By Susan Johnson
Larson Newspapers
Howard Hughes was a well-known victim of obsessive compulsive disorder, so fearful of germs that he washed his hands constantly and avoided contact with others, dying alone in a sealed hotel room.
While to some his behaviors may seem like a choice, perhaps used as a coping mechanism, the distress caused by OCD is real and can be as disruptive as schizophrenia, according to Medscape, an online health professional’s network.
Aileen Lee, Ph.D., a neuropsychologist practicing in Sedona, explained, “OCD is an anxiety disorder in which the belief system of a person creates such increasing levels of anxiety that they cannot tolerate it, resorting to behaviors which alleviate the anxiety but also reinforce the feedback loop of cognition-anxiety-behavior circuitry.”
Lee offered this example: “A person who fears contamination by germs refuses to touch door knobs and toilet seats and constantly washes their hands until raw and bleeding. The person is aware of the irrationality of their thoughts, but at the same time their anxiety becomes increasingly intolerable until they wash their hands.”
Carol Gandolfo, Ph.D., is a clinical psychologist living in Sedona who’s had broad experience with those suffering from the disorder.
“OCD is common in many people to a lesser degree,” Gandolfo explained. “Their symptoms may be as minor as checking doors over and
over, to cutting themselves or pulling out hair.”
Unlike compulsive drinking or gambling, OCD compulsions do not give the person pleasure.
Rather, the rituals are performed to obtain relief from the discomfort caused by the obsessions.
For David Beckham, one of the world’s highest paid soccer stars, OCD manifests itself in his constant arrangement of magazines, books and glasses into symmetrical rows and allowing only an even number of Pepsi cans in the refrigerator, a condition he confirms by counting them repeatedly.
When an individual’s obsessions interfere with their everyday life, a diagnosis of OCD is appropriate, Gandolfo explained. “Often the person suffering from OCD is unaware that they have a problem. Others often become aware of it sooner. For mild cases, the individual may decide the obsessions are minor and not worthy of treating, but they should still consider treating the underlying anxiety.”
She said treatment for minor cases, as well as helping more severe cases, is antianxiety medication. But she added that this is not without problems.
“Most antianxiety medications are addictive,” Gandolfo said. “The most effective therapeutic intervention is cognitive behavioral, changing thought processes and the behaviors associated with the thought process. One intervention is called ‘thought stopping.’ The professional will ask the patient to use a rubber band on the wrist and snap it when they start thinking about the obsession, or they will be taught to focus on other things, or to keep a
list to show they completed a task.”
While OCD may seem to non-sufferers like an addiction in and of itself, Lee said its genesis is different.
“Addictions involve both physiological dependency as well as psychological dependency. Hence the physical withdrawal symptoms when severe alcoholics stop drinking,” Lee explained. “The addiction comes from the genetic, physiological status and psychological status of the individual and treatment must address all dimensions.”
In cases of OCD, Lee and Gandolfo both said there has been success with antidepressants known as selective serotonin reuptake inhibitors which modulate levels of serotonin in the brain.
Among the SSRIs are Paxil, Prozac, Luvox, Celexa and Zoloft.
“People who don’t even realize they have OCD are so anxiety ridden they find it difficult to function in society,” Gandolfo said. “Getting help as soon as possible is imperative. If you have a minor case that can be treated with therapy, so much the better. For more severe cases, medication is a must, along with therapy to provide support and relief to the person.”
Susan Johnson can be reached at 282-7795, ext. 129, or e-mail sjohnson@larsonnewspapers.com
