Health and Wellness

By Ranu Boppana, MD

Confronting Obsessive Compulsive Disorder

Asha decided to go to a therapy session at her university counseling service because she felt overwhelmed and unable to concentrate. Her parents were also concerned that she often missed classes and just didn’t seem to be happy at college. In one of our sessions, Asha admitted that she sometimes felt like life was too hard and she couldn’t go on living like this. She felt that everyone around her was happy and successful, enjoying college the way she should. But she was just not able to see herself positively and was becoming increasingly socially withdrawn and depressed.

Beginning a course of antidepressant medication helped improve Asha’s mood and outlook some. As she continued her sessions, she sheepishly shared that she also had been struggling with obsessive thoughts and compulsive rituals that made no sense to her. Asha reported that she frequently worried about germs and spent a lot of time involved in cleaning and washing rituals. She sometimes missed classes and dates with friends because she couldn’t get through her elaborate rituals in time to leave her dorm. Asha’s hands were dry, rough and bleeding from excessive washing.

Asha also had intrusive thoughts that were aggressive or sexual in nature. She felt embarrassed that these images and thoughts would pop into her mind. Furthermore, they made it impossible for her to concentrate. Asha began to believe that if she could perform her washing rituals in a particular order, she would be free of these thoughts. Though this idea made no sense to her, she would still be filled with anxiety if she didn’t perform the rituals. She was often unable to sleep at night because she was so worried and even began to develop some new symptoms. Asha found herself worrying that she had contracted a rare illness if someone asked her if she was sick, and began to worry that she was a bad person if she didn’t give money to a homeless person. She started to ask for repeated reassurance about these issues from friends and family who quickly began to tire of this.

While Asha worried that she was losing her mind, she is in fact part of the two percent of the population that suffers from Obsessive Compulsive Disorder (OCD). Because most people with OCD like Asha realize that their symptoms make no sense, many hide their disorders from close family and friends. OCD is highly genetic, caused by an abnormality in serotonin functioning, and often runs in families. Asha reported that she had been struggling with milder OCD symptoms as a child and had always felt “different.” When Asha began college, however, stress caused her symptoms to multiply.

Through a combination of medication and therapy, Asha managed to regain her life and learned that she can have power over her symptoms. She also learned strategies for dealing effectively with her anxiety and for reducing and eliminating her compulsions. Behavioral therapy taught Asha to expose herself to anxiety and not give in to her rituals in a gradual, manageable way. She also benefited from participating in group therapy with other individuals who suffer from OCD. Although it took a lot of determination for Asha to fight back against this insidious disease, each success has left her more confident so that she can tackle larger fears. Luckily Asha sought help for her condition rather than just avoiding her fears, because avoidance exacerbates OCD. For more information about OCD and how to access treatment, visit www.ocfoundation.org.

Ranu Boppana, MD is an Adult and Child Psychiatrist in private practice in New York, NY and a Clinical Instructor at the NYU School of Medicine.

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