OCD strikes men and women in approximately equal
numbers and afflicts roughly 1 in 50 people. It can
appear in childhood, adolescence, or adulthood, but
on the average it first shows up in the teens or
early adulthood. A third of adults with OCD
experienced their first symptoms as children. The
course of the disease is variable--symptoms may come
and go, they may ease over time, or they can grow
progressively worse. Evidence suggests that OCD
might run in families.
Depression or other anxiety disorders may accompany
OCD. And some people with OCD have eating disorders.
In addition, they may avoid situations in which they
might have to confront their obsessions. Or they may
try unsuccessfully to use alcohol or drugs to calm
themselves. If OCD grows severe enough, it can keep
someone from holding down a job or from carrying out
normal responsibilities at home, but more often it
doesn't develop to those extremes.
Research by NIMH-funded scientists and other
investigators has led to the development of
medications and behavioral treatments that can
benefit people with OCD. A combination of the two
treatments is often helpful for most patients. Some
individuals respond best to one therapy, some to
another. Two medications that have been found
effective in treating OCD are clomipramine and
fluoxetine. A number of others are showing promise,
however, and may soon be available.
Behavioral therapy, specifically a type called
exposure and response prevention, has also proven
useful for treating OCD. It involves exposing the
person to whatever triggers the problem and then
helping him or her forego the usual ritual--for
instance, having the patient touch something dirty
and then not wash his hands. This therapy is often
successful in patients who complete a behavioral
therapy program, though results have been less
favorable in some people who have both OCD and
depression.
Post-Traumatic Stress Disorder
-
"I was raped when I was 25 years old. For a long
time, I spoke about the rape on an intellectual
level, as though it was something that happened to
someone else. I was very aware that it had happened
to me, but there just was no feeling. I kind of
skidded along for a while."
-
"I started having flashbacks. They kind of came over
me like a splash of water. I would be terrified.
Suddenly I was reliving the rape. Every instant was
startling. I felt like my entire head was moving a
bit, shaking, but that wasn't so at all. I would get
very flushed or a very dry mouth and my breathing
changed. I was held in suspension. I wasn't aware of
the cushion on the chair that I was sitting in or
that my arm was touching a piece of furniture. I was
in a bubble, just kind of floating. And it was
scary. Having a flashback can wring you out. You're
really shaken."
-
"The rape happened the week before Christmas, and I
feel like a werewolf around the anniversary date. I
can't believe the transformation into anxiety and
fear."
--------------------------------------------------------------------------------
Ordinary events can serve as
reminders of the trauma and trigger
flashbacks or intrusive images.
Anniversaries of the event are often
very difficult.
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