, OCD sufferers can break free of these unwanted thoughts and irrational urges and take back control of their lives. It’s not easy but it can be done.
Treatment
OCD can be effectively treated, usually with a combination of individual therapy and medications.
Individual therapy usually includes both cognitive and behavioural techniques. These “talk-therapies” focus on helping individuals identify and understand their fears and learn new ways of reducing them.
Medications help by balancing brain chemicals.
Parents have an important supportive role to play in the treatment process. If you have an OCD child:
* Learn as much as you can about OCD and how to cope with it. Sit down as a family and decide how you will work together to tackle your loved one’s symptoms. Try to keep family life as normal and as stress-free as possible.
* Stick with your regular activities. Don’t let OCD hold you back from your routine of going to work or school, or spending time with family and friends.
* Try not to make negative comments or criticise. Keep calm and focus on the sufferer’s positive qualities.
* Be patient. Remember, each sufferer needs to overcome his problems at his own pace. Praise any successful attempt he makes to fight OCD.
* Do not play along with his OCD rituals. Helping the sufferer with rituals will only reinforce his unwanted behaviour. Support the person, not his rituals.
* Join a support group for people with OCD – people who face similar challenges.
* Find healthy outlets for your energy, such as hobbies and recreational activities. Regular exercise, eating a healthy diet and getting adequate sleep can also help.
* Learn to relax and control stress by doing meditation, muscle relaxation, deep breathing, yoga or tai chi.
Prevention of obsessive-compulsive disorder
We don’t know enough yet about how to prevent OCD. But we do know that early detection and treatment can help to reduce the severity of the symptoms.
* Ramphal is an educational psychologist with special interests in career counselling and the learning and behaviour problems of children and adolescents. Visit www.ramphaledupsych.co.za.
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