The Creeping Nature Of OCD

As I explained before, usually a long time elapses before OCD is properly diagnosed, and fitting treatment may become a reality. The average period that passes has been calculated to be 17 years. That is awfully long, you may say… how on earth is that possible? I will briefly name the reasons involved:

  • OCD creeps up on a person. It does not become manifest overnight. Someone may start checking for ‘dirt’ and ‘contamination’ for a couple of minutes only, and then was perhaps just a tiny bit extra long, compared to others. But that check-and-wash procedure tends to be all too present in that person’s consciousness. Others may ponder what’s on the agenda for the rest of the day, whereas this subject may be quite involved with the procedure of washing itself (have I done every finger, every nail well enough?). You will understand that the time spent in my example won’t really be a big burden for the rest of the day;
  • …but slowly, ever so surreptitiously, the time dedicated to ruminating about dirt, checking for it, and cleaning gets longer. Measures are taken to hide that problem from others, and people with OCD are very smart at this. However, the problem is really beginning to tax the subject’s well-being, and it is costly in terms of energy it requires. The attention available to other tasks is diminishing. The person starts to avoid some other obligations to be able to respond to contamination fears as intensely as he or she deems necessary;
  • the above two phases really can last for years. People can build up intense anxiety with regard to their problems. Still, they try to hide it from the outside world: they think it is something to be very ashamed of. Also, there is a lot of stigma about having a psychiatric condition. A subject with OCD may think: I’m not mad, but people may see me as being totally crazy! (incidentally, this feeling is testimony to the fact that OCD patients know that what they have is not normal; they perceive others as living much more spontaneously compared to themselves, and understand that life actually can be led that way without harm; and yet they can’t change their ways of fearful thinking and compulsive, repetitive behaviour – this insight into the abnormality of their condition is called: ego-dystonia, i.e. the disorder is not identical with the person’s ‘self’ – and this is a crucial difference between OCD and a delusional psychosis);
  • by now, the impact on the quality of life is getting dramatic. A subject with OCD may tend towards self-medication, i.e. with alcohol, other drugs of abuse, and also legally prescribed sedatives, such as benzodiazepines (Valium and Librium are well-known examples). OCD can lead to anxiety-driven life choices, such as changing to another occupation, in which the disorder can be better hidden; or it can incapacitate someone so dramatically that chronic unemployment is unavoidable;
  • at this point, problems with family and friends will have become reality. Initially, once the OCD in a beloved one is discovered (by accident, or after the patient has ‘come out’), people near him/her tend to coax the person into ‘normal behaviour’. That is by OCD’s very nature impossible, but this action may be repeated over time. Misunderstandings, anger, and even verbal abuse are quite common;
  • the next phase may be that family and friends become ‘co-patients’. They co-operate with the patient and accept the anxious moods and rituals of the disorder, to enable their companion a life as normal as possible. But the down side of this is that the ‘helpers’ get to suffer disadvantages of their assistance. Their efforts are time- and energy-consuming. The situation may be just bearable, but it certainly does not improve relationships. The atmosphere may be tense continuously;
  • finally, one or more people involved may reach the conclusion that a radical measure is unavoidable. The patient has to see an expert, in most cases a psychiatrist, because there is no other way to deal with the situation. Sadly, this step is frequently experienced as a form of defeat, because only ‘crazy’ people need a psychiatrist, isn’t it? The hope that the problem can be solved by the patient and those near to him is lost…
  • …and yet it is a victory, if only for the reason that at any rate the best that can be done, will now be done. A person is not ‘bad’ or ‘sad’ or ‘pathetic’ or ‘a loser’ because he/she is afflicted with OCD. He/she has to deal with a condition that the majority of people luckily never will encounter. It is a real hurdle.

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