One of the more difficult problems in psychiatry is the treatment of obsessive-compulsive disorder. The reason for this difficulty is, first, it is hard for sufferers to get to treatment. They are embarrassed by their symptoms and doubt that anyone would understand them. Many of them are reclusive and stay at home and avoid social contact.
The second problem is that many people think they can talk themselves or their patients out of OCD. Many people believe that you can cajole or impress upon a hoarder that they should give up their clutter. Anybody who has tried this, however, realizes how difficult, if not impossible, that is.
Other obsessions are frightening to the patient and cause them great distress. Some people have the obsession that they are going to harm a loved one by stabbing them or poisoning them. Even though this is the furthest thing from their mind in terms of actually doing it, the obsessive thought that this could happen is scary to them.
Obsessions fall into several categories. These include: sexual, harm to others, harm to self, fear of loss, contamination or germ, religious, or even just numbers or accounting. The compulsions are the actions taken to relieve these anxieties: saying prayers, counting, hoarding, washing, or touching repetitively. The severity of OCD is determined by how much time is spent either on the obsessions or the compulsions.
For some people, it’s a mild annoyance while for others many hours can be consumed in them, preventing the completion of daily tasks. Some people are so waylaid by their obsessions and compulsions that they cannot work or even leave the house.
A self-administered test that is used to determine the severity of the disorder is the Yale-Brown Obsessive Compulsive Scale. It measures the time spent on the symptoms, the difficulty resisting the symptoms, and the distress they cause. It’s useful in determining where a person is when first diagnosed and how much improvement they get from the treatments they receive. Medicine has been proven to be the most helpful in treating the symptoms.
What then can be done about OCD? The first step is to recognize that this is a treatable psychiatric disorder and to get help. The second step is not to give up if the first treatments do not succeed.
Dr. William Hankin, MD is Board Certified in General Psychiatry and is a Fellow of the American Psychiatric Association. For more information about this or other issues, contact Dr. Hankin at his Atlantic County office in Linwood 609-653-1400 or his Cape May County office in Cape May Court House at 609-465-4424. Or visit www.WHHMD.com for information about the practice.
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