What is Obsessive Compulsive Disorder (OCD) ?

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Obsessive Compulsive Disorder is an Anxiety Disorder that is mainly characterised by intrusive thoughts (obsessions) and behaviours (compulsions).

Individuals with OCD are besieged by patterns of unwanted, repetitive thoughts and repetitious behaviours that are distressing and difficult to ignore or overcome completely.

OCD is the fourth most commonly occurring psychiatric disorder after substance abuse, major depression and phobias.

OCD can affect anyone regardless of class, culture, sex, status or level of intelligence. On average OCD affects 2-3% of the Australian population (Robins et al, 1984). That means that about 450, 000 Australians will suffer from OCD during some stage of their lives.

WHAT ARE THE SYMPTOMS?

Obsessive Compulsive Disorder can affect people in many different ways. Not all people experience the same symptoms or the same degree of intensity of symptoms, although all people who suffer from OCD experience obsessions and/or compulsions.

Obsessions are intrusive, unwanted and often disturbing thoughts that the person cannot control. Persistent fears of contamination, that they are to blame for something or an overwhelming need to do things perfectly are common.

Time after time, the individual will experience a distressing and anxiety- provoking thought, such as, "have I left the iron on?", "have I injured somebody else?" or " do I have something physically wrong with me ?"

Compulsions are repetitive, distressing and purposeful physical behaviours, which may relate to the obsessive thoughts. Examples of compulsive behaviours include the need of the individual to repeatedly wash their hands due to the fear of contamination, the constant need to check that things have been done, like whether doors or windows have been locked, or even avoidance of certain objects and situations (holes in the road, cracks or lines in pavement).

All of these compulsive behaviours are a way for the person to try to reduce their feelings of anxiety. This repetitive behaviour can interfere with a person's life to the extent that the individual cannot leave home or function at school or at work because of the many hours spent performing these rituals.

WHAT CAUSES OCD?

The exact causes of OCD are not fully understood. There are, however, a number of possible theories which suggest that it could be genetic, a result of the effects of interaction between behaviour and the environment, beliefs and attitudes or even chemical changes in the brain, usually related to the brain chemical serotonin.

WHAT TREATMENT IS AVAILABLE?

Although there is currently no one theory that can explain precisely all causes of this disorder, there are a number of very effective treatments and therapies (see overleaf) for OCD. It was once considered to be an extremely rare disorder that was largely untreatable.

But when studies revealed that OCD was much more common than believed, the disorder began attracting much more attention from researchers. Consequently, breakthroughs in treatment of OCD have occurred and OCD is now a major focus of research in the mental health area.

Behaviour Therapy:
This type of therapy is a step-by-step structured technique tailored by therapists to suit individual clients. Essentially behaviour therapy is about 'unlearning' disruptive patterns and replacing them with new behaviours.

Cognitive Behaviour Therapy (CBT):
Cognitive behaviour therapy challenges the person's thought patterns and behaviour. Cognitive therapists focus their treatment on assisting the person to modify thoughts causing their unwanted behaviour.

In the case of OCD, Cognitive Behaviour Therapy can prepare the ground for the use of behaviour therapy and can also help to prevent any future return of the symptoms after the treatment has finished.

Pharmacotherapy:
Anti-depressant drugs, which specifically affect the serotonergic neurotransmitter system, are the most useful of pharmacological interventions. These drugs are not addictive substances and work on correcting chemical imbalances within the brain. This is thought to reduce patterns of compulsive behaviour. Unfortunately, medications are not equally effective for all sufferers.

Psychotherapy:
This is a form of 'talking' therapy. It can help the individual to understand and contemplate their feelings and the difficulties they experience directly as a result of the disorder.

Support Groups:
Support groups provide support, friendship, education, understanding and information for the individual with this disorder and to their friends and family. Presently in NSW alone there are eleven support groups for people living with OCD. Seven of these support groups are located in the Sydney metropolitan area, with four in regional NSW.

WHERE TO GO FOR HELP

• Your local Community Health Centre
• General Practitioner
• Anxiety Disorders Alliance on 02 9570 4126 or 1800 626 077
• Australian Psychological Society 1800 333 497 for a referral to a psychologist in your area.
• Mental Health Information Service (02) 9816 5688 or toll free 1800 674 200 for referral to services in your area.

If you are experiencing OCD, you may have constant and unwanted thoughts which often result in the performance of elaborate rituals in an attempt to control or banish those persistent thoughts. You will feel you have no control over your actions.

You may be so embarrassed about your obsessive behaviour that you have kept it a secret, even from your family. Some people may be obsessed with order and cleanliness. One ritual associated with this can be washing hands hundreds of times a day.

