OCD (Obsessive Compulsive Disorder) is no laughing matter. It is a devastating mental disorder that can easily turn one’s life into a living hell. But that does not mean we cannot use a little bit of humor to cope with this terrifying disorder. While OCD itself is far from being funny, the situations that can […]OCD & Humor – Is Life A Tragedy..Or A Comedy? — Overcoming OCD
Cover your face, scrub your hands, repeat. The pandemic has heightened anxieties of infection, even more so for people with obsessive compulsive disorder
Once in every 20 minutes, like clockwork, Sivakumar Bharati* washes his hands and checks if the window are shut. “I have not ‘relaxed’ in three months aside from my REM sleep,” he says. “There is the prevalent fear of germs and contamination which is why the pandemic has been particularly stressful.”
This is the reality of OCD or obsessive compulsive disorder.
“You don’t really take notice of it until someone else points it out — and a lot of people did,” says 59-year-old retiree Sivakumar . “And back in the 70s, mental health was not taken seriously. People back then just thought I was militant about being neat, some poked fun at it.”
Sivakumar’s home in Hyderabad is evident of his obsessive compulsive disorder: to want everything symmetrical, no clutter, even the presence of muted tones. There are moments of anger and frustration where if things are not lined up, there would be a meltdown, curable only by the correct positioning and considerable time to cool off.
Chennai-based Professor Dr Gauthamadas Udipi, specialist in neuro-behavioural medicine, who has worked with people with OCD for almost many years explains, “OCD may only be the behavioural marker of a more extensive systemic disorder. “After all, the mind is only an expression of the functioning of the brain, and the brain is only a part of the body. At one end of the OC spectrum is ‘normal’ obsessive thinking and ordered behaviour in daily life, which does not interfere significantly with daily functioning. At the other end is severe obsessive rumination and compulsive behaviour that does not allow daily function.”
Essentially, the underlying pathology is in the Salience Network (SalNet) or ‘worry-loop’ of the brain, which sees a person having uncontrollable, reoccurring thoughts and/or behaviours that they feel the urge to repeat over and over; it can be especially harrowing now, owing to the COVID-19 pandemic which invites uncertainty, rising tensions and innumerable risk factors. Often caused by severe psychological stresses, OCD manifests in different forms, from ritualistic obsessions to suicidal compulsions. Sivakumar is on the lower end of this spectrum, and it took a long time for him to realise what he had.
‘I’m OCD about that’
Sivakumar, during the late 2010s, was finally formally diagnosed by a neurologist in South Africa, who stated that OCD is a legitimate condition — and not one about which to be ashamed. “I remember him mentioning how popular culture had not even normalised but trivialised OCD. The parameters of what was ‘deemed’ OCD had shifted in a big way; people thought being tidy was OCD,” recalls Sivakumar.
And things have not been easy as the pandemic trudges on.
Dr Udipi affirms that the pandemic can be a heightener, explaining, it could “result in triggering underlying OC spectrum disorders in a genetically prone person, tilt the balance from ‘normal’ obsessions to a pathological OC pattern, or worsen an already existing OC disorder.”
The International OCD Foundation, Boston, sees the unique challenges for the OCD-afflicted and has offered numerous online resources, which are free-to-use and which help people run through their OCD anxiety with some ease while maintaining physical distancing. These options include WHO-approved tips on how to deal with contamination fears, video teletherapy, which helps those with OCD find a licensed teletherapy provider while retaining physical distancing, and printable coping cards. These cards, not a replacement for help from a medical professional, are written reminders and questions for the self to be mindful, breathe easy, take back control and understand that progress is better than perfection.
Dr Udipi adds that empathy from close friends and family is helpful. “[They] must understand that this is a disorder originating in brain circuits over which the person has little control, and advising the person that ‘it is all in the mind’, and ‘learn to control it’ is of no use, and that yoga, meditation, and other ‘self-therapies’ will not work in the case of a ‘pure obsessive thinking’ (which occurs in a very small percentage of people with SalNet disorder), as the person cannot bring the mind to focus on them due to pure circuit overdrive.” He emphasises that early identification and proper treatment by a qualified psychiatrist and team is the key.
