Obsessive-Compulsive Disorder

What is Obsessive-Compulsive Disorder? I’m sure that most everyone has seen different news shows or talk shows where you see the person washing their hands until they bleed, or go back and forth into the house to double, triple, quadruple check something. A person may walk around their house making sure everything is “in its place” and not stop until a level of perfect is reached but often perfection in their eyes is never achieved.

Magazines and books need to be parallel to the table they are on and of course the table must be parallel with the rest of the furniture in the room. These are just a few examples of behaviors that are demonstrated when a person has OCD. If you are facing this illness, you may feel alone but in reality, nearly 1 in 50 adults in the United States currently has OCD and twice that number have had it at some point in their lives (OC Foundation). The OC Foundation also has listed many common obsessions and common compulsions to give you an idea of what symptoms these individuals have:

Common Obsessions Common Compulsions

1. Contamination fears of germs, dirt, ECT. Washing

2. Imagining having harmed self or others Repeating

3. Imagining losing control of aggressive urges Checking

4. Intrusive sexual thoughts or urges Touching

5. Excessive religious or moral doubt Counting

6. Forbidden thoughts Ordering/arranging

7. A need to have things “just so” Hoarding or saving

8. A need to tell, ask, confess Praying

Everyone has worries, doubts, and maybe superstitious or seem anxious at times about various things in life. It is when these actions become excessive (more than an hour in a day) and are affecting and individual’s daily life that it leads to a diagnosis of OCD. Individuals will often recognize that their obsessions are coming from their own minds and are excessive and unreasonable. “OCD, a psychological disorder typically marked by uncontrollable, repeated thoughts and recurrent, “driven” patterns of ritual-like behavior, has only recently been recognized as far more common than previously believed” (Sebastian, p. 15).

When defined, we can break this disorder down into the two basic words, “obsession” which is when persistent thoughts, images, impulses, or ideas continue to run though a person’s head even though they have no importance and “compulsion” which are urges to act in a certain way based on the obsessions. The difference between OCD and “compulsive” eating, drinking or gambling is that there is pleasure from the later activities but in the OCD person (Sebastian p.16). It is as if your brain was to stop on one thought and is unable to move on from that thought.

People often wonder at what age does OCD start? It usually starts in childhood and is either hidden from family and friends or is mistaken by parents as bad behavior and punish the child believeing they will outgrow the behavior. Anywhere from a third to a half of adults with OCD started as a child, but is not diagnosed due to the parents mistaking it as a behavioral problem or their hiding it. OCD can start at any time in life from preschool age to adult, but will usually develop by 40. It appears that some people will have a biological or hereditary predisposition to OCD, but it seems that environmental factors may have a final role in whether the disorder will develop in the individual (Sebastian, p. 63). There have been suspicions that genes have a part in OCD, but there have not been any specific identification of such genes.

OCD is a medical brain disorder that causes problems in information processing (OC Foundation). Research tends to suggest that there are problems in communication between the deeper structures of the brain (the basal ganglia) and the front part of the brain (the orbital cortex). The lack of serotonin, the chemical that brain uses to send messages, is believed to be the base of the problem with the OCD individuals. When drugs are used to increase serotonin, there is an improvement in those with OCD and brains circuits appear to go back towards normal.

If OCD develops suddenly in a youth, there is also a link to strep throat, and an autoimmune mechanism may be at fault and antibiotics may show improvement in this individual. With the varying faces of OCD, it averages 9 years and 3-4 doctors to get the correct diagnosis and about 17 years from when OCD starts to receive the right treatment (OD Foundation). The problem with this is that the earlier the diagnosis and treatment of OCD occurs, you can lessen the suffering, depression, and work or relationship problems the diagnosed individual will eventually encounter.

There are two areas to look at treatment of those diagnosed with OCD. As already mentioned, drugs are an option and with increased levels of serotonin there are documented successes. Clomipramine is approved in the U.S. for treatment, and fluoxetine and fluvoxamine are other drugs used in Europe for treatment. Psychosurgery, cutting the neural connections between the frontal and deeper parts of the brain in order to prevent message transmission, has also been used in extreme cases (Sebastian).

Some individuals and parents of kids with OCD do not want to go the route of using drugs or surgery. Other areas of treatments are behavioral therapy and cognitive therapy when considering psychological treatment of this disorder. Behavioral treatment involves exposure and response prevention. The individual is pushed into situations or activities that cause their obsessions, but then are refrained from encaging in the compulsive activities they would normally become involved in (Tallis p.124). When the cognitive therapy approach is taken, an attempt is made to change the thinking and beliefs of the individual directly (Tallis p.135).

Educators need to be prepared to see the early beginnings of OCD in their classrooms since the onset of this disorder is often in adolescence or young adulthood. It is becoming common enough that Libby Tucker recently had an article published in Scholastic’s magazine for teens, “Choices” addressing OCD and the number of teens that are fighting this disease. Some basic behaviors that she mentions in the article are picking your fingernails with fears of germs being in them and showering for 3 hours in fear of not being clean. You will often see high levels of anxiety and stress in these adolescents. Students will OCD will end up re-reading and re-doing much of their work.

They will be unable to complete tests since they can not concentrate and run out of time (Choices p.17). These students will do things that they get picked on for, so will find it difficult to make friends. As the students age, their areas of concern will also change and often become increasingly intense. A younger child may worry about a burglar coming into their house or family members getting hurt. They may also worry about getting sick and missing school. An older teen with OCD will lean more towards fear of AIDS or getting murdered just going outside. The “rituals” that these young adults follow are developed by them in order to help them deal with their fears.

One way that you can make it better in your classroom for those students suffering from OCD is to talk to them about the disorder. First you need to make them feel comfortable around you and in the classroom setting. Asking them questions about their habits will let them know that you understand about OCD, and lets them know you care about them as an individual (Choices p.17). Make sure that you follow a set pattern in your daily lessons, and inform the students of any possible changes in the daily routine.

This will help them to survive the day in class. Keeping the doors of communication open with the student’s parents is also important. They can help you to understand what areas the individual has more specific problems with and informed of any dramatic change in the family or individual life. The most important thing you can do as an educator for students with OCD is the same as your other students, show them that you care.