Obsessive Compulsive Disorder is an Anxiety Disorder that is mainly characterised by intrusive thoughts (obsessions) and behaviours (compulsions). Individuals with OCD are besieged by patterns of unwanted, repetitive thoughts and repetitious behaviours that are distressing and difficult to ignore or overcome completely.

OCD is the fourth most commonly occurring psychiatric disorder after substance abuse, major depression and phobias. OCD can affect anyone regardless of class, culture, sex, status or level of intelligence. On average OCD affects 2-3% of the Australian population (Robins et al., 1984). That means that about 450, 000 Australians will suffer from OCD during some stage of their lives.

Obsessive Compulsive Disorder can affect people in many different ways. Not all people experience the same symptoms or the same degree of intensity of symptoms, although all people who suffer from OCD experience obsessions and/or compulsions.

Obsessions are intrusive, unwanted and often disturbing thoughts that the person cannot control. Persistent fears of contamination, that they are to blame for something or an overwhelming need to do things perfectly, are common. Time after time, the individual will experience a distressing and anxiety- provoking thought, such as, “Have I left the iron on?”, “ have I injured somebody else?” or “ Do I have something physically wrong with me?”

Compulsions are repetitive, distressing and purposeful physical behaviours that may relate to the obsessive thoughts. Examples of compulsive behaviours include the need of the individual to repeatedly wash their hands due to the fear of contamination, the constant need to check that things have been done, like whether doors or windows have been locked, or even avoidance of certain objects and situations (holes in the road, cracks or lines in pavement).

All of these compulsive behaviours are a way for the person to try to reduce their feelings of anxiety. This repetitive behaviour can interfere with a person’s life to the extent that the individual cannot leave home or function at school or at work, because of the many hours spent performing these rituals.

The exact causes of OCD are not fully understood. There are, however, a number of possible theories which suggest that it could be genetic, a result of the interaction between behaviour and environment, beliefs and attitudes, or even chemical changes in the brain, usually related to the brain chemical serotonin.

Diet change strategies:

When You Crave A Good Feeling

Some moods trigger food cravings -- and vice versa. The challenge is to keep both in check.

Think of your body as an insanely complex, gooey car. Put in gas and oil (a balanced diet), and you're good to go. Put in nicotine, alcohol, caffeine, weird, manufactured fats, gummy, washed-out flour, and sugar, and it's like pouring sugar into the gas tank. You'll sputter, run on, stop and start, or stall.

Put Food In, See a Difference

Senior New York University clinical nutritionist Samantha Heller, MS, RD, would probably prefer an analogy to a chemistry set. "If you are chemically balanced," Heller contends, "your moods will be balanced."

A lot of factors can throw the body out of balance. "A lot of women are anemic," she says. "This leads to depression and fatigue. Older people are often deficient in the B vitamins. People who don't eat regularly often have big shifts in blood sugar." People also have chemical sensitivities to certain foods that can govern mood.

In a study of 200 people done in England for the mental health group known as Mind, subjects were told to cut down on mood "stressors" they consumed, while increasing the amount of mood "supporters." Stressors included sugar, caffeine, alcohol, and chocolate (more of that coming up). Supporters were water, vegetables, fruit, and oil-rich fish.

Eighty-eight percent of the people who tried this reported improved mental health. Specifically, 26% said they had fewer mood swings, 26% had fewer panic attacks and anxiety, and 24% said they experienced less depression.

How Moods Are Fed or Starved

One big set of chemicals that control mood are the neurotransmitters in the brain led by the pleasure "drug" serotonin. These substances determine whether you feel good and energetic or tired, irritable, and spacey. They run on sugar, preferably the form that comes from low glycemic carbohydrates (not doughnut sprinkles), according to Molly Kimball, RD, sports and lifestyle nutritionist at the Ochsner Clinic Foundation and Hospital in New Orleans.

The idea, she says, is to maintain a stable blood sugar level through the day, slowly feeding these substances into the brain. Low glycemic carbs include whole grain bread, beans, whole grain crackers, soy, apples, pears, peaches, and other fruits.

What Kimball calls "crappy carbs" -- commercial granola bars, animal crackers, graham crackers, potato chips, and of course, cakes and pies -- flood into the system too fast and cause your body to order up a big shot of insulin, which then tips the balance you've tried to maintain. "You can see it when you've had a white flour pancake and syrup for breakfast," Kimball says. "By mid-afternoon, you're ready for a nap." This sugar alert/insulin cycle can gradually become less efficient and lead to diabetes and other problems.

Comfort Foods Really Work

If you have let your neurotransmitters get off balance or if external forces have conspired to put you in a bad mood, don't fret, it happens. That's when your body will start to think "comfort food."

According to Joy Short, MS, RD, assistant professor and head of undergraduate nutrition and dietetics at St. Louis University, you should fulfill that craving -- but in moderation. "You might take time to think, 'Am I really hungry or just feel like eating because I am stressed,'" she says.

