Obsessive compulsive disorder (OCD) is a chronic disorder in which a person has re-occurring thoughts (obsessions) and compulsions (behaviors) that the person repeats over and over. There is an urge for this repetition. These obsessions, compulsions, or both, can disrupt a person’s’ life, interfering with relationships, careers, school, and social life. Diagnosis is typically determined by the Yale-Brown Obsessive Compulsive Scale (Y-BOCS). This disorder is quite common, and many people finally are diagnosed around the age of 19.
The exact cause of OCD is unknown. However, genetics might play a part, possible abnormalities in certain parts of the brain may be at fault, or this could occur as a result of a person’s environment (sexual abuse or physical abuse).
There are several signs and symptoms to look out for. Some people may only experience obsessions, others might only experience compulsions, and some experience both. Obsessions deal with repeated thoughts that cause anxiety. A person might have a fear of germs, they might need things in a specific order, or that might have unwanted taboo thoughts. Compulsions are repetitive behaviors that might include cleaning, handwashing, double checking things, or counting.
In general, everyone does some of these actions every now and then. The difference is that a person with OCD is not able to control this. At the very least, one hour of their day is consumed by these thoughts and behaviors. They do not check the door four times to make sure it is locked or count the number of cracks on the sidewalk for pleasure. Rather, the ritual is necessary to relieve anxiety. These thoughts and behaviors disrupt life. Persons with OCD might isolate themselves and try to avoid situations they know will interfere with rituals or might be noticeable to others.
When it comes to eating and exercise, OCD can influence a person’s behaviors. Many of the symptoms associated with obsessive compulsive disorder are related to binging and purging and food restriction. Two thirds of people with eating disorders have an anxiety disorder, specifically OCD that contribute to anorexia nervosa and bulimia nervosa (Kaye WH, Bulik CM, Thornton L, Barbarich N, Masters K. Comorbidity of anxiety disorders with anorexia and bulimia nervosa. Am J Psychiatry. 2004;161(12):2215-21. doi:10.1176/appi.ajp.161.12.2215). Certain types of foods might be avoided, eliminated, or even excessively eaten. Counting and calculating become extreme. Eating in public can be difficult or non-existent. This can also transcend into exercise habits. The person can try to exercise until they feel they have negated what they have consumed. Body image is the underlying issue coupled by the need to control or fix what the person perceives and intolerable. What the person sees in the mirror and what everyone else sees are very different images.
The person can be stuck on how much food or when they have to eat or what they have to eat to the point that daily living is greatly disrupted by these obsessions. Preparing or shopping for “safe” foods takes priority. Binges can lead to such physical discomfort to the point that the person can’t move for the rest of the day. Hours on end can be devoted to exercise such as reaching as certain calorie count, time, or certain amount of working out. Obsessions have taken over and this lifestyle has become dangerous. The person is trying to control their body with obsessions, but really, they have lost control of their health in the process of doing so. The nature of OCD is too much or not at all. Healthy eating and healthy exercise can become unhealthy when they cause anxiety and non-stop attention. How can a person maintain a job, family, or relationships living this way? The answer is they learn to function until it is too late and without help life can’t go on this way.
There is help. One can use therapy or medication, or both. Serotonin reuptake inhibitors (SRIs) and selective serotonin reuptake inhibitors (SSRIs) are used to treat OCD. Understanding the side effects and interactions with other drugs is important. Children often use psychotherapy, specifically cognitive behavior therapy, to help with behaviors. Symptoms may come and go. Some grow out of this disorder; others aren’t struck until adult life. Having OCD can be debilitating for some people because they are not able to function efficiently due to the burden of their constant and chronic obsessions and compulsions. A person with OCD is aware of their predicament but doesn’t feel in control to find peace with their actions. Seeking help is necessary to regain the enjoyment of everyday life, which is very possible.
