OBSESSIVE COMPULSIVE DISORDER AND ADDICTION

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OBSESSIVE COMPULSIVE DISORDER AND ADDICTION

Obsessive Compulsive Disorder earlier was part of Anxiety Disorders but in the latest Diagnostic and Statistical Manual of Mental Disorders it has been given a standing of its own.

OCD has been a topic of comedy , parody or horror in movies -Jack Nicholson’s character in As Good As It Gets , sitcoms like Monk etc. It can be a very debilitating, restricting disorder. Isolating oneself and isolation of oneself from social circumstances and people become the norm.

It is characterized by repetitive ritualistic behavior related to grooming , counting, organizing things, excessive cleaning etc which generates anxiety and fears if not followed through and also anxiety and fear if one does follow through with the action and intrusive repetitive thoughts. The rituals are never enough to ease tension.


Characteristics

  • The fear of germs, bugs, termites , contagious ailments .
  • The anxiety of unclean substances or environments .
  • The fear of harming others or harming oneself .
  • The fear and anxiety that a loved one will be harmed.
  • The fear of illness and resulting anxiety to a hypochondriacal level .
  • The fear of forgetting things or losing possessions .
  • Anxiety about offending religious sentiments an personal superstitions .
  • A preoccupation or superstition about certain numbers and counting eg, going to the loo 3 times, touching somebody a particular number of times etc .
  • An obsession with symmetrical placement in objects .
  • Repetitive intrusive sexual thoughts and sexual imagery .
  • An obsessive fear of being “bad” or “evil,” or a fear of doing evil things .

The following repetitive compulsions are frequently observed in people with OCD:

  • Handwashing , bathing, grooming etc .
  • Superstitiously counting objects .
  • Cleaning , arranging and re arranging things in one’s house or office .
  • Organising things in a particular order eg color coding , stacking as per size etc .
  • Checking one’s body, skin, or hair for flaws .
  • Arranging things repeatedly in order .
  • Reviewing one’s actions over and over again to see if one has harmed someone else or committed a sin .
  • Repeating activities or movements, such as tapping one’s foot or taking steps, a certain number of times locking doors and checking them, turning on and off the light switches etc .
  • Hoarding or collecting items that have little or no value to anyone else People with OCD may know that their behaviors and thoughts are irrational or unrealistic. But they are unable to control or stop them .

CAUSES/ ORIGINS FOR OCD

Individuals with OCD usually have been seen to have an experience of sexual abuse or molestation in the past following which the symptoms have been elicited.

Another theory is of an imbalance of serotonin in the brain , a neurotransmitter involved in emotional regulation, moods, metabolism, sleeping patterns, and vasopressin, a hormone that affects fluid regulation and cellular function, have been associated with the behaviors and thought processes of OCD. Structural abnormalities in the frontal lobes and basal ganglia of the brain — areas associated with cognition and movement — have also been identified in people with OCD.


OCD AND ADDICTION [ Dual Diagnosis]

In individuals who have OCD from childhood is most likely to get into substance use and addiction as substances are seen to reduce anxiety and internal tension . The substances that are usually seen to do this are downers like weed, hash and alcohol . As children with OCD they are often teased and bullied by other children and face a lot of social isolation , timidity , shyness, low self - esteem etc. and hence follow easy prey to substance use and abuse, to look cool, fit in with the peers and the major, reliever of anxiety and terror.

Using can be alone or as a social lubricant as they isolate themselves to be housebound because of their several severe anxieties and repetitive intrusive thought processes.


SOLUTIONS

People with OCD manage to hide their symptoms and distress for so long from their families that help received is often very late and they also then manage to hide the substance use and abuse from those around them .

Many times anti depressant medications are known to help in easing ou the anxieties and distress in OCDs.

For a combination with Addiction an integrated approach is required.

Counseling Solutions- The OCD fears and symptoms are faced and acted upon so that the individual has the experience of realising that facing one’s fears one by one and countering them with reality without or despite the anxiety surfacing helps in getting beyond the Obsessive Compulsive thought processes.

Introspective writing enables one to safely watch and detach one’s emotions from personally perceived painful incidents .

Meditative techniques – For those suffering from OCD and Addiction, active meditative techniques which involve the body help more as any technique involving sitting still will lead to overworking of the already overworked mind.

An environment that is accepting, non- judgemental, patient and compassionate wherein one on one counselling can be done in tandem with working with a psychiatrist for medication works best. We at Anatta provide such an environment .

Help is available.

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