Sivakumar agrees, concluding, “There are times you may not feel worthy because you feel like you are adding stress to home life or work life. But when you start humanising yourself with the help of a mindful and informed healthcare professional, it helps tremendously. It also helped that my family and I could find common ground with patience. But for other OCD folks out there, you have to want to accept it as a condition and not as an extension of the self. It’s emotionally taxing to go through it because your mind is telling you that this obsessive order of things is paramount.”
* Name changed to protect identity
1. Most of us tend to be attracted to people who are similar to ourselves.
2. We ignore the ones who adore us and pay attention to those who ignore us.
3. Looking into each other’s eyes can make strangers fall in love.
4. It only takes up to 4 minutes to decide whether you like someone or not.
5. Falling in love has a similar neurological effect as getting high on cocaine.
6. Butterflies in the stomach are real and they’re actually caused by adrenaline.
7. The longer you hide your feelings for someone, the harder you fall for that person.
8. 90% people text things they can’t say in person.
9. People at the same level of attractiveness are more likely to end up together.
10. Romantic love is biochemically indistinguishable from having a severe obsessive-compulsive disorder.
11. Feeling ignored causes the same chemical effect as that of an injury.
12. The very last person on your mind before you fall asleep and the first person on your mind when you wake up is either the reason for your happiness or your pain.
13. Looking at a picture of a loved one can help to relieve pain and stress.
14. The brain treats rejection like physical pain.
15. It is possible to die from a broken heart. It is called Stress Cardiomyopathy.
16. Once you fall in love, there is no going back to being friends again. So, you can’t be a friend with the person you loved after you broke up. If you can still stay as friends, you have never been in love with that person.
17. Hearts have nothing to do with the feeling of ‘being in love.’ It is only a chemical reaction happening in your brain.
Pica is a term that refers to cravings for substances that are largely non-nutritive or rather non-foods, such as hair, paper, ice, glue soil, stones, drywall or paint, sharp objects, metal, glass, chalk, etc. The word pica is derived from the Latin word for the bird magpie that feeds on whatever it encounters.
According to the current estimate of the Handbook of Clinical Child Psychology the prevalence rates of pica range from 4% to 26% among institutionalized populations. Pica is more common among children and pregnant women. People with certain mental health conditions such as schizophrenia and obsessive-compulsive disorder may also develop pica as a coping mechanism. It is usually temporary but is often more severe and long-lasting in people with severe developmental disabilities.
There’s no single cause of this eating disorder. In some cases, it may be related to mental retardation or mental illness, while in others, it may be associated with a deficiency in iron, zinc, or another nutrient resulting from malnutrition. Pica has also been found to be associated with decreased activity of the dopamine system in the brain. Dopamine is a neurotransmitter that aids relaying the transmission of nerve impulses from one neuron to another. Due to this association, some researchers think that there may be a connection between abnormally low levels of dopamine in the brain and the development of pica. However, no specific underlying biochemical disorders have been identified.
The following four criteria have been posited by Diagnostic and Statistical Manual of Mental Disorders, 5th edition that must be met to diagnose a person with pica:
1. Person must persist in eating non-nutritive non-foods for at least one month.
2. This eating must be considered abnormal for the person’s stage of development.
3. Eating these substances cannot be associated with a cultural practice that is considered normal in the social context of that person.
4. For people who currently have a medical condition such as pregnancy or a mental disorder like autism spectrum disorder, the action of eating non-nutritive non-foods should only be considered pica if it is dangerous and requires extra medical investigation or treatment on top of what they are already receiving for their pre-existing condition.
