No Escape from the Mind

No Escape from the Mind

For many years only a small number of patients reported OCD symptoms to their doctors.

It was thought that OCD was a rare disorder. A survey conducted in the early 1980s by the

National Institute of Mental Health provided new knowledge about the prevalence of OCD.

The NIMH survey showed that OCD affects more than 2 percent of the population, meaning that

OCD is more common than such severe mental illnesses as schizophrenia, bipolar disorder, or

panic disorder. OCD strikes people of all ethnic groups. Males and females are equally affected.

The social and economic costs of OCD were estimated to be $8.4 billion in 1990 (DuPont et al,

1994).

Obsessive-compulsive disorder (OCD) is characterized by recurrent thoughts known as

"obsessions” and ritualistic behaviors or "compulsive" behaviors that are distressing and difficult

to control. Recent research has shown OCD to be a common psychiatric disease. The best known

treatments for OCD- are anti-depressants and cognitive behavioral therapy. When Meredith had

her first child she became a competent young mother. Then the obsessive thoughts began; she

feared that she might harm her child. Over and over again she imagined herself stabbing the

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baby. She busied herself around the house, tried to think of other things, but the distressing

thought persisted. She became terrified to use the kitchen knives or her sewing scissors. She

knew she did not want to harm her child. While OCD is classified as an anxiety disorder, it

commonly occurs with depression.

A depressive disorder is an illness that involves the body, mood, and thoughts. It affects

the way a person eats and sleeps, the way one feels about oneself, and the way one thinks about

things. There are several types of anti-depressant medications used to treat depressive disorders.

These include newer medications, the selective serotonin reuptake inhibitors (SSRIs) the

tricyclics and themonoamine oxidase inhibitors (MAOIs).

Eating disorders may accompany OCD. People with Bulimia will eat a large amount of

food in a short time (binge). Then they will do something to get rid of the food (purge) such as

forcing themselves to vomit, over exercise, or use medicines such as laxatives or water pills.

Without treatment, this cycle of bingeing and purging can lead to serious, long-term health

problems such as tooth decay, gum disease, bone thinning, kidney damage, heart problems, or

even death. Bulimia is most common in teens and women.

Anorexia nervosa is another type of eating disorder. People who have anorexia have an

intense fear of gaining weight. It may start as dieting, but it gets out of control. Anorexia can

become a lifelong problem. If it is not treated, it can lead to starvation and serious

health problems, such as bone thinning, kidney damage, and heart problems. The disorder affects

less than one percent of the population, it is most common in teens and women. It is not clear

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whether other mental health disorders occur before or as a result of anorexia nervosa.

Body dysmorphic disorder is a type of somatoform disorder that may occur along with

OCD. Somatoform disorders are characterized by physical symptoms that suggest a medical

condition. However, a complete physical examination doesn't reveal any underlying medical

cause for the physical symptoms. Body dysmorphic disorder (BDD) is characterized by an

excessive preoccupation with a real or imagined defect in the persons physical appearance. An

insufficient level of serotonin, one of the brain's chemical messengers involved in mood and

pain, may contribute to body dysmorphic disorder. Other complications may include social

isolation or social phobias and requesting unnecessary medical procedures, such as cosmetic

surgery. Doctors often use a specific type of antidepressant called selective serotonin reuptake

inhibitors (SSRIs) and cognitive behavior therapy (psychotherapy) to help people overcome

body dysmorphic disorder: Consultation for skin picking was requested by a primary care

physician for a 48-year-old, married, white female accountant. She began picking her skin at age

44 for up to four hours per day. The patient eventually required several medical hospitalizations

for treatment and surgical revision of non-healing wounds.

Another disorder that may accompany OCD is Paraphilia. Its symptoms are rare sexual

attractions. Psychoanalysts theorize that an individual with a paraphilia is repeating or reverting

to a sexual habit that arose early in life. Nonsexual objects can become sexually arousing if they

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are repeatedly associated with pleasurable sexual activity. Or, particular sexual acts (such as

peeping, exhibiting, and bestiality) that