Obsessive-compulsive disorder a.k.a. OCD is not something to be laughed at

Harikrishnan, the quirky hero of North 24 Kaatham (N24K), is different from most of us and that is why there is a rush to encounter him in theatres. He makes us laugh and, occasionally, think. But his condition is no laughing matter as any psychologist will tell you.

It’s normal, on occasion, to give into our urges and compulsions. But when it becomes persistent and repetitive (as it does for Harikrishnan) and disruptive, it’s usually typical of obsessive-compulsive disorder (OCD). Of late, OCD seems to have entered the Malayali psyche, largely thanks to N24K that stars Fahadh Faasil in the lead as a young techie who suffers from the disorder.

But did you know that most of us have differing levels of OCD? Says city-based psychologist Amar Rajan: “Many of us have a measure of OCD – some of us are extremely fastidious about cleanliness, some like to double-check or even triple check if doors are locked, alarms are set or the gas is turned off, some like to count steps, and the like. However, it becomes a clinical issue only when your irrational behaviour affects your day to day social functioning. For example, one patient of mine started counting lampposts on his way to work. He got so obsessed with it that if he thought he had miscounted he would go back and start again, thereby disrupting his entire schedule. If you have OCD you may be able to do little else but spend time on your obsessions and compulsions.”

People are becoming aware of OCD through their exposure to movies such as N24K, television, health magazines, the internet, and so on. “They are actively searching for informed solutions, when earlier such behavioural disorders would be broadly categorised under that quintessential Malayali phrase vattu (mad)!” says Amar, director of Mindcarter, who, incidentally, enacted the role of the psychologist who treats the hero in N24K.

OCD, say mental health professionals, is not be brushed away as another loony trait and is a far more common disorder than we would imagine.

OCD was considered a relatively rare disorder until about a couple of decades ago – perhaps because very few cases were reported. Data available for OCD prevalence in India is limited, say mental health professionals, but at least three per cent of the population, is said to have the disorder.

“Over the past 10 years or so, OCD seems to be on a rise. It is increasingly becoming prevalent in early adulthood and middle aged professionals,” says psychologist Aravind Thampi, assistant professor, S.N. College, Chempazhanthy.

Dr. Aravind attributes the rise in OCD to the quest for perfection. “Many of us are forced to aim for perfection. Only about 40 per cent of people would fall into the groove. The rest of them fall short of expectations and would naturally tend to get stressed out trying to maintain a certain standard. Some of these people internalise the issues which may lead to OCD,” he explains.

For instance, nowadays a five year old is expected to have perfect handwriting! “This undue over importance given to trivial stuff unknowingly leads to over perfection and fear – one of the typical symptoms of OCD,” he adds. Amar, meanwhile, says that it has also got to do with the concept of “more” that’s prevalent in society, what he calls the “supermarket shopping” behaviour. “If once we only had the option to select, say, a dress, from four or five available in a store, today we get to choose one from over 500 pieces! Our choices have grown exponentially but time has remained the same or is limited. This often manifests as anxiety, which is the primary cause of OCD.”

OCD symptoms include a variety of obsessive thoughts such as fear of dirt and germs, fear that something’s going to happen, over concern with neatness, order, cleanliness, and so on, and/or compulsive behaviour such as frequent hand washing, repeated checking, hoarding and the like.

Now that awareness is much more, treatment is not limited to age-old therapies of (literally) beating the devil out of the body. Says Amar: “Treatment, these days, is a combination of various forms of counselling such as exposure therapy and cognitive therapy. For example, one of my patients used to shower at least five to six time times a day. Then he had to go for a medical camp where he couldn’t shower for 15 days and that helped alleviate his anxiety by a huge measure. In acute cases of psychotic OCD, where patients may have harmful or murderous thoughts, medication is also recommended.”

What’s OCD?

OCD is characterised by distressing, intrusive obsessive thoughts and/or repetitive compulsive physical or mental acts. With OCD, you may realise that your obsessions aren’t reasonable, and you may try to ignore them or stop them. But that only increases your distress and anxiety. Ultimately, you feel driven to perform compulsive acts in an effort to ease your stressful feelings.

Case Studies

One of Dr. Aravind’s patients is a 23-year-old techie, who works at Technopark and who is the sole breadwinner for his family. “His manager referred him to me – not because he is tardy at work but because of his desperation for perfection!” The youngster’s every fear, from losing his job, to fraternising and socialising with his colleagues, to even eating out revolves around money. “He feels that whatever he does out of routine may cost him money; money that he thinks he doesn’t have. His OCD symptoms manifest into gastric problems, introvert behaviour, excessive hand washing, unwarranted sexual thoughts, having things orderly and symmetrical, intense doubts, and so on.”

Another is a middle aged man, a well-known figure in the city, who indulged in an extra-marital affair for a couple of months and developed OCD out of guilt. “It’s been three years since the affair but he is living with the guilt as if it happened yesterday. He compulsively checks his mobile phone several times in the middle of the night to see if he had deleted messages from his former lover. He washes his hands because he feels “unclean”. He bites his nails until they bleed. He finds it difficult to go alone to even a male friend’s house, and, more curiously… he needs to circle a roundabout at least six times before taking an exit!”