Anxiety is one of the most common yet most debilitating mental health conditions that can range from worry to full-blown anxiety disorders. There would rarely be anyone who has never worried about anything in his or her life and therefore, occasional worry or fear is rather a part of normal life. We often worry about the wellbeing of our loved ones or we may fear for our own safety too. Sometimes we worry about our financial situations or our work while at other times we are just concerned about our future. These occasional worries are not always bad; in fact, they are somewhat good for our survival. They help us prepare ourselves to deal with life’s challenges. However, worries can sometimes take acute form and become unbearable, excessive, irrational, or even uncontrollable and are accompanied with physical symptoms such as increased palpitation of heart, sweating, and trembling. If you too are experiencing these symptoms, you might be suffering from full blown anxiety disorder. The Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) recognizes seven primary types of anxiety disorders: phobic disorders of the “specific” or of the “social” type, panic disorder with or without agoraphobia, generalized anxiety disorder (GAD), obsessive-compulsive disorder (OCD), and posttraumatic stress disorder (PTSD). GAD is the most common of these anxiety disorders and is characterized by chronic excessive worry about a number of events or activities. The subjective experience of excessive worry in GAD is accompanied by following symptoms:
- Restlessness or feelings of being keyed up or on edge
- a sense of being easily fatigued
- difficulty concentrating or mind going blank
- muscle tension
- sleep disturbance
However, an individual who worries a lot does not necessarily suffer from anxiety disorders. Sometimes having an unhealthy lifestyle can make you feel anxious. Following are some self-help techniques that can help you keep anxiety in check and manage symptoms of anxiety, though these must not be considered a substitute for professional help or treatment:
Exercise/Running: Performing regular exercise and going for jogging or brisk walk has been scientifically proven to help allay anxiety symptoms. Exercise releases chemicals, i.e., endorphins in the brain that can counter symptoms of anxiety and improves mood. It also helps in lowering stress hormone cortisol that is secreted when we are anxious. Several studies have shown overall benefits of exercise on mind and body. Exercising for half an hour four times a week has been recommended for those suffering from anxiety.
Socialize: Meet people you trust and share your thoughts and feelings with them. Isolation and loneliness has been shown to increase the symptoms of anxiety. You can also talk to your trusted friends over phone and share your worries with them. Since anxiety is often based on irrational thoughts, talking to others can bring sense to our unwarranted thoughts. Suppressing and keeping your thoughts to yourself, on the other hand, can make them overwhelming and difficult to deal with. You can join some support group also, where other anxiety patients like you share their thoughts, feelings, progress, etc. Make socializing a part of your daily routine no matter how difficult it sometimes may feel.
Muscular relaxation technique: Try Jacobson’s progressive muscle relaxation technique. Since individuals who experience anxiety symptoms tend to have high arousal, progressive muscle relaxation technique can help release physical tension.
Sleep: Lack of good sleep can aggravate the symptoms. So in order to keep your anxiety symptoms under check, get qualitative 7 – 8 hours of sleep a night.
Deep breathing: Breathing from your gut has been scientifically proven to lower the arousal level of body. Hence, deep breathing exercise can help calm your body and mind. Use deep breathing to relieve immediate symptoms of anxiety like hyperventilation or shortness of breath.
Stay in the present: Anxiety disorders are often future-based, which means, you tend to worry about the things that you feel are going to happen. So in such instances, try to focus on the present. Ask yourself about what is happening at the moment. Mindfulness can help you stay in the moment. Mindfulness is a technique where we are made aware of what is going on around us through our five senses. What do we see, hear, smell, feel, and taste. A regular practice in mindfulness can help you ease anxiety symptoms.
Train your mind: Anxiety is often based on thoughts; therefore, in order to deal with it, one has to work on one’s thoughts. Be accepting to the fact that you cannot actually control everything. Try to do your best instead of striving for perfection. Research studies provide evidence regarding link between perfectionism and mental health disorders like anxiety and depression. Replace negative thoughts with positive ones and try to maintain positive attitude about life.
Challenge your thoughts: Most of the worries and fears in anxiety are irrational and without any base. Identify your apprehensions and challenge each and every single thought that comes to your mind.
Eating healthy: Avoid consuming alcohol and caffeine and focus on eating a well-balanced diet. Eating healthy food helps maintain healthy mind and body. Stay hydrated. It may seem like too simple a remedy but staying hydrated can go a long way in managing anxiety. Whenever you experience anxiety symptoms, drink water as it helps lower the arousal.
Use art as mode of expression: Art therapy has also been found to help relieve anxiety symptoms. Use dance or painting as a mode of giving outlet to your thoughts and feelings. It can also help you take your mind off your worries.
Professional help: If you feel that your anxiety symptoms are interfering with your daily functioning, don’t hesitate to take professional help from a psychiatrist or psychologists or other healthcare provider in your community. Professional treatment mostly includes medications for severe symptoms, along with cognitive behavioral therapy.
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