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Obsessive-compulsive disorder (OCD) is a psychiatric disorder, specifically, an anxiety disorder. OCD is manifested in a variety of forms, but is most commonly characterized by a subject's obsessive drive to perform a particular task or set of tasks, compulsions commonly termed rituals. more...

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OCD should also be distinguished from the similarly named but notably different obsessive-compulsive personality disorder, which psychiatric guidelines define as a personality characteristic rather than an anxiety disorder.

The phrase "obsessive-compulsive" has worked its way into the wider English lexicon, and is often used in an offhand sense to describe someone who is meticulous or absorbed in a cause. Such casual references should not be confused with obsessive-compulsive disorder; see clinomorphism. It is also important to distinguish OCD from other types of anxiety, including the routine tension and stress that appear throughout life. A person who shows signs of infatuation or fixation with a subject/object, or displays traits such as perfectionism, is not necessarily stricken with OCD, a specific and well-defined disorder.

Symptoms and prevalence

Modern research has revealed that OCD is much more common than previously thought. An estimated two to three percent of the population of the United States is thought to have OCD or display OCD-like symptoms. Because of the condition's personal nature, and the lingering stigma that surrounds it, there may be many unaccounted-for OCD sufferers, and the actual percentages could be even higher.

The typical OCD sufferer performs tasks (or compulsions) to seek relief from obsessions. To others, these tasks may appear simple and unnecessary. But for the sufferer, such tasks can feel critically important, and must be performed in particular ways for fear of dire consequences and to stop the stress build up. Examples of these tasks: repeatedly checking that one's parked car has been locked before leaving it; turning lights on and off a set number of times before exiting a room; repeatedly washing hands at regular intervals throughout the day.

OCD rituals are often bound up with intricate detail — detail that may seem arbitrary to outsiders. Smokers with OCD, for instance, may argue with themselves that quitting cigarettes is possible only on the 13th or 27th of a month, and only when they are in possession of four cigarettes at noon.

Obsessions are thoughts and ideas that the sufferer cannot stop thinking about. Common OCD obsessions include fears of acquiring disease, getting hurt, or causing harm to someone. Obsessions are typically automatic, frequent, distressing, and difficult to control or put an end to by themselves. People with OCD who obsess over hurting themselves or others are actually less likely to do so than the average person.

Compulsions refer to actions that the person performs, usually repeatedly, in an attempt to make the obsession go away. For an OCD sufferer who obsesses about germs or contamination, for example, these compulsions often involve repeated cleansing or meticulous avoidance of trash and mess. Most of the time the actions become so regular that it is not a noticeable problem. Common compulsions include excessive washing and cleaning; checking; hoarding; repetitive actions such as touching, counting, arranging and ordering; and other ritualistic behaviors that the person feels will lessen the chances of provoking an obsession. Compulsions can be observable — washing, for instance — but they can also be mental rituals such as repeating words or phrases, or counting.


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Homeopathy can benefit patients with OCD
From Townsend Letter for Doctors and Patients, 10/1/04 by Daniel Ko

Obsessive-compulsive disorder (OCD) cost the United States $8.4 billion in 1990 in social and economic losses, nearly 6% of the total mental health bill of $148 billion. (1) Such a staggering statistic necessitates that individuals be accurately diagnosed and be given effective treatment for this debilitating condition.

Definition and Classification

OCD falls under the broad category of anxiety disorders, which encompasses conditions such as panic disorder, social phobia, and posttraumatic stress disorder (DSM-IV). A person with OCD usually has obsessions and compulsions (~90%), but sometimes may only have one or the other.

Obsessions are recurrent intrusive thoughts, impulses, or images that are perceived as inappropriate, grotesque, or forbidden. They are not simply excessive worries about real-life problems. The person usually recognizes that the obsessions are excessive or unreasonable and fears he or she will lose control or act upon such thoughts or impulses. One metaphor likens OCD symptoms to a case of mental hiccups that won't go away.

Some common obsessions include:

* Fear of dirt or germs

* Disgust with bodily waste or fluids


* Concern with order, symmetry (balance) and exactness

* Worry that a task has been done poorly, even when the person knows this is not true

* Fear of thinking evil or sinful thoughts

* Thinking about certain sounds, images, words or numbers all the time

* Need for constant reassurance

* Fear of harming a family member or friend

Compulsions are repetitive behaviors (rituals) or mental acts that reduce the anxiety that accompanies an obsession. The person feels driven to perform them in response to their obsession, or according to rules that must be rigidly applied.

Some common compulsions include:

* Cleaning and grooming, such as washing hands, showering or brushing teeth over and over again

* Checking drawers, door locks and appliances to be sure they are shut, locked or turned off

* Repeating, such as going in and out of a door, sitting down and getting up from a chair, or touching certain objects several times

* Ordering and arranging items in certain ways

* Counting over and over to a certain number

* Saving newspapers, mail or containers when they are no longer needed

* Seeking constant reassurance and approval

These obsessions or compulsions cause marked distress, are time consuming (>1 hour a day), or significantly interfere with the person's normal routine, occupation (or academic) functioning, or usual social activities or relationships.

