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Obsessive-Compulsive Disorder

Obsessive-compulsive disorder (OCD) is characterized by disturbing thoughts or images, called obsessions, and rituals, called compulsions, that are performed to try to prevent or dispel them. The obsessive-compulsive does not take any pleasure from performing the rituals, but is forced to perform them by unbearable feelings of anxiety and unease. Performing the ritual gives the OCD sufferer temporary relief from the discomfort caused by the obsession.

Some OCD sufferers are obsessed with germs or dirt, and wash their hands over and over. A journalist may be filled with doubt, and checks his facts repeatedly, even if it means going out of his way to find a telephone in a remote village. A child may refuse to leave the house without putting his or her toys in a particular place, or going around turning the lights on and off in a particular order. A lot of healthy people might think that they have OCD, when they find themselves repeatedly checking the stove before leaving the house. The disorder is diagnosed, however, when such activities consume at least an hour a day and the sufferer experiences intense feelings of discomfort and unease if he or she resists performing the required ritual. In addition, the activities appear to be senseless, are very distressing, and interfere with daily life.

OCD affects men and women equally, and afflicts about 2% of the population. It can appear in childhood, adolescence, or adulthood, but on the average it first shows up in the teens or early adulthood. A third of adults with OCD experienced their first symptoms as children. The course of the disease is variable. In some sufferers, the symptoms come and go. In others they ease over time, or can grow worse. There is some evidence that OCD might run in families.

The OCD sufferer might also be depressed, and have other anxiety disorders. Some may avoid situations in which they might have to confront their obsessions, or they may try to use alcohol or drugs to escape their compulsion. Some OCD sufferers have been able to adapt to their condition, and even find that it may help them in a career. An obsessive journalist, for example, may harness his obsession to ensure that his articles are extremely accurate. However, severe OCD can keep someone from holding down a job or from carrying out normal responsibilities at home.

Exaggerated Fears (Phobias)

Many people suffer from phobias. They are intensely and irrationally afraid of specific things or situations, like dogs, tunnels, and needles. A person might have no fear or travelling at high speeds, but panic in the subway. Some phobics are afraid of social settings. Agoraphobia, a condition that is often related to panic disorder, is a fear of being in any situation that might provoke a panic attack, or from which escape might be difficult if one occurred. An adult with a phobia may be aware that his or her fears are irrational. But this knowledge does not lessen the fear. Many find that even thinking about facing the feared object or situation brings on a panic attack or severe anxiety.

More than one in 10 people suffer from particular phobias over their lifetime. Scientists do not know what causes them. They do appear to run in families and are a little more prevalent in women. Phobias usually first appear in adolescence or adulthood. They start suddenly and tend to be more persistent than childhood phobias. Childhood phobias, like a fear of animals, usually disappear over time. But in some cases, for unknown reasons, they may continue into adulthood.

People with phobias do not always seek treatment. Some may have phobias that are easily avoided. Sometimes, however, phobias may force a person to make important career and personal decisions. This can be particularly the case with social phobia, which is an intense fear of becoming humiliated in social situations. This phobia often runs in families and may be accompanied by depression or alcoholism.

Although this disorder is often thought of as shyness, the two are not the same. A shy person can be uneasy around others, but does not experience extreme anxiety when they think about a social situation. A person with a social phobia may not be shy at all. Only in a particular situation, like giving a speech, do they experience intense anxiety. Social phobia can disrupt normal life and interfere with a person's career or social relationships. The dread of a social event can begin weeks in advance, and symptoms can be quite debilitating.

Post-Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) used to be called shell-shock or battle fatigue. It was first diagnosed in war veterans, notably the soldiers who survived the horrifying trench warfare of World War I and more recently in veterans of the Vietnam War. Since then, the condition has been identified more generally in people who have experienced a terrifying event. Often, people with PTSD have persistent frightening thoughts and memories of their ordeal and feel emotionally numb, especially with people they were once close to. It can result from traumatic incidents like serious accidents, natural disasters and violent attacks like mugging, rape, or kidnapping.

PTSD can occur at any age, including childhood. Depression, substance abuse, or anxiety can accompany the disorder. Symptoms may be mild or severe. In severe cases, the person may become easily irritated or have violent outbursts and have trouble working.

PTSD does not afflict every person who experiences a trauma. Those who are affected usually have symptoms within three months of the event, but there have been cases where the illness has only appeared years later.

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Reviewed: 02/2006