Mental Illness Paper

Obsessive-compulsive disorder (OCD) is real illness that can be treated with medicine and therapy. When have OCD, you have recurring, upsetting thoughts (called obsessions). You repeat doing the same thing, over and over again (called compulsions) to make the thoughts go away. And, you feel like you cannot control or stop these thoughts or actions. The obsessions, or upsetting thoughts, can include things like a fear of germs, a fear of begin hurt, a fear of hurting others, and disturbing religious or sexual thoughts.

The compulsions, or actions you repeat to make the thoughts go away, can be things like counting, cleanings hand washing, and checking on things. While these actions provide only short-lived relief, not doing them only increases anxiety. Many people who have OCD know that their actions often do not make sense. They may try to hide their problem from family and friends, and may have trouble keeping a job because of their actions. Without treatment, obsessions and the need to perform rituals can take over a person’s life. OCD is an anxiety disorder that can be life-long.

A person with OCD can also recover and then get the illness again, or relapse. This illness affects women and men in equal numbers. Most often, OCD begins during the teenage years or early childhood, although it can start in an adult. For many years, mental health professionals thought of OCD as a rare disease because only a small minority of their patients had the condition. The disorder often went unrecognized because many of those afflicted with OCD, in efforts to keep their repetitive thoughts and behaviors secret, failed to seek treatment.

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This led to underestimates of the number of people with the illness. Time changes all concepts. “OCD” is no exception. In the seventeenth century, obsessions and compulsions were often described as symptoms of religious melancholy. The Oxford Don, Robert Burton, reported a case in his compendium, the Anatomy of Melancholy(1621: “If he be in a silent auditory, as at a sermon, he is afraid he shall speak aloud and unaware, something indecent, unfit to be said”. In 1660, Jeremy Taylor, bishop of Down and Connor, Ireland, was referring to obsessional doubting when he wrote of “scruples”. A scruple is trouble where the trouble is over a doubt when doubts are resolved. OCD is recognized as the fourth most common mental disorder following, in order of occurrence, substance abuse, phobias, and major depression (Spengler, Jacobi, 1998). Perhaps part of the reason for the “confusion” is that several disorders manifest ideational processes that are much like the obsessional thinking in OCD. People with Generalized Anxiety Disorder (GAD) and posttraumatic stress disorder (PTSD) also have cognitive processes that are intrusive, repetitive, and exaggerated.

The difference lies in how clients view their obsessions. OCD that comes and goes some children will have one obsession or compulsion for a few months and then it will disappear. There may be no obsessions or compulsions for years, and then they might return for no apparent reason. OCD that comes, but never exactly leaves a common pattern is for a person to have a number of obsessions and compulsions which are quite severe, but which then lessen, at least for a while. Example of OCD that comes and goes: Jody was 6; she had a little “habit”.

Before she picked up anything in her hand, she would very lightly touch it once with her index finger. When her parents asked her why Jody just said that she liked to. There were no other obsessions or compulsions. Although no one mentioned it outside of the family, Jody’s mother and father became worried when Jody’s little sister, age 3 started imitating this habit. There were about to see their family doctor about this when it started to go away and never really came back. Two years later, after no signs of OCD, Jody started counting.

She thought her mother, who had a routine hysterectomy, would die if she made a mistake. She was counting and checking her counting for errors each day. Only when they were in the pediatric psychiatrist’s office did they remember the “habit” she had at age 6. For a long time OCD was thought to be an infrequent disorder. In other words, it was believed to be rare among “general population”. Now, it is estimated that over the course of a lifetime approximately 2. 5 percent of individuals will develop this disorder. For children and adolescents, it is estimated that approximately the same percentage suffers from this disorder.

In fact, this figure appears to be consistent with regard to American populations and worldwide populations, as well as male and female occurrences. Clinical and animal research sponsored by NIMH (National Institute of Mental Disorders) and other scientific organizations has provided information leading to both pharmacologic and behavioral treatments that can benefit the person with OCD. One patient may benefit significantly from behavior therapy, while another will benefit from pharmacotherapy. Some others may use both medication and behavior therapy.

Others may begin with medication to gain control over their symptoms and then continue with behavior therapy. Which therapy to use should be decided by the individual patient in consultation with his/her therapist? Treatment with psychotherapy includes cognitive-behavioral therapy (CBT) and behavioral therapy. In CBT, the goal is to change how a person thinks about, and then reacts to, a situation that makes them anxious or fearful. In behavioral therapy, the focus is on changing how a person reacts to a situation. BCT or behavioral therapy most often lasts for 12 weeks.

