OCD is more than just an obsession with washing hands

Anu, a mother to two children, often insisted her family members to take a bath as and when they entered the house. If they refused, she would get extremely stressed out. Her rigidity towards the habit forced her husband to approach a psychiatrist, and the 50-year-old homemaker was diagnosed with obsessive-compulsive disorder (OCD).

OCD, which originates during adolescence and manifests over a period of time, is characterised by uncontrollable and unwanted thoughts or actions that are repetitive.

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The condition is different when compared to other psychological problems such as schizophrenia where others can see the symptoms crawling in, as only patients diagnosed with OCD are aware and suffer helplessly, explains Dr R Sathianathan, former director at the Institute of Mental Health, Chennai.

“It could be either washing hands repeatedly or the recurring thought of something outlandish like pushing someone close to them off the balcony. Only when it begins interfering with their productivity or their routine do they seek help. Till then, they suffer silently. The condition, if faced at the prime of youth, it can be distressing,” he says.

More common than imagination

With 3–4% of the general population suffering from OCD, it is one of the commonest psychological disorders. But OCD generally has been misconstrued as just obsessions.

More often than not people make flippant statements such as “I suffer from OCD, as I repeatedly check my door to ensure it is locked”.

Explaining the rising phenomenon of using names of disorders in the spoken language, Dr Vivian Kapil, consultant, Sri Ramachandra Medical Centre says that these are mere obsessions that about 30% of the general population have.

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“If your thoughts and acts are pervasive, causing distress and impairing other functions, like getting up frequently to wash your hands in the middle of an important meeting, it is OCD. On the contrary, obsessions can make you productive since you seek nothing but perfection,” he says.

Experts opine that while every 20th patient presents themselves with OCD, the cases are also diagnosed with a more obvious condition like depression. “One has to understand the psychodynamics as well to see if guilt and depression are an offshoot of OCD,” Dr Sathianathan says.

OCD can be treated

While the line of treatment for OCD includes medications such as anti-depressants, cognitive and behaviour therapy, of late, deep brain stimulation (DBS), which is a type of surgery where micro-electrodes are placed in specific parts of the brain to stimulate groups of nerve cells and their connections, have become an option.

The surgery is done mostly to cope with Parkinson’s disease and other abnormal movements like Dystonia. In recent times, the indication has also included certain psychological disorders.

Dr K Sridhar, senior neurosurgery and director neurosciences at MGM Healthcare, recalls the case of a 44-year-old man who underwent the procedure recently after battling OCD for over two decades.

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“His obsessive behaviour was stopping him from leading a normal life and after the surgery, which involved stimulating the part of the brain that cuts of the cycle of obsessive thoughts, he indicated that he’s doing better,” he says explaining that less than 10 such surgeries have been performed in India till date.

“We will be having follow-ups with the patient and in perspective of long term results, it will yield positive results,” he added.

Though the procedure is performed following a set of protocols, it requires the consensus of members of a multi-disciplinary team, including a psychiatrist, clinical psychologist, neurologist, neurosurgeon and a specialised neuro-anaesthetist, Dr Sridhar observes.