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June 14, 2015, last updated June 18, 2015
By LOUISE CARR, Associate Editor and Featured Columnist



Everyone has to double check sometimes. Okay, did I lock the door? Can't remember. Back down the road to check. At some point you’re going to panic that you left the iron or the stove on and have to return and make sure. That's normal. But there comes a time when the checking and double-checking trigger a doubt in your mind that you really are normal. 

And thus begins a struggle, to refrain from checking, to resist an urge  to doubt your memory --- to doubt your self --- that gets stronger and stronger.  Has an invisible line been crossed? Has my memory become my enemy. Has my mind starting to undermine my well-being?

If you are one of the 2.2 million American adults who according to the National Institute of Mental Health suffers from obsessive compulsive disorder (OCD) , you are whipsawed by this type of inner struggle every day of your life. Many famous people have been diagnosed as having OCD, including actress Lena Dunham of the HBO "Girls".


With OCD you repeatedly feel the need to check things, or you have intrusive thoughts and compulsions to perform certain rituals over and over again. Because you feel you have lost control over the decision --- the impulse --- to double check, you begin to feel like a puppet whose strings are being pulled by something else. 

The thoughts and the compulsive actions cause distress and interfere with daily life. Trying to hide these actions from other people through fear or shame also makes everyday life tough.


Do you need to constantly check the lights are off or the doors locked? Do you obsessively wash your hands? Does this mean you have OCD? How many times do you have to redo something for OCD to be diagnosed?


What is OCD?


There’s a difference between being a perfectionist, being forgetful, or liking a clean house, and having OCD. You may joke that someone has OCD when they like their books arranged a particular way on their shelves.  But the truth is that OCD is more than a simple desire for neatness, cleanliness and order.

People with OCD experience frequent, overwhelming and upsetting thoughts, called obsessions. To try to control these thoughts, the person feels an overwhelming urge to repeat an action – called a compulsion.


If you have OCD you cannot control these compulsions. 

Repeating the rituals does not feel pleasurable and at best you only get temporary relief from the fear and anxiety caused by the upsetting thoughts.

You can have your own rituals when you do not suffer from OCD, such as a particular way of checking the house before you leave, or a particular way of washing your hands. But if you have OCD you must repeat things to the extent that the need for repetition interferes with your daily life and cause significant distress.

Take note! Just to muddy the waters, there is also a condition called "obsessive compulsive personality disorder", also known as OCPD. While people with OCD have unwanted thoughts, people with OCPD believe their thoughts are correct. The sufferers of OCPD are concerned with rules, control and order. They becomes upset if anyone interferes with their strict routines. They lack flexibility and become withdrawn when they cannot control a situation. According to a 2005 study from Brown University, there is evidence that OCD and OCPD are linked but the majority of people with OCD (75%) do not have OCPD. Similarly, the majority of people with OCPD (80%) do not have OCD."


What Are the Tell-Tale Symptoms of OCD?

 

 

 

 

 

 

 


Symptoms of OCD involve obsessions and compulsions. Obsessions are repeated and include unwanted urges and images that cause distress and anxiety. These urges may have themes such as germs and dirt, the need for symmetry and order, aggressive thoughts of harm to yourself or others, or unwanted sexual thoughts.


Compulsions are repetitive behaviors you feel driven to perform. The compulsive behaviors are designed to reduce the anxiety or distress related to your obsessions, or to prevent the bad thing you fear from happening.

Compulsions also follow themes including washing and cleaning, checking, counting, touching, following a strict routine, demanding reassurances, and orderliness.


What Causes OCD?


No one really knows what causes OCD. Experts suggest that OCD may be the result of changes in your brain function or your body chemistry. According to a 2013 study led by Dr. Dennis Murphy of the National Institute of Mental Health, people with OCD often suffer from other conditions such as major depression (over 70%) and bipolar disorder ( more than 10%).

Genes may play a part, or possibly infections. Stressful life events are also believed to trigger the intrusive thoughts and compulsions.


You may not know why you have OCD. You may not even be sure if you are suffering. How do you tell?


What Are the Tests for OCD?


OCD is diagnosed by your doctor or mental health provider and the tests and diagnoses are different in each case. There may be a physical exam to rule out any other physical issues that could be causing your symptoms. In addition, a doctor may run lab tests to ascertain how well your thyroid is working, and to rule out any other complications.


But the main test for OCD involves a psychological evaluation. To be diagnosed with OCD you must meet the criteria for the disorder as laid out in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This tome is published by the American Psychiatric Association.

General criteria include having obsessions or compulsions, or both, which are significantly time consuming and affect your normal functioning at work or socially.

Obsessions must be recurrent and persistent, and cause distress. You try to suppress these impulses with compulsive behaviors. These compulsive behaviors are repetitive and are meant to reduce distress, but they are so excessive that they become a problem in themselves.


Checklist of OCD Symptoms


Do you identify with any of the following symptoms?
•    Fear of contracting a terrible disease
•    Excessive fear of dirt
•    Overwhelming need to arrange objects in a specific way
•    Overly concerned about the neatness of your environment
•    Unwanted sexual thoughts that you view as inappropriate
•    Repetition of routines for no real reason
•    The need to repeat a routine until it is just right
•    Repeating questions many times
•    Fear of hurting someone or having hurt someone
•    Excessive hand washing or showering
•    A belief that certain numbers are lucky or unlucky
•    Repeatedly checking appliances and doors
•    Need to tap or touch objects repeatedly
•    Counting compulsions

It is often difficult to diagnose OCD because the symptoms are similar to other mental health conditions like depression and schizophrenia.

There are quizzes and tests for OCD on the internet but it is worth remembering that there is no substitute for a diagnosis from a professional mental health specialist.

In fact, your own search patterns may give you a clue. If you find yourself obsessively answering these quizzes, print out the results and take them to a mental health professional for a full investigation of the causes of your symptoms.
 



























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