You arrive on scene of a single vehicle injury accident; paramedics are en route. A young man is outside a car that is wrapped around a tree. His clothes are bloody and he has a large laceration across his forehead. He is the only victim. He is clearly agitated; pacing, wringing his hands and is counting to seven over and over again. As you try to redirect him away from the smoking car his agitation increases and he begins screaming about the blood and the germs and tells you to back away….
Your partner is driving you crazy. Every time you leave the car he remotely locks and unlocks the doors repeatedly. In the car, everything has its place. Deviation of more than ¼” results in a readjustment. He dusts his perfectly polished shoes after every call. He wouldn’t be caught dead without gloves. Yet, his attention to detail makes him one of the best cops on the watch.
Obsessive compulsive disorder (OCD) is characterized by a subject's obsessive and repetitive intrusive thoughts followed by related compulsions (tasks or rituals) which attempt to neutralize the obsessions. It is one of several forms of an anxiety disorder. OCD symptoms cause anguish, take up a lot of time (more than an hour a day), or significantly interfere with the person's work, social life, or relationships. Unlike other compulsive behaviors (drinking or gambling) OCD compulsions do not give the person pleasure.
Most people are at least a little OCD. However, as you look at the symptoms of OCD, you need to evaluate degrees of severity. Only 2½ percent of the U.S. population has true OCD, the lifetime prevalence of the disorder is 5%. Many more people demonstrate obsessive compulsive traits. Under most circumstances, those traits will not interfere with a person's life the way that an obsessive compulsive disorder does. However, having these traits is considered as risk factors for developing the disorder.
Can you leave your home without it being totally tidy? Do you crave reassurance? Do you find yourself rechecking things? Do you re-read/re-write your reports many times? How about repeatedly counting in your head? Do you have excessive superstitions? How far out of your way do you go to avoid walking under a ladder? Do you have lucky socks or a lucky color or number you repetitively wear or play? These all could be symptoms of obsessive compulsive disorder.
OCD typically begins during adolescence or early childhood and effects men and women equally. It is a brain disorder, a medical disease that causes problems in information processing. On average, people with OCD see 3-4 doctors and spend over 9 years seeking treatment before they receive a correct diagnosis. Sufferers are generally of above-average intelligence, as the very nature of the disorder necessitates complicated thinking patterns.
The OCD Process and Diagnosis
Obsessions are recurrent and persistent thoughts, impulses, or images that cause marked anxiety or distress, which is not related to real-life problems. The sufferer attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action. Compulsions are repetitive behaviors or mental acts that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation. The person recognizes that the obsessive thoughts, impulses, or images are a product of his or her own mind, and the sufferer realizes that his/her obsessions or compulsions are unreasonable or excessive. The obsessions or compulsions must be time-consuming (taking up more than one hour per day) to be diagnosed as OCD. Additionally, it must cause distress or impairment in social, occupational, or school functioning.
Contamination Obsessions are obsessive concern with dirt or germs: