Dear Dr. Garner,
I really need your help. I have not spoken to anyone about my problem, because I am too embarrassed.
I am becoming trapped by thoughts and actions that have basically paralyzed me.
I constantly do things which make no sense, such as rearranging the pillows on the bed, so that they are in a certain position.
I must make sure that the place settings I put on the table are exactly symmetrical. I believe if I don’t do this that something bad will happen.
Every time I leave the house I say the same words (I would rather not say what they are), for fear that something bad will happen if I don’t say them. I collect useless items such as pieces of garbage and keep them in a certain drawer.
I am religious, but fear the bad thoughts I have, which are not in keeping with our religion.
Everyday that I leave the house, I lock the door and then go back in to make sure everything is OK.
My problem and actions are becoming worse and worse. Pretty soon I will not be able to continue to carry on with everyday activities. Please tell me what I can do.
Desperate in Ditmas Park
Dear Desperate,
I am very sorry to hear about your problem. Of course, I have not had time to examine you, but based upon your letter, there is a good chance you are suffering from obsessive compulsive disorder (OCD).
Everyone has worries now and again but worries that consume a person are called “obsessions.”
Compulsions are rituals that are performed over and over again to deal with the obsessions.
Obsessions are unwelcome thoughts, urges or images that surface in the mind over and over again.
These obsessions are very hard to get rid of.
The main signs of OCD include obsessions and rituals that take up more than one hour a day or cause significant distress or impairment.
Many people like you are aware that the obsessions are not reasonable, and feel ashamed to talk to any one about it.
Common obsessions include:
• Fear of dirt or germs.
• Repeated doubting. (Did I turn the stove off?)
• Needing to have exactness and order to things for no real reason.
• Aggressive or horrible impulses.
• Fear of being contaminated by shaking hands or touching others.
• Intense stress or sadness when objects aren’t orderly or facing the “right way.”
Common compulsions related to the obsessions above include checking doors repeatedly to make sure they are locked, counting in certain patterns, arranging canned goods to face the same way, collecting useless items and mental rituals, such as counting or repeating certain words and constant washing of the hands to the extent that skin irritations may develop.
There is a difference between being a perfectionist and having obsessive compulsive disorder. Just because you keep the floor in your house very clean does not mean you have obsessive compulsive behavior.
OCD is a very serious disorder which can incapacitate people.
The causes include:
• Biology — It may be the result of imbalance of chemistry in the brain.
• Environment — It may stem from habits you learned over time.
• It is more common in families where some members have the disease.
OCD can lead to suicidal thoughts, alcohol or substance abuse, depression and eating disorders.
There are good treatments available, including antidepressant medication, and psychotherapy. The therapy involves what is known CBT, or cognitive behavioral therapy, in which your thought patterns and routines are rearranged so that compulsive behaviors are no longer necessary.
The progress of recovery is slow, but your problem can be helped. The treatment will most likely be a lifelong one, but you will be able to take back control of your life and function normally.
I am sure that many other readers can relate to your situation and hope they will seek the help of their doctor (I would be happy to provide referrals) as the process worsens over time.
Before closing, I want to wish my grandson, Nevin Roy Stephens, a happy first birthday (June 3).
I used to think people were making it up when they talked about how great being a grandparent is. I can tell you from my experience, that this is no exaggeration and that it is truly an amazing experience