There is no single, proven cause of OCD. Experts today believe that a number of intertwined and complex factors are responsible for OCD, such as genetics, different brain activity patterns or insufficient neurotransmitters, personality development, and how a person reacts to the environment around them. It certainly isn't a sign of a character flaw or personality weakness.

Prevalence and Diagnosis of OCD

Approximately 3.3 million American adults ages 18 to 54, or about 2.3% of people in this age group in a given year, have OCD. (2) It affects men and women equally and knows no geographic, ethnic, or economic boundaries. Typically, OCD begins in adolescence to young adult life, but at least a third of cases of adult OCD start in childhood. For the most part, onset is gradual. Most people have a chronic waxing and waning course, with an exacerbation of symptoms that may be related to stress.

Interestingly, about 20-30% of OCD patients report a past history of tics, and approximately 25% of these people meet the full criteria for Tourette's disorder (DSM-IV). (3) Conversely, up to 50% of people with Tourette's disorder develop OCD in their lifetime.

On average, people with symptoms of OCD see three to four doctors and spend over nine years seeking treatment before they receive a correct diagnosis. (4) Moreover, studies have shown individuals with OCD suffer for an average of 17 years from the time the disorder manifests until proper treatment is obtained.

It's unfortunate that OCD tends to be under diagnosed and under treated. People who experience symptoms of OCD need to open up and discuss their situation with their healthcare providers. On the other side, doctors need to be familiar with how to recognize OCD and prescribe appropriate therapy.


OCD was once thought to be untreatable, but today's medicine can help most individuals achieve meaningful long-term symptom relief. Some individuals have even reported being cured of OCD. Individuals whose symptoms persist, make no sense, cause much distress, or interfere with functioning, need to seek clinical help. Once the diagnosis is made, appropriate treatment can be prescribed.

It is important for someone with OCD to be treated early because approximately 70% of adults with the disorder have an episode of major depression at some point in their lives. Prescription medication is an option for some individuals. Drugs like clomipramine (Anafranil), fluoxetine (Prozac), sertraline (Zoloft), paroxetine (Paxil), and fluvoxamine (Luvox), can be tried, but they can cause side effects like dry mouth, nausea, drowsiness, and decreased sexual performance. Furthermore, individuals often have to take the drugs for a minimum of several weeks before they can tell if the medications are helping.

An alternative treatment for OCD is behavioral therapy. In one type called exposure and response prevention, individuals under the guidance of a trained therapist are deliberately and voluntarily exposed to whatever triggers their obsessive thoughts. They are then taught techniques to avoid performing the compulsive rituals, and to deal with the anxiety. It is especially helpful for patients whose compulsions focus on situations that can be easily re-created. Various studies indicate that behavioral therapy has a 50-70% success rate with OCD. (5)

Homeopathy--Using the Power of the Vital Force

A popular non-invasive therapeutic option for many ailments is homeopathy. This "energetic" type of medicine helps the body re-establish balance and homeostasis. With the growing interest in complementary medicine, homeopathy may help people manage their mental or physical complaints. In fact, Todd Rowe, MD, a psychiatrist who incorporates homeopathy into his practice in Phoenix, has found it to be more effective than conventional drugs in the treatment of OCD.

"Not only does homeopathy treat the existing symptoms, but it also offers the possibility of a permanent cure," comments Dr. Rowe. "This is not to say that it is easy to treat. I would say that I am successful in about two-thirds of my cases."

As a recent naturopathic college graduate, I asked Dr. Rowe for advice he would give to new practitioners of homeopathy or experienced clinicians who aren't getting desired results.

"It is important to remember that in treating OCD, as in any condition, not to overly focus on the common symptoms of the disorder, but to focus on what is individuating in the case," advises Dr. Rowe. "This means that the homeopath must be aware of the common symptoms of OCD."

Furthermore, Dr. Rowe tells practitioners and patients not to be discouraged with the pace of healing. He says it is often slow in OCD and the possibility of a cure may take as long as a year.

Although OCD interferes with a person's life, fortunately there are many available options that can help those afflicted. Homeopathy is worth considering since it is safe, effective, and inexpensive.

For more information:

National Institute of Mental Health

1-866-615-6464 (toll-free)

Obsessive-Compulsive Foundation




2. Narrow WE, Rae DS, Regier DA. NIMH epidemiology note: prevalence of anxiety disorders. One-year prevalence best estimates calculated from ECA and NCS data. Population estimates based on US Census estimated residential population age 18 to 54 on July 1, 1998. Unpublished.

3. Pitman RK, Green RC, Jenike MA, Mesulam MM. Clinical comparison of Tourette's disorder and obsessive-compulsive disorder. Am J Psychiatry. 1987 Sept; 144(9):1166-71.



Daniel Ko, ND

COPYRIGHT 2004 The Townsend Letter Group
COPYRIGHT 2004 Gale Group

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