Do you wash your hands more than 30 times a day because of an intense fear of germs? Do obsessive thoughts such as causing tragedy, images of violence or inappropriate sexual thoughts constantly run through your head? What about perpetual doubts such as whether or not the front door is locked or if you turned off the stove? If so, you could be part of the two to three per cent of North Americans who suffer from Obsessive-Compulsive Disorder (OCD).
OCD is an anxiety disorder that leaves sufferers constantly troubled by persistent thoughts, images or impulses also called obsessions and/or compulsions. This forces them to perform repetitive actions or rituals that relieve discomfort or anxiety. Obsessions include aggressive, sexually repugnant or blasphemous impulses, thoughts and images. Compulsions are anxiety-reducing behaviour in the short-term and are unwanted, repetitive, distressing and difficult to overcome. They include repeated hand washing, checking, counting and/or hoarding behaviour.
According to the National Institute of Mental Health in the United States, OCD is more common than panic and bipolar disorders and schizophrenia, yet it is still commonly overlooked.
When asked about the probable causes of OCD, Sarah Brown Tesolin, the senior research assistant at the Fear and Anxiety Disorders Laboratory at Concordia, says there is a cognitive-behavioural perspective.
“It is believed that symptoms of OCD are a product of someone’s experiences and interpretations. We think of OCD as a set of learned behaviour.”
As an example, she uses someone who washes excessively.
“That person may have learned that by washing themselves they could reduce the amount of anxiety they are experiencing at the time. This reduction of anxiety is pleasant and may reinforce the person to attempt the same behaviour on another occasion. The anxiety, however, is only temporarily reduced. With time, this cycle of anxiety followed by temporary relief through specific type of behaviour becomes a vicious circle, and the behaviour itself becomes excessive and problematic.”
Begun in August 2001 by Adam Radomsky, Ph.D, the Fear and Anxiety Disorders Laboratory is a research unit within the psychology department that conducts research on the development and application of cognitive-behavioural models to anxiety disorders and related problems. Currently, it is involved in researching information processing related to various emotional states in OCD.
“Obsessions and compulsions cause marked distress. The compulsions or obsessions are incongruent with what the person would desire and they often desire change,” says Brown Tesolin.
“High states of anxiety and fear as well as depression are often commonly associated with OCD. Although, these states do fluctuate depending on the degree of stress the individual may be experiencing at a particular period in time.”
Rachel Hoffman, the founder and president of the Quebec Obsessive-Compulsive Disorder Foundation Inc. (QOCDF) adds a few more probable causes of OCD.
“In the genes, there [can be] a predisposition, and also a chemical imbalance where serotonin reuptake inhibitors are not functioning well. It is ‘the disease of doubt.’ Also some of it is brought on by socialization,” she says. “A mother can have three kids: one kid will follow in her footsteps and the other two kids are not affected.”
Speaking of children, OCD can start as early as preschool age and can go right up to adulthood usually by age 40. While one third to one half of OCD-affected adults report that the disorder started during adulthood, OCD often goes unrecognized.
Due to the fact that more attention is not being devoted to OCD, Hoffman does her part by holding support groups including a Concordia-based one. Starting on Oct. 3 from 6 p.m. to 8 p.m., these meetings will take place the first Thursday of every month in the basement of 2090 Mackay.
She strongly advocates attendance for students diagnosed with the disorder or who live with or know someone who has it.
“[In] a comfortable atmosphere, they can discuss their hopes and fears in safety and without shame. Also, they can get first-hand information and support. Each one feels they’re alone, but they’re not.”
She goes further by making a terrifying point. “Think of 25,000 students at Concordia and three per cent have OCD, which means 750 students.”
Besides founding the QOCDF in 1999, Hoffman was the community representative on the Research Ethics Committee for the Douglas Hospital for five years and has been a volunteer at AMI-Quebec since 1991 and was on the board for nine years.
AMI-Quebec is another organization concerned with mental illnesses. It is a non-profit organization celebrating 25 years of helping families cope with the effects of mental illness, through information, education, support and advocacy. Through raising public awareness, it wants to help dispel the shame and stigma often surrounding mental illness. Like the QOCDF, it also provides free support groups.
Ayala Conway, the administrative assistant at AMI, says people seek help for many reasons.
“Shame, feeling personal weakness if they can’t conquer it themselves,” she says. “Some don’t know that there are many others in the same situation. They don’t know where to go for help and don’t know their illness has a name.”
What is important to remember is that pharmacotherapy (medications) and cognitive-behaviour therapy (CBT) are currently the two effective treatments for OCD. Medications that are often prescribed are several of the tricyclic antidepressants such as Anafranil, Prozac and Luvox.
“CBT involves searching for evidence that supports alternate ways of thinking and using this evidence to help clients to engage in new behaviour. One main CBT technique called Exposure and Response Prevention (ERP) involves placing the client in a real-life anxiety-provoking situation and then preventing the client from carrying out his/her compulsive behaviour,” says Brown Tesolin.
“Several treatment studies have shown that ERP is quite successful at reducing the frequency, intensity and duration of compulsive activity.”
When all is said and done, one must remember that support and treatment is available.
“In our support groups, we’ve had wonderful success stories and have licked this monster,” says Hoffman. “[OCD] needs a proactive attitude and along with medication and/or therapy, you can lead a very productive life.”
If you are interested in the support groups offered by the Quebec Obsessive-Compulsive Disorder Foundation Inc., the first meeting is on Oct. 3 from 6 p.m. to 8 p.m. in the basement of 2090 Mackay. For further information, you can call Rachel Hoffman at 624-4036. If you are interested in the support groups offered by AMI-Quebec, call 486-1448. Lastly, if you find yourself troubled by obsessions and/or compulsions and are interested in helping out with research, you can call the Fear and Anxiety Disorders Laboratory at 848-2199 or visit them in PY-051.