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
