Dear Asad,
I don't know if I am really an Obsessive Compulsive Disorder (OCD) patient but I have been obsessing with excessive cleanliness. I actually start crying if a person touches me and I think they have unclean hands. And it’s too hard for me to tell them not to touch me without offending them. It happened the other day when my brother went to the bathroom to wash his hands and he wasn't wearing his slippers and it annoyed me. I asked him to wash his feet which in turn annoyed him and at that moment I really wished I could kill myself. So you see, the first thought that entered my mind was to kill myself and I was seriously considering doing it. I sat down later to think whether what I did was wrong or not. It sounds lame, right? There are times when my own obsessions scare me.
I have tried talking to my mother several times but she always rebuffs me by saying that I simply am being wehmi (superstitious). She just doesn't understand what I feel. I feel absolutely helpless at these times. She thinks I am overreacting but I really don't know how to stop myself.
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I really want to see a doctor about it but the people around me just don't understand that mental issues could be this serious and also they are afraid of the social stigma attached with it. I am very disturbed that I can't share this with a professional.
If after reading my letter you think I am not suffering from OCD then please help me in getting over this false idea that I am an OCD. On the other hand, if you believe I am suffering from OCD then please tell me how to get cured without getting labelled as a psycho?
Compulsive Hand Washer
Dear Compulsive Hand Washer,
First of all, you are not a psycho. Neither are you wehmi (superstitious). You are a completely normal human being who it seems is suffering from OCD. But suffering from OCD does not make anybody a psycho or a crazy person; the same way someone suffering from a physical ailment doesn’t become an abnormal person.
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Secondly, I must commend you for your honesty for sharing this with me and the readers of this column. As you pointed out, most people in our society either do not take mental health issues seriously or if they do then they try to hide them for the fear of being labelled as psycho, crazy or mad. It takes a lot of courage to discuss this openly like the way you have done. Kudos for that!
OCD is characterised by unreasonable fears or obsessions that cause a person to engage in compulsive behaviours – such as excessive cleanliness, as in your case – to minimise or relieve their anxiety. OCD can range from mild to severe and can be well-managed through a combination of therapy, understanding, and self-help methods (including overall lifestyle changes).
OCD sufferers may also be plagued by intrusive, repetitive thoughts and urges as well as unwanted and uncontrollable behaviours, which may hamper one’s ability to function. Behaviours may include:
1) An obsession with hand-washing or dirt/contamination. People suffering from this will wash their hands after touching anything they consider contaminated.
2) Having to check everything multiple times. This includes things like checking that you have locked your car door many times, turning the lights on and off a set number of times to see that they really are off, or generally repeating things over and over.
3) Intrusive thoughts. Some people with OCD suffer from intrusive thoughts: thoughts that are inappropriate and that cause stress to the sufferer. These usually fall into the three categories of inappropriate violent thoughts, inappropriate sexual thoughts, and blasphemous religious thoughts.
OCD sufferers experience anxiety and stress from their triggers, which is why they feel compelled to engage in certain behaviours. These behaviours help to temporarily relieve or reduce the anxiety that they feel, but the cycle starts over again when the relief wears off. OCD sufferers may go through the cycle of obsession, stress, and compulsion many times in a day.
Force yourself to start paying extra close attention in the situations you typically become obsessed about. Little tricks can help you feel more control in such situations, which can be just enough to challenge your stress producing patterns.
For example, if you constantly worry about whether or not you have washed your hands, create a mental picture of yourself washing your hands every time you do. Creating this mental picture should help you to remember that you actually did wash your hands.
Get a diagnosis for OCD!
It is important to see a professional for diagnosis, as there are other problems that have similar symptoms to OCD. A qualified mental health professional should conduct the diagnosis.
There are two groups of OCD symptoms, obsessions and compulsions:
Obsessive symptoms are constant, tenacious and undesirable thoughts, impulses or images that trigger feelings of anguish or apprehension. You may feel thoughts or images keep popping up even though you try to avoid them or shut them down.
Compulsion symptoms are the behaviours that you perform in order to cope with the concern linked to obsessions. These are the behaviours that supposedly prevent the fear from coming true, and they often appear as rules or rituals.
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To be diagnosed with OCD, you must have obsessions and compulsions on most days for at least two weeks. Alternately, you may be diagnosed with OCD if your obsessions and compulsions have a significant impact on your daily life (for example, you are so afraid of germs that you wash your hands so often they bleed and you cannot touch anything that is outside your house).
Choose a therapist!
Find a therapist that has experience treating OCD or related disorders. Make sure that this is a person you feel comfortable with and has the credentials required to meet your needs. Ask your doctor for a referral if you are not sure where to start.
Prescription medications!
There are also several prescription drugs that have been shown to help with the short term obsessive thoughts or compulsive behaviours associated with OCD. Keep in mind that such drugs treat the symptoms without actually curing the disorder, so it is better to combine drug therapy with talk therapy to treat OCD than to use drug treatment alone.
Build a strong support system!
While many people consider OCD to be a problem caused solely by an individual’s dysfunctional brain, it’s important to keep in mind that the onset of OCD is often preceded by traumatic, or even a series of especially stressful, life events. Going through experiences such as the death of a loved one, losing an important job, or being diagnosed with a life-threatening illness can all produce stress and anxiety. In some people, this stress and anxiety can lead to an increased urge to control certain aspects of one’s life that might seem unimportant to others.
Work towards building a strong social support system where your past experiences will be given the respect they deserve. Feeling supported by a group of others has been shown to be important to promoting mental health in general. Find ways to spend as much time as possible with people you care about.
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Keep a journal to write about your feelings!
Journaling is a great tool for working with your emotions and learning more about yourself. Take some time each day to sit down and write about any experiences you might have had that produced anxiety or distress. Putting your obsessive thoughts down on paper and analysing them can be a great way to feel some degree of control over them. Journaling may also help you make connections between your anxiety and other ideas you have had or behaviours you have exhibited. Building this type of self-awareness can be a great tool for learning which types of situations contribute to your OCD.
Remind yourself of your good qualities on a regular basis!
Self-affirmation has been found to be very effective against negative feelings. Don't get down on yourself or let OCD define who you are. While it may be hard for you to look beyond your OCD sometimes, remember that you are more than your condition.
Take good care of yourself!
While you are getting treatment for your OCD, it is important to take good care of your whole body, mind, and soul. Join a gym, nourish your body with healthy foods, get plenty of rest, and nurture your soul by attending religious services or engaging in other soul soothing activities.
Incorporate relaxation techniques!
OCD causes lots of stress and anxiety. Therapy and medication may help to relieve some of your negative feelings, but you should also take time to relax every day. Incorporating activities like meditation, yoga, deep breathing, aromatherapy, and other soothing techniques will help you cope with your stress and anxiety.
Maintain your daily routine!
Dealing with OCD may cause you to feel like abandoning your usual routine, but this will not help you. Stick with your daily routine and keep moving forward with your life. Don’t allow OCD to prevent you from going to school, doing your job, or spending time with family.
All the best!
Asad
Asad is a counsellor, life coach, inspirational speaker and a personal-development expert. He advises on social, personal and emotional issues. You can send him your questions for this weekly column at advice@tribune.com.pk with “Ask Asad” mentioned in the subject line and provide as many details as possible.
Note: The opinions expressed in this article are those of the author and do not necessarily reflect the views of The Express Tribune.
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