Most people behave in one or more ways that others might find peculiar, and I am no exception to that rule. I want my clothes to match, from shoes to glasses and everything else in between (including my lingerie – a challenge when packing for a trip). If people who visit me use my kitchen, I ask them to keep things exactly where they found them. As I organize my furniture, countertops, and wall objects, I work hard to find symmetry. And I tag packaged foods with expiration dates and then arrange them in my pantry in chronological order.
I know I’m not the only one with quirks like these that others might consider too “TOC”, a reference to the obsessive-compulsive disorder. But the clinical syndrome, in which people have spontaneous recurrent thoughts that lead to repetitive habits, is much more than a collection of quirky behaviors. Rather, it is a condition neuropsychological highly distressing chronicle that can trigger anxiety serious and make it difficult to live together at school, at work or at home.
It is believed that for someone with TOCHowever, some circumstances or actions that most people would consider harmless, such as touching a doorknob, have potentially dire consequences that require extreme corrective responses, if not, avoid them altogether. A person can have so much fear of germs, for example, that shaking someone’s hand can force them to wash their own hand 10, 20 or even 30 times to make sure it’s clean.
For many, the pandemic of Covid-19 it just made things worse. Previous research has found a potential correlation between the traumatic experience and an increased risk of developing OCD, as well as worsening symptoms. A person with OCD who already believes that dangerous germs are lurking everywhere, as might be expected, has become paralyzed with anxiety over the spread of the new coronavirus. And, in fact, a Danish study published in October 2020 found that the first few months of pandemic resulted in increased anxiety and other symptoms in both newly diagnosed patients and those already on treatment aged between 7 and 21 years.
How severe is OCD?
The disorder usually runs in families and different family members can be affected to varying degrees. Symptoms of the disease often start in childhood or adolescence, affecting about 1% to 2% of young people, reaching approximately one in every 40 adults. About half of these people are severely affected by the disorder; 35% are moderately affected and 15% are slightly affected.
It’s not hard to see how the disease can be so disturbing. A person with OCD who is concerned about whether or not they have locked the door, for example, may feel obligated to continually unlock and lock it again. Or maybe you get overly stressed in anticipation of disaster if a strict routine, like turning a light on and off 10 times, isn’t followed before leaving a room. Some people with OCD are plagued by taboo thoughts about sex or religion or the fear of harming themselves or others.
Comedian Howie Mandel, now 65, told health news website MedPage Today in June that he has suffered from OCD since childhood, but was not officially diagnosed until many years later, after spending most of his life ” living in a nightmare” and battling an obsession with germs. He has worked to help combat the stigma of mental illness and increase people’s understanding of OCD, in the hope that greater awareness of the disease will favor early diagnosis and treatment to avoid its life-threatening effects.
How is OCD treated?
“Until the mid-1980s, it was believed that there was no treatment for OCD,” said Caleb W. Lack, professor of psychology at the University of Central Oklahoma. But currently, he said, there are three evidence-based therapies that can be effective, even for those most severely affected: psychotherapy, pharmacology and a technique called transcranial magnetic stimulation (EMT), which sends magnetic pulses to specific areas of the brain.
Most patients initially undergo a form of cognitive-behavioral therapy, called exposure and response prevention. Starting with something less likely to provoke anxiety—for example, showing a used tissue to people with an obsessive fear of contamination—patients are encouraged to resist a compulsive response, such as washing their hands repeatedly. Patients are taught to initiate “inner conversations,” exploring the often irrational thoughts that are running through their heads, until their anxiety level subsides.
When they realize that no illness has been caused after encountering the handkerchief, therapy can progress to more provocative exposure, such as touching the handkerchief and so on, until they overcome their unrealistic fear of contamination. For particularly fearful patients, this therapeutic approach is often combined with a medication that combats depression or anxiety.
One good thing about the pandemic is that it may have allowed more people to be treated remotely through online health services. “With the telemedicine, we are able to make a very effective treatment for patients, no matter if they are near or far from the therapist,” said Lack. “Without ever having to leave Oklahoma, I can see patients in 20 states. Patients do not need to be within a radius of about 50 kilometers from the therapist. Telemedicine is a real revolution for people who do not want or cannot leave the house.”
For patients with severely debilitated OCD for whom nothing else has worked, the last option is transcranial magnetic stimulation (EMT), a non-invasive technique that stimulates the brain’s neurons and helps redirect brain activity involved in obsessive thoughts and compulsions.
“It’s as if the brain is stuck on the same route and EMT helps the brain activity go down a different path,” explained Lack. As with exposure and response prevention, he said, EMT uses provocative exposures but combines them with magnetic stimulation to help the brain more effectively resist the urge to respond.
In a study of 167 severely affected OCD patients at 22 clinical facilities published in May, 58% remained with significant improvement after an average of 20 sessions with EMT. The US Food and Drug Administration (FDA) has approved the technique to treat OCD, although many health insurers do not yet offer coverage for the service. / TRANSLATION OF ROMINA CACIA
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