Obsessive Compulsive disorder (OCD) seriously interfere day to day activity. It affects work, school and personal relationships. In this condition, person suffer from obsession and compulsion.
Obsession is repeated thoughts, urges, or mental images. This often cause anxiety. Obsessions are different from delusions. In delusions patient remains aware about wrong thoughts. In delusions, patient believe to be true. In obsessive compulsive disorder patient remains unhappy and tense about wrong thoughts and at times. He feels sad or guilty. Patient is unsuccessful in resisting the thoughts.
It is seen that 80 percent of patients with OCD have both obsessions and compulsion whereas 20 percent have only obsessions or only compulsions.
Some important obsessions are:
Obsessive thoughts like hands are dirty, counting money, seeing address in a letter repeatedly.
Obsessive doubts like repeatedly checking lock or bolt, seeing face in a mirror, repeatedly checking roll number or answer in an examination
Thoughts like how the world was produced? Who is best and what is the aim of life?
Obsessive fears: Fears of ghosts, dead bodies, cremation grounds, death of a parent or meeting an accident.
Compulsions are repetitive behaviour which is seen in patient. He has an urge to do something for these obsessive thoughts. If these acts are not performed, patient feels restless and tense. For Example, if on remembering thoughts about dirt, patient starts washing hands repeatedly, although patient knows that his hands are clean. If doesn’t clean he feel tense.
Common compulsions include:
- Excessive cleaning and hand washing.
- Ordering and arranging things in a particular and precise way.
- Reputedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off.
- Compulsive counting.
- Applying rigid rules and patterns to the placement of objects, furniture, books, clothes and other items.
- Constantly asking questions to seek reassurance.
- Excessive checking of electrical and gas appliances.
- Excessive cleaning and washing of house, household items, food, car and other areas.
- Excessive tooth brushing.
- Fear of germs or contamination.
- Patient has aggressive thoughts others or self.
- Patient often replace bad though with a good thought.
- Patient wants everything to be in perfect order. He wants symmetry in arrangement of objects.
- Unwanted forbidden thoughts which involves sex and religion.
Prevalence of OCD
- It is seen that for every 10,000 persons, 5-10 develop this disorder. Out of all type of mental patients, few fall victims to this disorder.
- About two- third of patients of this disorder are below 25 years of age.
- This disorder occurs equally in males and females and in found in every age group.
- This disorder is more common in adolescents and in old age.
- Pregnant women and new mothers are at increased risk of developing OCD.
Obsessive compulsive disorder begins during early childhood usually around age of 10. In adults, OCD begins around age 21.
Causes of OCD
Genetics: It is seen that this disorder is found more than one member of the family. Out of twins, if one child is affected then there are 30: 50 perfect chances of occurrence in other. It is seen through research that low levels of one neurotransmitter known as serotonin causes OCD. This imbalance can be passed on from parents to children. So it is said that OCD is genetic disorder.
Psychological: Personality of certain individuals who have habits may lead to OCD. These traits include disciplined, punctual, like cleanliness, meticulous in nature. Patient wants to everything perfect. Besides this life events like death of a close relative due to some infection.
Those people who have experienced abuse whether physical or sexual in childhood or other trauma have higher chance of development of OCD.
OCD can also develop in children with streptococcal infection. This is called Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections (PANDAS).
Trigger factors of obsessive thoughts:
Situations, smells or something heard on television, radio or in a conversation.
Patient can have obsession about any word or number like 7 or 13. Doing every act by definite numbers 3,5 or 7 times.
- Patient can’t control his or her thoughts, even he realises that these thoughts are excessive.
- He spends at least 1 hour a day on these thoughts.
- He doesn’t get pleasure when performing the behaviour.
- He often experiences significant problems in his daily routine.
- Patient will do something over and over according to certain rules that must be followed exactly to make an obsession go away.
Besides mental symptoms patient can have some physical symptoms like:
In this patient have sudden, brief, repetitive movements, such as eye blinking. He can have eye movements, facial grimacing, shoulder shrugging. He can have head or shoulder jerking.
He can have common vocal tics like repetitive throat clearing, sniffing or grunting sounds.
Obsessions may be related to many things:
Dirt: Thoughts of dirt about hands, clothes, utensils, beddings, meals and home.
Office: Many times obsessive thoughts are seen in office and related to objects or persons.
In office patient may job related thoughts, thinking about ways of repeatedly wishing. He keeps checking files again and again. He repeatedly counting notes by a bank cashier.
Religion related thoughts: Patient may have occurrence of sexual thoughts even when in religious places. He can sexual thoughts about opposite sex or idols of goddesses. He will do religious ritual by counting or according to time frame.
Sex related thoughts: Patient has repeatedly occurrence of nude pictures of relatives of friends, thinking of sexual acts on seeing people of opposite sex. He fear of having contracted some sexually transmitted disease.
Complications of OCD
- Patient of long duration can develop conditions like:
- Contact dermatitis from frequent hand washing
- Drug dependence
- Poor quality of life.
- Psychosomatic Disorder like headaches, migraine, acidity and high BP.\
- Diagnosis of OCD is made through:
- Physician go through emotional functioning of patient. He will check the ability ot think, reason, and remembering things.
- Examination of nervous system
- Written or verbal tests
- Blood and urine tests.
Homeopathic Remedies for OCD
It is suited to a person who has hot, red, skin, flushed face with glaring eyes. It is given to a person who lives in a world of his own. He is engrossed in his own visions. He has various imaginations and sees monsters, hideous faces and various images. It is given when patient who is furious and patient bites, strikes to other person. He has a desire to escape. Patient does not want to walk. He has sensitiveness of all senses.
- Worse: from touch, noise after noon, lying down.
- Dosage: 30, 4 pellets, 2 times for 5 days.
It is given to patient who dislike for water, dry and hard hair and skin. He has sinking feeling in the stomach around 11.a.m. Standing is the worse position for this patient. It is suited to a person who is dirty, filthy, who have skin infections. Patient is very offensive, as all the discharges are offensive in nature. It is given to patient who is very forgetful. He has difficulty in thinking. He things that rags are beautiful thing. He has a feeling that he is immensely wealthy, while actually he is not. Patient has aversion to bathing. He does not want to do any work. Patient is very selfish. He has no regard for others. He imagines that he is giving wrong things to people which is causing their death. Patient is very irritable, depressed, thin and weak.
- Worse: from heat or cold, in the forenoon, evening
- Better: warmth and lying on the side which has some complaint.
- Dosage: 30, 4 pellets, 2 times a day for 10 days.
Kali carb It is given to patient who are fat, aged people and is very weak. He has alternating moods. He is very irritable. He has full of fear and imaginations. He has anxiety. He has sensation as if the bed was sinking. He never wants to be alone. Patient is never quiet. He is never satisfied. Patient is hypersensitive to pain, noise and touch.
Worse: in cold weather, from taking soup and coffee, in the morning around 3 o’clock, lying on the left and painful side.
Better: in warm weather, during the day , while moving around.
Dosage: 200, 2 times a day, for 15 days.
Phosphorus is suited to tall, thin people with narrow chest, having thin skin, weak. He has weakness of mind with physical weakness. He has depression of mind. He has fear, as if something was creeping out of every corner. He has great tendency to weep. He is over sensitive to all things. He has loss of memory. He has a fear of death when alone. It is given to patient who is insane. He has idea that he is very important. Patient is very restless.
Dosage: 1M, one dose every week for 3 weeks.