The truth about obsessive compulsive disorder

By Time of article published Jul 28, 2005

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By Charlotte Dovey

Until just two years ago, I spent at least three hours in the bathroom every day. While most people would be happy with a quick shower, I had to spend two hours in the bath, washing every part of my body three times.

As soon as I got out of the bath, I'd spend another 40 minutes or so in the shower. I'd get through two bars of soap every day, countless bottles of shampoo and shower gel and, despite knowing this was not "normal" behaviour, I couldn't stop myself.

The first memory I have of obsessive compulsive behaviour was when I was about 10. The condition can manifest itself in many different ways and change regularly, so my first sign was hoarding magazines. I kept years worth of them "just in case".

As I turned 11 or 12, I began to feel I had to keep my desk at home and school spotless, and every object had to be at a certain angle or I couldn't rest.

Bizarrely, for a non-religious person, I also started saying the Lord's Prayer every evening.

I had to repeat it three times without interruption or I couldn't sleep.

It started to be more of a problem when I was 17 and I began to have an obsessive fear of contamination from the outside world - particularly public toilets.

I believe the catalyst for this was my first job, working in the motor industry. The longer I worked in the oily, spare parts department, the worse it became.

Every evening I spent hours in the bathroom decontaminating myself. If my brother interrupted me, I'd have to start again. Then do it two more times to complete the ritual.

Medical experts are divided over the causes of OCD. One school of thought is that the condition is caused by a chemical imbalance within the brain because of low levels of neurotransmitters - chemicals that act as messengers between cells in the brain and the nervous system.

The second theory is that a person develops learned negative thoughts and behaviour patterns due to certain life experiences.

At 26, I moved to London to work as an IT technical support consultant and gradually realised I didn't have much of a life.

The stress of a new flat, new friends and a new job made it worse. I was so concerned with being contaminated when I was out that I couldn't wait to get home at the end of the day to wash.

On particularly bad days, I'd get through the door feeling such panic that I couldn't relax until I'd taken off my clothes, put them in a bin bag and thrown them away.

This happened at least five times in two years and the replacement of suits, shirts, ties and shoes cost me thousands of pounds.

But I was prepared to go through this because, in my mind, they would never be clean again. Equally, there were occasions when three hours just wasn't enough to get rid of all the germs.

My record, if you could call it that, was walking through the bathroom door at 6pm and not coming out again until 11pm.

With this daily ritual, I had no social life or girlfriends. In retrospect, it would have saved a lot of heartache to simply tell people what was going on.

But, like most OCD sufferers, I found it difficult to talk about.

Not only did I find it embarrassing, but I believed people would label me weird or tell me to "snap out of it". I was trapped by this condition. As much as I wanted to be normal, the OCD wouldn't let me.

It was a complete mental block and as difficult to resolve or rationalise as a fear of heights or flying. It wasn't until I saw an episode of Casualty, when I was 27, that I knew my condition had a name. It was a revelation. I made an appointment with my GP and thought he'd solve all my problems in a 10-minute consultation.

But when I told him I thought I had OCD, he said rather irritatingly: "What's that?" I walked out of that surgery feeling extremely alone.

Determined not to give up, I decided to go through my private health insurance. With their help I was referred to The Priory Hospital in Southgate, north London.

I saw a psychiatrist for an hour a week. The treatment they offered was cognitive behavioural therapy (CBT), a "talking treatment" which identified how negative thoughts affect us and then looked at ways of tackling them.

I learned a lot about the condition, but CBT didn't work well for me. After six weeks I decided I'd got as much out of the treatment as I could. But I didn't want to go down the anti-depressant route.

Fortunately, after hours of research on the condition and chatting to other sufferers at the hospital and on the Internet, I was recommended the self-help book Brain Lock: Free Yourself From Obsessive-Compulsive Behaviour, by Dr Jeffrey Schwartz (not available in South Africa. The ISBN number is ISBN 0060987111).

It is based on a cognitive behavioural therapy which has four steps: Relabel, Reattribute, Refocus and Revalue. The goal of step one is for the sufferer to recognise intrusive thoughts and urges as obsessions and compulsions.

In step two you must reattribute the thought or urge to its real cause - a biochemical imbalance in the brain.

The aim of step three is to refocus attention on more constructive behaviour, and the final step is about revaluing the obsessive thoughts so you realise they are not worth paying attention to.

After hours reading the book, and with the support of other sufferers, I started to have the confidence to reduce my washing time. Instead of spending three hours in the bath, I'd spend two.

Instead of washing every part of my body three times, I'd try to do it once. And eventually I broke the cycle when, late one evening, I told myself I was simply going to use the bathroom, wash my hands and go to bed.

In that instant, I knew I was stronger than the OCD which had ruled my life for more than 20 years. This strength and knowledge enabled me to give up my job and set up a charity devoted to people affected by OCD, providing information that previously was scant.

It's been two years since my breakthrough and I believe I'm 95 percent cured. Of course, I still wash my hands a little longer than most people; but reducing it to just 20 minutes is a miracle for me.

I now have a social life, can use a public toilet and, most importantly, can live like any other normal 32-year-old.

Signs and symptoms of OCD

Obsessions:

- Recurrent and persistent thoughts, impulses or images that are usually experienced as senseless;

- The person attempts to ignore or suppress these thoughts, impulses or images.

Compulsions:

- Repetitive and ritualistic behaviour e.g. washing, checking, ordering, or mental acts (praying, counting, etc.);

- The person often completes a compulsion in response to an obsession.

Examples:

- Concerns about dirt and germs, leading to excessive washing and cleaning;

- Thoughts about possible harm, repetitive checking;

- Concerns about symmetry, leading to repetitive ordering;

- Thoughts about saving things, leading to excessive hoarding of objects;

- Intrusive blasphemous images, leading to repetitive praying.

Myths and Facts

Myth: OCD is a rare problem. It is hardly ever seen by doctors and psychiatrists.

Fact: OCD is very common. People with OCD often are too ashamed to get help, and they sometimes have the illness for years without getting treatment.

Myth: OCD is caused by stress or worry. It is seen only in people who are unable to resolve a psychological conflict.

Fact: OCD is not related to stress or worry or psychological conflict. OCD can be seen in all kinds of different people.

Myth: OCD is a medical condition that is best treated by simply "pulling oneself together".

Fact: OCD is best treated by medication and specific psychotherapy techniques.

Questions and Answers

Question: What causes OCD?

Answer: OCD seems to involve a brain chemical called serotonin, and a brain region called the basal ganglia. Genetic and environmental factors play a role.

Question: Why has OCD only recently been recognised as common?

Answer: People hide signs from friends and relatives, and may even avoid seeking professional help.

Question: How is OCD best treated?

Answer: The best agents are a group of anti-depressant medications that work on a brain chemical called serotonin.

Where to get help:

Obsessive Compulsive Disorder UK

Visit the Mental Health Information Centre of South Africa at the University of Stellenbosch: 021 938 9229.

Depression and Anxiety Support Group: 0800 567 567.

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