Behaviour, Mental Health | July 14, 2014 | Author: The Super Pharmacist
Do you really have obsessive compulsive disorder? We've all done it. You check the lock on your door to make sure that it is secure even though you just locked it. Or once you embark on a long road trip you can't fight the sensation that you left something behind or left something running that should've been turned off. Some of us may compulsively wash our hands even if they are not dirty. It is common to hear people say “I'm OCD” or “that's just my OCD” when describing certain compulsions or hang-ups that they have. It is a way to justify or explain their meticulous nature or for insisting that certain things are done in a particular manner. But do you really have a mild form of obsessive compulsive disorder?
The American Psychiatric Association recently released the latest version of the Diagnostic and Statistical Manual of Mental Disorders called the DSM-5. This manual is considered the benchmark of psychiatric diagnoses and includes diagnostic criteria for virtually every psychiatric disorder and illness.
A. Presence of obsessions, compulsions, or both:
Obsessions as defined by:
Compulsions as defined by:
B. The obsessions or compulsions are time-consuming (e.g., take more than one hour per day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.
C. The obsessive-compulsive symptoms are not attributable to the physiological effects of a substance (e.g., a drug of abuse, a medication) or another medical condition.
D. The disturbance is not better explained by the symptoms of another mental disorder.
Obsessive compulsive disorder is an illness of obsessions and compulsions. Obsessions are thoughts, and compulsions are behaviors.
The obsessions and compulsions in obsessive compulsive disorder are repetitive, persistent, time-consuming, and cause significant stress or anxiety for the sufferer. Of note, the symptoms must not be due to drug intoxication or drug withdrawal. Also, the diagnosing clinician must consider other forms of mental illness (e.g., schizophrenia) that may explain the symptoms better than a diagnosis of obsessive-compulsive disorder.
Obsessions and compulsions tend to go hand in hand. For example, someone with obsessive compulsive disorder may be obsessed with symmetry.
The person is constantly looking for examples in his environment that are asymmetric and feels compelled to make those items more symmetric. When things are asymmetric, the person feels acutely uncomfortable and distressed.
In order to relieve this uncomfortable feeling, he performs a compulsion, such as making the asymmetric items line up symmetrically.
In severe obsessive compulsive disorder, seemingly symmetric items may appear to be asymmetric to the sufferer such that any amount of compulsive arrangement cannot ease the discomfort of the obsession. The person with obsessive compulsive disorder may avoid all places with asymmetry. The person may even become trapped in his or her own home.
Perhaps most importantly, the diagnosis of obsessive compulsive disorder requires that obsessions and/or compulsions significantly disrupt the patient's life. For example, does the sufferer avoid social or pleasurable activities so they can avoid the unpleasant feelings of an obsession? Do they devote significant time to a compulsion instead of doing other, important or pleasurable things? In essence, do these obsessive thoughts and compulsive rituals interfere with the person’s life or the lives of friends, coworkers, and/or family? If so, the person may have obsessive compulsive disorder.
Various obsessions and compulsions can occur in people with obsessive compulsive disorder; however, some features or clusters of symptoms appear to be more common than others are. People with obsessive compulsive disorder often have one or more of the following symptoms (symptom clusters):
Obsessive-compulsive disorder can be a debilitating illness that can severely impair a patient's functioning and quality of life. On the other hand, people may experience a mild form of obsessive compulsive disorder that only slightly, but significantly disrupts their lives.
The true test of whether someone has obsessive compulsive disorder is whether obsessions and/or compulsions cause significant distress or are inordinately time-consuming.
Being neat and orderly is not a disease; however, preventing people from visiting your home for fear they will make it dirty or contaminated is an abnormal behavior and may indicate obsessive compulsive disorder.
If you run back from the car to make sure the front door is locked—this is not obsessive compulsive disorder—you are probably just being thorough. However, if it takes you several minutes to check and recheck the front door, which makes you late for work or social engagements,
this could be obsessive compulsive disorder.
Avoiding dangerous situations is prudent. On the other hand, avoiding common situations because of irrational worries about being harmed or harming others could be a symptom of obsessive-compulsive disorder.
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders (DSM-5). 5th ed. Washington, DC: American Psychiatric Association; 2013.