It can be group or individual therapy. A special type of behavior therapy, call exposure and response prevention, is often used with OCD. With this approach, a person is exposed to whatever triggers the obsessive thoughts. Then the person is taught ways to avoid doing the compulsive rituals, and how to deal with the anxiety. Some studies have shown that the benefits of CBT or behavioral therapy las longer than do those of medications for people with OCD. Clinical trials in recent years have shown that drugs that affect the neurotransmitter serotonin can significantly decrease the symptoms of OCD.

The first of these serotonin reuptake inhibitors (SRIs) specifically approved for the use in the treatment of OCD was tricyclic antidepressant clomipramine (Anafranil). It was followed by other SRIs that are called “selective serotonin reuptake inhibitors” (SSRIs). Those that are approved by the Food and Drug Administration for the treatment of OCD are fluoxetine (Prozac), fluvoxamine (Luvox), and paroxetine (Paxil). Large studies have shown that more than three-quarters of patients are helped by these medications at least a little.

Another neurotransmitter is also believed to result in mental illness when it is not working properly, this neurotransmitter called nor epinephrine. Studies have revealed that individuals with OCD have an insufficient level or serotonin, one of the brain’s neurotransmitters. Other studies also reveal that some individuals with OCD have abnormalities in dopaminergic transmission. Commonly, OCD is first diagnosed when parents recognize that their young child or teenager seems preoccupied with ritualistic behaviors associated with excessive cleanliness or unusually meticulous organization, and they seek help from a mental health professional.

Adults on the other hand, may seek professional help when they realize that it is becoming difficult for them to do their job or school work because they are spending too much time with their obsessive thoughts or compulsive behaviors. Therapists make the diagnosis of OCD by taking a careful personal history from the patient/client and any available family members, such as in the case of a young child. Although most people improve with adequate treatment, the condition can continue for many years.

Primary care physician should be familiar with the various ways obsessive-compulsive disorder can present and should be able to recognize clues to the presence of obsessions or compulsions. Proper diagnosis and education about the nature of the disorder are important first steps in recovery. Treatment is rarely curative, but patients can have significant improvement in symptoms. Obsessive-compulsive disorder is chronic condition with a high rate of relapse. Discontinuation of treatment should be undertaken with caution. Patients should be closely monitored for comorbid depression and suicidal ideation.

People with OCD sometimes also abuse alcohol and drugs and can have other illnesses, such as depression, eating disorders, attention deficit hyperactivity disorder (ADHD), or other anxiety disorders. When a person also has other illnesses, OCD is often harder to diagnose and treat. Symptoms of OCD include; having upsetting thoughts or images enter your mind again and again, washing your hands, cleaning, re-arranging objects, doing things until it feels “right,” or collecting useless objects, worrying a lot about terrible things that could happen if you are not careful.

If you think you may have symptoms of OCD, visit your doctor is the best place to start. Keep in mind that it can be a challenge to find the right treatment for an anxiety disorder. But, if one treatment does not work, the odds are good that another one will. New treatments are being developed through ongoing research. If a person has recovered from an anxiety disorder and it comes back at a later date, the person can be treated again the skills you learned dealing with the disorder the first time can help you in coping with it again.

As the twenty-first century begins, advances in pharmacology, neuroanatomy, neurophysiology and learning theory have allowed us to reach a more therapeutically useful conceptualization of OCD. Although the causes of the disorder still elude us, the recent identification of children with OCD caused by an autoimmune response to group A beta-hemolytic streptococcal infection promises to bring increased understanding of the disorder’s pathogenesis.

References

1. Obsessive-Compulsive Disorder. Washington, District of Columbia, US: US Department of Health and Human Services, Office on Women's Health; the National Women's Health Information Center. Retrieved from PsycEXTRA http://search. ebscohost. com/login. aspx? direct=true&db=pxh&AN=303972004-001&site=ehost-livedatabase.
2. Depression & Anxiety (1091-4269); 2008, Vol. 25 Issue 9, p761-767, 7p, 3 Charts, 2 http://search. ebscohost. com/login. aspx? direct=true&db=a9h&AN=34281062&site=ehost-live
3. Abel, J. (1994, March). Obsessive Compulsive Disorder: Interdisciplinary Treatment May Be Best. Clinician's Research Digest, p. . Retrieved from PsycEXTRA database. Stanford Medicine » School of Medicine » Departments » Psychiatry » OCD Research»Treatment http://ocd. stanford. edu/treatment/history. html Symptoms of OCD (Obsessive-Compulsive Disorder)http://counsellingresource. com/distress/anxiety-disorders/obsessive-compulsive. html
4. The National Institute of Mental Health (NIMH) is part of the National Institutes of Health (NIH), a component of the U. S. Department of Health and Human Services. http://www. nimh. nih. gov/health/topics/obsessive-compulsive-disorder-ocd/index. shtml

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