What is anxiety disorder and obsessive compulsive disorder (O.C.D.)?

Anxiety disorders are conditions that interfere with your ability to control or stop a sense of continuous worry or fear. They are very common and have the same incidence and lifetime risk as the mood disorders. Anxiety disorders are commonly found with depression since the continuous anxious thoughts are just another form of negative clutter and racing thoughts that can't be shut off. In my opinion, anxiety appears to be a subtype of the depressive mood disorder since they both have negative thoughts that can't be controlled and they both respond to the same medications.

There are several types of anxiety disorders. Panic disorder is the most severe and disabling of these conditions. In this disorder, panic attacks will start with no obvious trigger. There will be sudden unexplained terror and a sense of impending doom. There will be many physical symptoms that occur simultaneously like a pounding heart, sweating, chest pain and light headedness. Phobic disorder is when a person will become very fearful or even panic over a well defined object or situation like heights, snakes or crowds. General anxiety disorder is when a person is worried all the time about everything.

Obsessive Compulsive Disorder (O.C.D.)

Obsessive Compulsive Disorder (O.C.D.) is quite a common disabling anxiety disorder. Three percent of the population will suffer from it at some time in their lives. It is more common than schizophrenia or manic depression but it is well concealed and rarely diagnosed.

Obsessional thoughts are recurrent, intrusive, unwanted ideas, images, impulses or worries that are often senseless but can't be shut off. They will often take the form of swear words, repetitive phrases, violent thoughts which are totally out of character or feelings of being dirty or contaminated. This is very disturbing for the victim who feels powerless to control the thoughts. The anxiety associated with O.C.D. can be overwhelming.

Compulsions are repetitive unnecessary acts done in response to the obsessional thoughts. They are intended to neutralize the fear or discomfort that comes with the obsessional thoughts. These acts are purposeless, time consuming and unwanted. They are very disruptive to relationships and to one's performance at home or work. The acts usually involve excessive touching, checking, cleaning, washing, counting or note taking. The victim hates doing it but must continue the act until they get a sense of completion which may require a large number of repetitions. During the compulsion there is never a sense that the action has been completed correctly. Some have described it like an itch that won't go away until it is scratched a certain way and a certain number of times.

The most common obsessions are fear of contamination by dirt or germs, fear of harm to self or others, fear of illness, fear of sexual thoughts and fear of committing sins. The most common repetitive rituals to suppress the fearful thoughts are repetitive cleaning, recitation of a phrase or number, touching, checking of locks, excessive orderliness and hoarding. It is not uncommon for someone with O.C.D. to wash their hands thirty times a day to stop the fear of contamination.

Anxiety and depression are often so intertwined that they are indistinguishable. In my clinic I have not found it necessary to separate the conditions. They both have negative thoughts that can't be shut off and they both respond to the same antidepressants which are designed to restore thought control.

The text of this section contains excerpts from "Healthy Moods"

Illustrations by Rev. Jim Keddy

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