Marie is a 36-year-old mother of two children. She has been married to David for 10 years. David always describes Marie as a very clean person and he always noticed that their house is always spotless. According to David, Marie is too obsessed with cleanliness. He saw that Marie tends to wash her hands several times during the day. Recently he saw her bleaching surfaces at home, even if they haven’t been touched. When he returns from work she tells him to wash himself and put all his clothes for washing immediately. She cleans them thoroughly. She does the same with her children. She barely gets out of the house, but when she does, Marie makes sure she does not touch things with her bare hands. If she has to open doors in public places she uses a tissue. When David asked her about this she said she does not want to be contaminated with germs. Marie is fixated with this. She realises that this fear of being contaminated is somehow stupid, but she seems not to be able to get rid of it. David mentioned this to his GP, and he told him that Marie might be suffering from Obsessive Compulsive Disorder.

To some extent, we all experience some types of obsessions and compulsions, but for people suffering from OCD, these are continuous, difficult to get rid of, and can be very disabling, that the sufferer cannot live his or her life normally.

The obsessions can take different forms. The most common ones are thoughts of germs and contamination, unpleasant thoughts and images of death or sexual nature, fear that something disastrous might happen (eg. the death of a loved one), and thoughts of harming one’s self or others.

These images and thoughts will make the person feel anxious, so he or she will perform a number of rituals which will help to ease the anxiety.

These are known as compulsions and they usually take the form of cleaning continuously, repeating certain numbers and phrases, checking and re-checking (eg. if doors and windows are closed, if gas and electrical appliances are switched off, etc), arranging things in certain order, collecting (sometimes useless) material and ruminating about trivial things which may result in difficulties in taking even simple decisions.

OCD may also result in the person avoiding certain places or situations, not going out and not touching certain things. Some of the thoughts experienced by people suffering from OCD can be quite disturbing, and might involve violence or blasphemy, which will make the sufferers feel bad about themselves, and they may think they are going “mad”. However these so-called intrusive thoughts are not compatible with the personality of the individual suffering them. Actually, it is extremely rare that people act on these thoughts.

Individuals suffering from OCD realise that the obsessions and compulsions are irrational and ridiculous, but find it difficult to resist them. This can make them feel bad about themselves, it affects their self-esteem and this might have an impact on their social life.

Unfortunately, most of the time, OCD remains undiagnosed for years, and sufferers tend to take long to recognise it as an illness and ask for help. This is because it brings shame and fear to the person experiencing it, and the individual will think this is somehow his or her fault, or that it is something which they can overcome on their own. Due to this embarrassment and reluctance to ask for help, OCD is labelled as the “silent illness”.

OCD affects as many as three in a hundred people, regardless of age, gender, cultural or social background. The World Health Organisation (WHO) rates OCD as the tenth most disabling illness due to diminished quality of life.

Several famous people have admitted to be affected by OCD. Among these, there are actor Billy Bob Thorton, football player David Beckham and historically, the evolutionist Charles Darwin and the famous nurse Florence Nightingale also were known to suffer from OCD. In the movie The Aviator, we see Leonardo Di Caprio playing Howard Hughes, the millionaire entrepreneur who spends his last days of life completely incarcerated by fears of contamination.

Treatment for OCD can be divided into two parts. There is the pharmacological treatment which consists of new, quite effective medication which although can be used for the treatment of depression, has been found to be quite helpful in treating OCD as well.

The other part of the treatment is psychological therapy. A very useful approach in treating OCD is a mixture of medication, cognitive therapy and behavioural techniques. The latter usually helps the individual in managing the anxiety caused by the obsessions, while trying to find ways to avoid performing the compulsions.

These are some other ways on how you can help yourself if you are suffering from OCD:

• Recognise that this is an illness, something for which you need professional help;

• Do not get alarmed by certain disturbing thoughts you might be having, these do not indicate something bad with you as a person;

• Recognise these thoughts for what they really are: Just thoughts and thoughts cannot harm you;

• Avoid alcohol, as although this can help with relieving you from some anxiety, it will make it worse in the long-run;

• Make a list of your compulsions, (eg. checking, counting, washing) and put them in order of severity. Then you can discuss these with your doctor;

• Finally, do not be afraid to ask for help. Consult your GP or a mental health professional. They can direct you on the best way to treat your fears.

Pierre Galea is a Community Psychiatric Nurse