However, if you can't think of a healthier response, eat your comfort item and enjoy it! If you must eat a deep-fried Twinkie, eat one and lighten up on (but don't skip) the rest of the meals in the day, she says.

You could make comfort foods more nutritional, she says. Interestingly, both men and women choose ice cream as their preferred comfort food, but coming in second is chocolate for women and pizza for men. "If you want a cookie, make it oatmeal raisin or vanilla wafers. Buy low-fat ice cream. Make your hot chocolate with skim milk. And forget the chips, in favor of popcorn or pretzels," Short says. Or after Domino's arrives, throw some artichoke pieces, anchovies, or frozen veggies on top and heat.

What about that universal comfort food, chocolate? Much has been written about chocolate's rich complement of mood-altering chemicals, some of which trip the serotonin receptors and cause a "falling in love" feeling, according to millions of chocoholics.

Chocolate is also supposedly loaded with antioxidants that keep the brain and other organs from being bashed by rogue cells called free radicals. Kimball says chocolate can act almost as a cannabinoid -- the mood-altering chemical found in marijuana. But Heller and Short say the touchy-feely chemicals are not in sufficient strength to make a difference in the body.

Recommendations for Managing Moods

• Maintain a stable blood sugar, no big swings. This means frequent small meals and snacks, every four hours or so.
• Be sure to drink a lot of water and juice.
• Exercise 20 minutes a day for mood -- and an hour for fat-burning.
• Do not follow an extremely low-fat diet (quick weight loss is also bad for mood, Heller says). Fat is needed for anti-depression. Stick with polyunsaturated and monounsaturated fats and fatty fish or flaxseeds, which are full of healthy omega-3 fats.
• Take in tryptophan, an amino acid that makes blood sugar accessible to the neurotransmitters. This means milk or turkey. Eat a carb alongside your tryptophan source for better absorption.
• Have breakfast.
• Spend time in the produce department when you shop (try to eat a lot of bright colors, which means fruits and veggies).
• Pass on food items that come wrapped in crackly cellophane.
• Limit coffee (even nutritionist Kimball drinks some).
• Don't eliminate any one food group, such as carbs.

Herbs

Herbs and related supplements are one natural treatment alternative for mental health disorder patients. Some patients prefer to use natural treatment choices as stand alone treatment, whereas others use them in combination with medication and psychotherapy. Work with your health care practitioner to find out what is best for you.

The best place to get quality supplements is from a natural healthcare provider. There are dozens of supplements marketed on supermarket shelves today, but many of these do not receive standardization. It is important if you decide to use supplements that you get the best quality supplement possible.

Here is a listing of a few supplements that healthcare providers have used for many years to treat symptoms of bipolar and related disorders. Most herbs come from plants and can help relax or provide support with sleep disorders and depression in patients.

Black Cohosh – This may affect one’s hormones, which may be one cause for symptoms of some mental health disorders.

Damiana – Often used to help lessen depression, but may cause mania in people with bipolar disorder.

Ginseng – May help provide more energy to people who feel fatigue during depressive states.

Gotu Kola – May help address symptoms of anxiety.

St. John’s Wort – One of the most popular of herbal supplements supported with scientific research that may help lessen mild depression. Again, one should use with caution and can interact with other medications including antidepressants.

Vitamin & Nutrient Associations

If you suffer from mental health disorders, it is important you eat well to nourish your body. Deficiencies of vitamins and minerals can contribute to your symptoms. Deficiencies of vitamins and minerals in anyone can contribute to symptoms including anxiety, depression and poor health.

A good quality multivitamin is a good start, especially if you do not have a history of eating well. Even if you do eat well, not all people absorb the vitamins and nutrients from their foods completely, so a multivitamin may help correct any shortages.

Many therapists recommend patients with bipolar disorder take extra B vitamins because these vitamins may affect our moods. A deficiency in vitamin B of any type may result in symptoms of depression or anxiety.

B vitamins are also often recommended to people to help lessen fatigue. For most, B vitamins help energize the body. There are many forms of B vitamins, so your best bet is a complex tablet containing all the B vitamins. For your information, here is a breakdown of the B vitamins by category.

• B-1 – Also known as “Thiamin.” This may impact anxiety, irritability and improve blood circulation in the brain and body.

• B-6 – Also known as “Pyridoxine.” This B vitamin may help reduce irritability. Doctors sometimes recommend it to patients with premenstrual irritability and agitation. You can take too much however, so be sure you consult with your doctor.

• B-12 – This vitamin helps convert what you eat into fuel for your body. It is most helpful for reducing drowsiness.

• Folic Acid – Important for preserving the body’s systems and biochemical balance. Careful however, as this supplement may interact with some of the more commonly prescribed mood stabilizers including Depakene.

