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OCD & OCPD-Two syndromes. One misconception. Everything you need to know about it.


With the entire world going through a healthcare crisis at the moment, hygiene and sanitation are of utmost priority in this arduous battle. Putting aside the fact that hygiene must be a priority despite the presence of a Pandemic, now more than ever, we constantly find ourselves hyper-vigilant about what we touch, washing our hands repeatedly and the general anxiety that looms over us like a rain laden cloud.

Imagine this anxiety, this need to dispel said anxiety by doing tasks (like washing hands or locking doors) 10, 20, 30 times, repeatedly, unable to get out of this never-ending loop?

That is just scratching the surface of how people with OCD manage to go through their daily tasks on a regular day. Doctors or medical professionals having this disorder fall into a rare category. Under high pressure circumstances like the COVID –19 pandemic, these individuals find themselves in a deeper rut than most. This is why we felt that it couldn't have be a more appropriate time to discuss what OCD actually entails, clear up certain myths related to it, understand the fundamental difference between OCD and OCPD and look at examples of people in the medical/healthcare industry that carry the burden of this disorder along with the pressure of being a healthcare professional.

What is OCD?

OCD is a specific type of anxiety disorder characterized by unwanted or recurring thoughts, feelings, ideas or sensations (also known as obsessions) and/or behaviours that drive people to do something over and over again (also known as resulting compulsions) in order to reduce the anxiety caused by the obsessions.



In simpler words, it is the presence of an intrusive thought (obsession) in your mind that causes you crushing anxiety. To get rid of a thought is not as easy as it sounds. So, in an attempt to expel said intrusive thought, you begin doing activities that take your mind off of it. Over and over and over again.

Diagnostic criteria of OCD:



Note: An official diagnosis must be made by a mental health professional only.

In addition to the aforementioned criteria, it is important to remember that OCD is varied in its manifestation in different individuals. Not everyone suffers from a compulsion to keep everything neat or wash hands repeatedly. It might prove helpful to know the different kinds of compulsions that are born out of specific kinds of obsessions.



Note: Statistics of OCD prevalence and data collected about the people that actually suffer from the same are very less in India. This scarcity of data makes way for insufficient basis in research studies and hence most of the information derived about this disorder depends on the sparse pre – existing research journals based out of India.

A couple of Myth busters to give you a breather!


Myth: People with OCD love keeping things neat and organized.

Fact: OCD is a legitimate illness that affects a considerable slice of the population. Individuals with OCD do not love to have everything in order; they would face crushing anxiety and crippling thoughts if they do not engage in said activities.

Myth: OCD is just about cleaning, hand washing and being a “germaphobe”.

Fact: As stated by Psychology Today, “OCD is a heterogeneous disorder”. This means that it manifests in different forms in different people. While cleaning and hand washing are a result of a fear of germs and contamination, other kinds of intrusive thoughts involve fear of committing a sin, fear of a loved one dying or a debilitating fear of harming oneself.

OCPD:

We have often heard of people calling neat and organized individuals as being a little “OCD”. Here, “OCD” is being used as an adjective to describe someone. What they call “OCD” is plain wrong and is more often what we know as Obsessive-Compulsive Personality Disorder or OCPD.


Individuals with OCPD are said to have maladaptive traits and behaviours, including perfectionism that interferes with completing tasks, rigid following of moral or ethical codes, hoarding behaviours, and an excessive fixation with lists and rules. They have an overwhelming need for order, a strong sense of “how things should be done,” and a rigidity when it comes to following rules.

What is the difference between OCD and OCPD?

While OCD is an anxiety disorder, like Panic Attacks or Phobias, OCPD is a Personality Disorder. What it simply means is that individuals that are perfectionists, rigid in their way of doing things and obsessed with cleanliness have it as a part of their personality right from their childhood. It is as normal as being an extrovert or an introvert; a personality trait and not a disease. On the other hand, OCD is born out of unwanted thoughts and often shows up in young adulthood. It is not a part of the person’s personality and is always akin to torture to the individual suffering from it.



OCD and OCPD in medicos: A glimpse


“I wasn’t trying to honor everything; I was just trying not to fail. I was trying to manage debilitating anxiety so I could become a doctor.” - Rachel Davis


According to a firsthand account given by Rachel Davis, an American Psychiatrist with OCD, functioning with high levels of anxiety in an environment such as the hospital was a massive task in itself. One would think that continuing in this profession seems like a distant dream while afflicted with this disorder, that it is the end of one’s career as a medical professional. However, Rachel details in her account of her experience that her training as an EMT was probably what got her through this difficult time. She says that disentangling herself from the crushing anxiety that accompanies OCD would have been nearly impossible without her overarching goal of becoming a doctor. Being able to do something in high pressure situations gave her a sense of control that her disorder never let her have. What jumps out as the most crucial part of her story is that she was recommended timely help by a mentor of hers. While she knew what she was experiencing (anxiety) was not normal in the least, the drive to becoming a doctor overshadowed her need to slow down and address her increasingly vice-like illness. It serves as a necessary reminder for all medical students and professionals alike to stay vigilant when it comes to matters of their own health.

A blog article by the Yale School of Medicine provides another interesting perspective. As mentioned earlier, OCPD is more prevalent than OCD is and it’s often confused with the latter. Several of these OCPD traits, like an overindulgence in work and perfectionism, also characterize many medicos without OCD. The risk of reaching a burnout when one has an Obsessive-Compulsive Personality is particularly high. Post Graduate students or working medicos are thus encouraged to strive for excellence and not get caught up in the vicious cycle of perfectionism (as permeated by an Obsessive-Compulsive Personality).


Note: A research paper conducted by The Indian Journal of Psychiatry exploring the prevalence of OCD in college students of Kerala found that the Indian youth were found to have a lesser percentage of prevalence of OCD in comparison to our Western neighbors.

Conclusion:

OCD is not just a personality quirk; it is a legitimate disorder. Despite the fact that it affects a miniscule portion of the population, the casual attitude towards its presence and treatment render it a necessity to bring about more awareness. Unlike other mental disorders, OCD cannot be completely cured. It is through a careful mix of therapy (like Cognitive Behavioural Therapy) and medications that it can be brought to a manageable level.


Note: If you suspect that you or a loved one is afflicted with this disorder, it is highly advisable to approach a mental health professional at the earliest.


Being as serious as it is, the next time you hear of someone bringing up any myths about this disorder, correct them with the facts that you have gleaned by reading this article. We believe small steps in debunking misinformation would go a long way in dispelling the stigma and ‘take it for granted’ attitude attributed to this disorder. We hope this was useful and that you’ve walked away with more information than you came here with! Stay safe and stay vigilant!

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