Your Health

Obsessive-compulsive disorder: Worries rule your life

Most people occasionally wonder if they remembered to turn off the stove or the lights when they left home. Generally, these concerns diminish as the day progresses. For people like Jennifer, however, these worries turn into fears that rule their daily lives.

Jennifer, who suffers from obsessive-compulsive disorder, worries that if the toaster oven is left on that a fire may destroy her home and kill her family. She checks the oven several times each day and frequently asks others for reassurance that her home is safe.

This type of behavior consumes hours of Jennifer's day and interferes with her work performance, social activity and relationships. While Jennifer knows her fears and actions are excessive, she feels powerless to stop them.

Many of us know people with obsessive-compulsive disorder. It is believed to be the fourth most common psychiatric illness after depression, phobias and substance abuse. As many as six million Americans may have the disorder.

While Jennifer worries about fire, others may worry about the possibility of hitting a person or animal with their car, for example. They may fear that they or loved ones will become seriously ill or injured. These worries, or obsessions, are intrusive thoughts, impulses or images the person generally knows are senseless.

Obsessive-compulsive disorder generally surfaces in late adolescence or early adulthood, although onset can occur in childhood and at other times. Most sufferers have compulsive behaviors meant to neutralize the obsession and diminish the anxiety, but they can also be crippling. The most common forms of compulsion involve:

Checking doors, windows, ovens and electrical appliances. Cleaning and washing often to counter obsessions about contamination and illness.Mental rituals such as praying and counting. Repeating behaviors such as walking in and out of a doorway until the bad thought is neutralized.Arranging objects in a certain way.Hoarding or saving objects of little value, such as newspapers, magazines, old clothing and junk mail.

Many people engage in such behaviors at times and don't have obsessive-compulsive disorder. The diagnosis is made when these actions create considerable distress and impact someone's ability to function.

After extensive research, medical experts believe that certain biochemical abnormalities and genetics probably explain why some people are vulnerable to having the disorder. Stress can also be an important factor in the onset of obsessive-compulsive disorder and in the exacerbation of symptoms.

While there is no known cure, there are several effective treatments, including medications and behavior therapy. While the former can provide significant relief, the latter can help sufferers confront their fears and develop coping strategies.

Group therapy can be helpful, providing support as individuals engage in the difficult, though rewarding process of behavior therapy. Support groups are also important.

For referrals to local therapists, doctors and support groups, contact the Obsessive-Compulsive Foundation of the San Francisco Bay Area at (415) 337-4160.

Scott Granet is a licensed clinical social worker at the Palo Alto Medical Foundation.

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