Four million in U.S. suffer with OCD

As a young boy, Bill Ford would spend hours in church, going to confession, trying to convince the priests that some thought or feeling he had was leading him straight to hell.

"I had persistent fears about committing a sin, and I was afraid of God's wrath," said Ford, now a 50-year-old psychiatric social worker at the Milwaukee Psychiatric Hospital.

After high school, Ford's religious obsessions turned to an overwhelming attention to detail, fueled by a fear of disaster.

"I had images of something terrible happening, and of it being my fault," Ford said. He lost his ability to drive because of fears that he might have an accident and injure a child, and he would spend day and night at work, checking and rechecking details.

He once spent an entire night walking through the hospital, touching ashtrays to see if they were cool, because he had a passing thought that a smoldering butt could spark an fire. By his 30s, his life had degenerated into a series of these rituals, repeated over and over.

"My life had turned into mush," he said. "I was exhausted, paddling as hard as I could to keep my head above water."

Ford is one of the estimated four million people -- about 2 percent of the adult U.S. population -- who suffer from obsessive-compulsive disorder (OCD), a psychiatric condition marked by terrifying thoughts and desperate attempts to make themselves feel better through repeated rituals, such as washing hands until the skin becomes raw or checking again and again to see if they locked doors or turned off stoves.

Although many people find themselves double checking, doctors say that the disorder is marked by frequency of these actions and how much time they take up in a day. According to the National Institutes of Health, there is a problem if these activities consume more than one hour each day, are extremely distressing, and if they interfere with normal living.

Many people with OCD say that they have lost jobs and destroyed marriages because of their condition. The Obsessive-Compulsive Foundation in Milford, Ct., estimates that OCD costs about $8 billion a year.

For about one third of these people the condition starts in childhood and snowballs over the years, said Susan Swedo, Head of the Section on Behavioral Pediatrics, Child Psychiatry Branch of the National Institute of Mental Health (NIMH) in Rockville, Md. and author It's Not All In Your Head, a book on OCD published by Harper-Collins.

She estimates that about one percent of elementary school children are suffering with OCD. Many hide their rituals from their parents until it is impossible to conceal them any longer.

Swedo treated a 10-year-old girl named Caroline from a middle-class suburban neighborhood, who one day got the idea that she had AIDS, even though she had no risk factors for getting the deadly virus.

To avoid contact with any possible source of contamination, Caroline would wrap bandaids around each one of her fingers every day. If one bandaid was crooked, she'd take it off and start again, sometimes going through 100 bandaids before she got it right.

Caroline knew her fear of getting AIDS was irrational, but she couldn't stop, Swedo said.

Understanding that their actions are illogical is a hallmark of OCD. No matter how much his parents and the priests tried to reassure Ford, for example, he could not shake the sense that he was a hopeless sinner.

"I knew my worry was unrealistic," Ford said. But he could not stop.

In serious cases, a child can become disabled by fear, avoiding school, playtime and other social activities. And the object of their fear may be "anything that exists, from green peas to spearmint gum," Swedo said.

Many of them worry that they'll become gravely ill because of germs or contamination, that their parents or siblings will be hurt or that tornadoes will touch down and kill them.

The condition had long been thought to be purely mental, the mind's reaction to too-strict parents or an abnormal emphasis on cleanliness. Scientists now believe it is the result of a physical or chemical imbalance, said Swedo.

"We have good firm scientific evidence these disorders are real," she said. Brain scans, for example, have shown a marked difference in brain activity patterns between people with no mental illness, other conditions and OCD.

Some cases may be triggered by infections, said Swedo. She is conducting research looking into the relationship between a neurological condition called Sydenham's chorea, or St. Vitus' dance, which occurs after rheumatic fever. Swedo said it is caused by an immune system response to strep infections.

The antibodies that attack the invading bug also go after part of the brain. The result is rapid, jerky movements and general clumsiness. In one study, some children with Sydenham's also had evidence of OCD.

NIMH research has shown that the majority of OCD patients can be treated with a combination of drugs and behavior therapy, a form of therapy designed to put a patient face-to-face with the object of terror.

"It's exposure with response prevention, a desensitization therapy, the kind you would undergo for bee stings," Swedo said.

For some OCD patients, however, this behavioral approach would be useless, because they have to fight hundreds of habits and rituals collected over years, she said.

Fran Sydney, 51, said that she started lining up her toys when she was five years old. After several traumatic experiences, she found herself seeking a comforting order to the world through housework.

For years, she spent 20 hours a day on bizarre chores. She lined up cans of food in alphabetical order, with all the labels facing in one direction; she used scotch tape to remove hairs from the bed; she washed her house keys.

"Prison would have been a lot easier," said Sydney, who was never able to hold a job and watched one marriage collapse.

Neither traditional psychotherapy, nor cognitive behavioral therapy made a dent in all those habits, so Sydney entered a study testing a drug called Luvox that boosts the levels of the brain chemical serotonin. She believes it has helped her give up all the cleaning and get on with her life.

For people who suspect that they have OCD, Swedo said the most important thing is to find a doctor who has some experience treating the disorder because some kinds of psychotherapy appear to have little impact. Mental health experts also recommend seeking help early as possible, because most people with OCD wait more than a decade before they consult a professional.

There are several helpful organizations that can provide information on OCD treatments.

Go back to True Stories about OCD...

Credits: UPI Science Feature by Mara Bovsun

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