Obsessive and compulsive: One in 50 adults now diagnosed with order

Some days are a struggle for Jason.

Occasionally certain thoughts get trapped inside his mind, causing the 14-year-old to worry that something bad will happen to him.

These worried thoughts prohibit him from participating in after-school activities or playing on a sports team. Even walking through the hallway during school can be a challenge.

The Perry County teenager is living with obsessive-compulsive disorder.

"Excuse me for cussing, but the only word I can think to describe it is hell -- that's what it's like for me," Jason said.

Judy Johnson, Cape Girardeau Community Counseling Center's clinical director, said OCD is a condition the center's counselors see frequently. The number of people being treated for OCD at the center has increased in the last five years.

"I think the public awareness of OCD has increased and that has led to more people requesting help," Johnson said.

In fact, one in 50 adults in the United States has OCD, according to the surgeon general.

The St. Louis Behavioral Medicine Institute, which is a nationally recognized center for treating anxiety disorders, offers cognitive behavior therapy. The therapy offers a series of exercises called "exposure and response prevention," which helps people learn to think, feel and behave in ways to reduce symptoms of OCD.

At one time, insurance companies didn't cover this type of treatment, said Debbie Milfelt, administrative manager for the institute. "More and more insurance companies are now recognizing the success of this therapy and are now covering this level of treatment."

From 2003 to 2005, the institute has seen a large increase in the number of people being treated for OCD, Milfelt said.

Dr. Brad Robison, a Cape Girardeau psychiatrist, said there are many misconceptions about OCD.

"Some people think because they are perfectionists, or if they like to clean a lot, they have OCD," he said. "But that's not OCD. It's not till you see someone who has a severe case of OCD that you truly know what it is."

Robison said OCD is a anxiety disorder due to an imbalance of the neurochemical serotonin in the brain.

"It has to do with your brain disfunctioning and not correctly processing information," he explains.

OCD involves both obsessions and compulsions. The obsession part of the disorder involves a repeated occurrence or particular thought or image that can disturb a person. The compulsion part is the urge or feeling the necessity to repeat a particular behavior to relieve the anxiety from the obsession.

"It's a very compelling feeling," Johnson said. "It's also a pretty difficult thing to get over."

Robison explained that a person who doesn't have OCD will be aware of certain things and that awareness will pass through the brain without much thought. However, for someone living with OCD, the awareness won't process through the brain.

For example, a person with OCD will touch a piece of raw meat and then the thought of getting sick from the meat will get stuck his head, Robison said. "That's the obsession part of it."

The thought of getting sick will cause a person with OCD to wash their hands, sometimes 50 times in a row.

"That thought gets stuck in their brain and it keeps repeating over and over again in their head, so they'll repeatedly wash their hands until they are raw," Robison said. "That's the compulsion part of it -- the thing people do to help them get over that anxiety."

In Jason's case, his OCD caused him to worry excessively about everything, said his mother, Linda.

Linda became aware of Jason's OCD while he was in the second grade.

"It started out when his teacher said he always wanted to go to the nurse," she said. "He would get a nervous feeling in his stomach and then just start gagging constantly. That was the compulsion part of it."

The excessive worrying caused panic attacks.

"I worried about everything," Jason said. "I would worry 'well, what's going to happen to me today?'"

Jason, 14, explained his house felt like a safety zone, where nothing bad could happen.

"Like I would think, 'Well, if I go outside today, I might get lost in the woods,'" he said.

OCD can be a hereditary disorder, Robison said. And in Linda's case, OCD runs in her family. Her 17-year-old son has OCD.

Several years ago, Linda and her husband took their children to Disney World in Orlando, Fla. The vacation was a difficult experience for her two sons.

"The trip traumatized them," she said. "On the drive down, any wreck we would pass was awful for them to deal with. You or I would think, 'Oh what a horrible thing.' But for my sons, they would start to think, 'Wow, what if this happens to us?'"

Linda said when the family passed through a big city, the boys would start to worry about a building falling on them or the family getting lost. At Disney World, the large crowds caused the boys to have anxiety attacks.

"They have to dissect every worry they have," Linda said. "And it was so hard for me, because I always dreamt of taking my kids to Disney."

Since Jason's diagnosis of OCD, doctors prescribed him Prozac, an anti-depressant used to treat anxiety disorders. Along with medications, Jason can sometimes control his OCD by deep breathing, listening to relaxing music and looking at relaxing pictures.

Robison said OCD is difficult to live with but is treatable. The disorder can range from minor to severe.

He once treated a patient who had difficulty leaving his house because he had an obsessive thought that he wouldn't be able to park his car correctly.

"When he would go out, he would constantly park and repark his car to make sure he was exactly between the yellow lines," Robison said.

People diagnosed with OCD understand that these reoccurring thoughts are unrealistic, Robison said. "They know it doesn't make much sense. But the intensity level of anxiety they feel is so high that it grabs that thought in their head, and it won't go away."

Johnson has counseled OCD patients who have a compulsion to shower in a particular way. It can sometimes take up to three hours before they are ready to leave their house.

"It's something that really impedes normal functions of everyday life," Johnson said.

After receiving treatment for his OCD, Jason finally has some control over his condition. This was the first year he was able to attend a dance at his junior high school.

"This is something he'll have to live with his entire life," his mother said. "OCD is like having your worst fears in life, things you hate the most put in front of you. There is no escape from them, and you are continually made aware of and feel threatened by them. My son has to fight every day for things most people take for granted, and that's the hardest part about it for me."

jfreeze@semissourian.com

---

Common Obsessions

Constant worries about: dirt, germs, contamination, infection or chemicals.

Recurrent thoughts about: the house on fire, losing something, hurting someone, spreading illness, running over a pedestrian with a car, feelings that things must be in a certain place or saying the wrong thing

Common Compulsions

Repeatedly checking to see if: light switches are off, doors are locked, numbers are correct and forms are filled out correctly.

Counting: counting to a certain number, counting objects over and over or repeatedly performing a behavior

Collecting or hoarding: collecting mail or trash to the point of filling up one's home, inability to throw away things or picking up trash on the streets to take home

Cleaning or washing: hand washing, showering repeatedly or decontaminating objects

Arranging or organizing: arranging items in perfect symmetry or in a certain order

~ Information provided by HealthyPlace.com Mental Health Communities