OCD is not an everyday disorder

Have you wondered why your colleague obsessively scrubs her hand till it’s almost bruised or why your boss always insists on keeping his eclectic collection of pens arranged in a particular order? That’s perhaps because they both suffer from a kind of anxiety disorder that they are either unaware of or choose not to speak about.

Obsessive-Compulsive Disorder or OCD is a chronic, anxiety disorder that is misunderstood and misinterpreted by many. Often, people assume OCD as an issue related to personal hygiene and perfectionism. In reality, however, OCD is much more than washing hands or organising pens in a certain order. It is about the anxiety victims face­­ while curbing intrusive thoughts such as the presence of germs everywhere, or dealing with disarray in everyday life. That is why the roots of OCD go way deeper into the subconscious mind of a person and distort their perception. “What sets apart those who are suffering from an anxiety disorder, of which OCD is one, is another idea, unspoken, but powerful, that lies underneath the surface. It is the idea that danger is lurking everywhere,” writes Dr. Fredric Neuman, Director of the Anxiety and Phobia Treatment Centre, on his blog.

The unspoken idea that New York-based psychiatrist Dr. Neuman talks about, is rather elusive in nature. Only people suffering from OCD realise they are going through it. Those witnessing it, perceive it as a personality quirk rather than a disorder. Owing to the low awareness around the disorder, people associate OCD with various commonplace activities, such as cleaning the house till it is spotless. Albert Rothenberg, professor of Psychology at Harvard University explains the difference between “liking” a clean house and obsessive cleanliness. “In the latter, you will have the presence of rigidity, excessive attention to detail, preoccupation with control of disorder and dirt. The latter can be measured by amounts of time spent on cleaning, intolerance of the slightest disarray or disorder, and punitive response to change or interference by others,” says Rothenberg.

Another major misconception around OCD is that it can be tamed by a person suffering from it if he chooses to. How hard is it to control irrational behaviour? Dr. Ashlesha Bagadia, a clinical psychiatrist, dispels the notion that it can be tamed: “There is repetitive behaviour to reduce the anxiety caused by the obsessive thoughts, but the repetitive compulsions don’t reduce the anxiety much, and they can get caught up in a vicious cycle of obsessive thoughts and compulsive behaviour.” Once anxiety kicks in, it springs compulsive behaviour that fuels the anxiety even further—it becomes a process that runs on itself, making OCD difficult to control.

Take the case of Aditi, a young mother, who had been struggling with OCD for more than five years. Aditi had compulsive cleaning behaviour and contamination phobia. She couldn’t use a washroom if someone had used it before her. She would spend hours cleaning the bathroom or bedroom, even if someone touched an object. Aditi even had to quit her job because of her obsessive compulsions. Her husband supported her, but in his own ways. For the most part, he believed her condition was incurable, and only she could control her OCD through a strong will and determination. However, not everyone can rise above OCD just through willpower. Dr. Bagadia explains, “For people with OCD, they never know when the anxiety will grip them and when they will lose control. They are unhappy about their own condition but feel compelled to act that way anyway. That’s why they are called compulsions.” Aditi’s condition took a turn for the worse when she had her first child.

OCD tends to worsen during pregnancy and the postpartum period because it’s the most unpredictable time for a woman, and people suffering from OCD struggle with unpredictability. “Being anxious during pregnancy can cause a lot of harm to the developing infant. During the postnatal stage, the infant can be fussy, and not easily soothed by a mother who’s anxious herself,” adds Dr. Bagadia. Aditi eventually realised that if she didn’t get professional help, it would affect her relationship with the child. With her husband’s support, she sought help. They both spent time understanding the condition and the best option for treatment—a combination of medication and therapy. After months of therapy and support from her husband, Aditi was free from her illness. Now, she spends her days enjoying being a mother and is looking forward to getting back to work as well.

Family and friends play an important role in one’s battle against OCD. Without them or any other emotional support, an individual with OCD may find it quite difficult to escape its perils. Consider 45-year-old Ashok, who lived alone in an apartment. He lost his mother when he was young and had no siblings. When his father, too, passed away, his OCD worsened. Ashok had obsessions around symmetry and numbers, which were followed by checking behaviour that would go on for hours every day. To suppress his anxiety, he would arrange his desk in a particular order every morning, spend hours going through reports, miss deadlines and often argue with his co-workers if something was not done the way he preferred them done. Due to his compulsive behaviour, Ashok sunk into depression. That’s when his boss came to the rescue.

He connected Ashok to a therapist who suggested behaviour therapy to reduce his compulsive behaviour. The therapist helped Ashok look beyond his trauma of losing his parents, which was a trigger for his OCD. Through daily practice, Ashok was able to overcome his disorder and return to normal work life.

When others start recognising OCD as a disorder, and not some “everyday behaviour”, it becomes easy for patients to cope with their anxiety. It is an assurance that they are not alone in their battle. “Many people don’t open up for the fear of being teased or laughed at, especially for something that looks trivial to the observer but can be really painful to the sufferer,” says Dr. Bagadia. The first step for any family member or a friend is to build trust. Once a person suffering from OCD feels comfortable sharing his predicament, people can suggest corrective measures to deal with it. “Family members should strongly encourage possible long-term psychotherapy and ensure the patients take their medication, refuse to comply with obsessive and compulsive demands for absolute cleanliness and rigidities of behaviour, etc. The most important is to support and maintain optimism about continuing treatment,” adds Rothenberg. The assurance of not being alone is bigger than any intrusive thought or compulsive idea. If those with OCD have the unflinching support of their loved ones, they can win their battle quite comfortably.