The disorder is much more common than was previously recognized. Few people affected with obsessive-compulsive disorder tend to share their bizarre thoughts and actions, and their tendency to keep it secret plays a major part in underestimating the numbers. Some recent community studies, however, made a specific enquiry into the presence of the symptoms and found that the disorder has a lifetime prevalence of 1.9 – 3.0 per cent in the general population. The disorder begins most often in young people between the ages 18 and 24, but it may also affect children and older people. There is no gender bias and men and women are equally affected. The prevalence in first-degree biological relatives of individuals with obsessive-compulsive disorder is higher than in the general population, and if one of the identical twins is affected, the other also runs a high risk of being affected, but this does not apply to non-identical twins.
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The key points of obsessions and compulsions central to the disorder are: One, an idea, impulse or image intrudes itself insistently and persistently into the person’s consciousness. Two, a feeling of anxiety and fear accompanies this central thought and frequently leads the person to take measures to counter it. Three, the obsession or compulsion is not native to the psychological being of the person. Four, the person recognizes the thought or deed as absurd and irrational. Five, the person feels a strong desire to resist the obsessions and compulsions, yet is unable to do so.
Obsessions and compulsions can take many forms. The most common obsession is fear of contamination from germs, and this compels the person to carry intense cleaning rituals. People with this obsession may wash their hands dozens of times each day and this may cause their skin to become raw.
The second most common obsession is the doubt about whether doors are locked and appliances are turned off or not. This drives people to check things over and over again. For example, people with this condition may be compelled into making repeated checks whether they did lock the doors and windows, turned off the gas stove, and closed the water faucet or not. The compulsion is so overpowering that many times a person is compelled to take multiple trips back into the house from his workplace. Other common obsessions include a fear that something terrible might happen-such as the death or illness of a loved one or self, or that a fire may break out. Some people may be obsessed about symmetry, order or exactness; forbidden or disturbing sexual thoughts, images, or pictures; nonsensical impulses such as shouting in public; and thoughts of accidentally and unknowingly harming someone. People may also avoid shaking hands with people because of the fear of contamination, or may stop taking the wheel because of the fear they will injure someone in a traffic accident.
Some 75 per cent people relieve the anxiety of their obsessions by performing equally irrational acts (compulsions). They are carried out to prevent or reduce anxiety, not to provide pleasure or gratification. The common compulsions-other than cleaning rituals and checking rituals that we just outlined-may include constantly rearranging or straightening objects, counting things, repeating words or prayers internally, and hoarding vast amounts of useless materials.
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The facts of the mind, the games it can play, and the aces it has up its sleeve can dwarf the most eerie pieces of fiction. When tormented by irrational ideas, we can be driven into doing the unthinkable. Ideas, impulses, and images of senseless and intrusive nature can possess us. Howsoever disturbing, unrealistic or repugnant, it is sometimes impossible to escape them. Such repetitive, unwanted thoughts called obsession, in conjunction with inappropriate or bizarre repetitive acts, termed compulsion, give birth to the obsessive-compulsive disorder.A common disorder, it can put you through hell and fire guzzling a lot of time, causing much anxiety and distress, and interfering with your ability to function in various social settings. Preyed upon by this illness, you may well realize the irrationality of your thoughts and acts, and yet be unable to suppress them.
There are moments in our lives when many of us have bizarre, inappropriate thoughts and we may even engage in strange, senseless actions. For example, about to leave for work you turn on the ignition of the car, and suddenly feel compelled to check if you had left the door open, stove burning, or the faucet flowing. Watching a game on the television you find that your team is doing well, and so you remain glued to your seat fearing that any movement on your part could undo your team! You are desperate to see a job through and decide that if you were to reach the spot in ‘x’ number of steps, you would accomplish it, and so you will yourself to take the ‘x’ steps! These are all examples of obsessive-compulsive behaviour, but they should not be regarded as a disorder unless they are persistent and repetitive and oppress life.
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