Other vitamins that may prove helpful may include vitamin E, which may combat the risk of seizures often associated with the use of traditional medication therapies.

Here are some other supplements and nutrients that may prove useful for combating the symptoms of mental health disorders.

SAMe (pronounced Sammy) – This supplement may affect levels of dopamine and serotonin in the brain, but carries with it a risk of mania.

Tyrosine – Often used in combination with B vitamins, this amino acid is a precursor to dopamine and norepinephrine, important neurotransmitters in the body. What this means is your body needs tyrosine to make norepinephrine and dopamine.

GABA – May help relieve some symptoms including anxiety, insomnia, racing thoughts and tension in patients with bipolar or related disorders.

Essential Fatty Acids – Essential fatty acids are important for our entire body to work properly. They nourish the brain and may help reduce symptoms of depression. You can get essential fatty acids by eating more fatty fishes and flax seed or by taking an Omega 2 supplement. Some healthcare providers recommend as much as 5,000 I.U. or more for patients with severe depression. Be sure you check in with your doctor. Most over-the-counter supplements contain only 1,000 I.U. per serving.

Lecithin – This substance may help stabilize mood swings. If you plan to use this supplement, you should do so while working with a natural health care provider.

Calcium – Calcium is a mineral our bodies need for proper neurotransmitter production. Look for a supplement with calcium and magnesium to heighten the effects. A lack in magnesium can often lead to insomnia and anxiety.

Zinc – This important and often ignored mineral is often lacking in many people’s diet. It can help combat colds and may help reduce some symptoms of depression or other mental disorders.

Remember, as with herbal supplementation you should embark on vitamin and nutritional therapy under a skilled practitioner’s guidance.

Even when we try to eat well, we're disadvantaged. The nutritional content of most food has been compromised over the years, not only by deficient soils and modern production, transportation, storage and processing methods, but also by the enormous amounts of chemical and artificial substances added to promote growth, storage life, taste and appearance.

It's for this reason that more and more medical authorities are advocating the use of vitamin and mineral supplements. However, finding them in the right combination can be both confusing and costly.

The nutrition products I am going to recommend you make use of knowledge gained from the botanical world's 6,000 year history. They incorporated health building nutritional herbs with the best modern technology to help our bodies cleanse and detoxify so that the cells - the tiniest living units - can be as fully nourished as possible.

This allows the cells to grow, repair and to perform their functions with the best possible efficiency so that we feel and look better and are more able to prevent and fight disease. Once the body begins to clear itself of toxins it can more efficiently absorb nutrition.

Aloe Vera Juice is a refreshing and anti-bacterial drink, you might find that taking this daily, diluted in some filtered water will not only refresh you like ‘a shower inside you’ but also assists in dealing with any digestive issues you may also be experiencing.

You may find benefit from our information on detoxification as well as a bit about detoxing because of change of diet

It may be due to difficulties with your digestive system that is causing your body to be starved of key nutrients, vitamins or minerals. In this case you may find useful answers by reviewing our article on Nutrition For Your Cells. There is also more information here about why is nutrition such an issue nowadays?

It may be that your metabolism has slowed due to pressures that have been placed on your system through life in general or through specific “challenges” you have faced in the last few months or last few years. Review this by looking at our article about balancing your Metabolic Rate.

Further reading through our articles on health issues will give you a body of information that will help you decide what options you have to deal with the underlying causes of your problem through giving your body the nutrition products that will assist you body to heal from the inside out.

Most mental health disorders are complex and often misunderstood, that affects millions of people every year. It is important that patients understand their disorder is one that they can live with, and even learn to enjoy life with.

There are many misconceptions surrounding mental health disorders. There are times when a patient’s symptoms may become very serious. In cases like this it is critical a person seek professional care and guidance. A mental health disorder can manifest in many different ways. It can for example, manifest as a mild disorder with mild mood swings, or a major mood disorder with swings that are very extreme.

There are many approaches to treating a mental disorder. A patient should always work with a competent doctor or other healthcare provider they can rely and trust on in times of need. Also important to one’s health is his or her ability to build a supportive wellness team.

Your wellness team can help you during the tough times, offering support and helping you make critical decisions when you may not be up to it. The most important step a patient can take, the one that will ultimately lead to their success and fulfillment, is to take a proactive role in their recovery and in their care. To do this, you must first embrace and accept the fact that you have a mental health disorder.

Once you do this, life gets a lot easier. You can then help manage your disorder by working actively with each member of your wellness team as well as with members of your family and your healthcare team to create an action plan that allows you to live a happy, healthy life. Many people live with mental health disorders. Your job is to learn to not only live with, but also learn to enjoy life with bipolar disorder or any serious ailment.

Congratulations on taking a step in the right direction, one that will lead to your long-term recovery and happiness.

We wish you well in your search for solutions to this problem and your movement towards better health in all areas.

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