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BENGALURU: She was scared to shake hands with anyone, would not touch anything, not even door knobs or telephone in home, and frequently washed her hands. After suffering from such a condition since she was 10, the 60-year-old Bengaluru resident recently knocked the doors of the Obsessive and Compulsive Disorder (OCD) clinic at the National Institute of Mental Health and Neuro Sciences.
Doctors at the Nimhans OCD clinic, which completed 20 years this June, say at least 3% of the world’s total population suffers from obsessive compulsive disorder.
Increasing awareness about the possibility of obsessions in daily life becoming a serious condition has resulted in more people seeking professional help.The Nimhans clinic that saw 100 OCD cases in its first year now gets at least 500 cases annually.
“We see more than 500 new cases every year apart from the over 2,500 follow-up visits by more than 1,500 patients. The number of new cases is growing with increasing awareness,” said Dr YC Janardhan Reddy, professor of psychiatry and head of the Nimhans OCD clinic.
Doctors say washing hands frequently, bathing for hours, going up and down the stairs and forever logging out and logging in on computer are some of the symptoms of OCD.Though overuse of gadgets cannot be called OCD, doctors observe that addiction to gadgets and OCD systems do overlap.
While a 26-year-old engineer could not stop logging in and out of his computer and made his parents do the same to save data and make sure he logged out of the system, another patient who visits the clinic would bath for 10 hours at night.
Another patient feared contracting HIV infection and would bathe himself dozens of times in an hour.
Counselling and cognitive behavioural therapy can help people suffering from the disorder. Doctors say about 40% of the patients don’t respond satisfactorily to the first drug therapy, necessitating administration of a second drug. Incidentally, obsessive compulsive disorder is usually never treated at its onset.
Drawn into the vortex of never-ending cycles of obsessions and compulsions, patients often end up harming themselves and become a burden on their families. A 45-year-old woman was so eager to get rid of virus on her hands that she constantly began washing them and the skin on her hands peeled off.
700 paediatric cases in 10 years
The OCD clinic at Nimhans has seen 700 paediatric cases in the past 10 years. At least of 15 new cases of children in the age group 8-12 years are treated at the clinic every year.
The clinic had a case of a 16-year-old boy who never went to school on time. Parents also revealed that he would never be satisfied with the way things were arranged on his study table or books were kept in his bag. He would spend at least two hours every morning arranging and rearranging various things and invariably get late to school.
There have also been cases of children who would write answers but strike them down every time and end up never completing their note books and exam answer sheets.
MOST PATIENTS CAN’T DEAL WITH IT
The OCD clinic at Nimhans opens at 9am every Tuesday but patients often turn up only around 10.30am.”Most of them get delayed owing to their obsessions. Most patients are aware of their problem but find it difficult to deal with it,” said Dr YC Janardhan Reddy, head of OCD clinic, Nimhans.
When OCD cases turn severe, one needs medical care, and often has to be hospitalized. Most of them don’t share bathroom with other patients in general ward. “As a new hospital block is coming up, I have requested authorities to consider providing an additional toilet for OCD patients,” he said.
LEGENDS WHO HAD THIS DISORDER
Legendary figures like Prot estant leader Martin Luther, author John Bunyan, litterateur Samuel Johnson and naturalist Charles Darwin suffered from obsessive compulsive disorder. In early 14th century, it was believed in Europe that those stuck in the cycle of obsessive thoughts were possessed by evil forces. Sigmund Freud, in early 20th century, attributed obsessive compulsive behaviour to unconscious conflicts manifesting as typical symptoms. He described the problem of frequent washing of hands as touching phobia.
SOME KEEP PULLING HAIR
The obsessive and compulsive spectrum includes hair pulling, skin picking and body dysmorphic disorders. “There are some who keep pulling their hair and eyebrows. It’s called Trichotellomania.
The patient is completely aware of the condition but is unable to overcome it.
Some suffer from skin picking disorder, a rare condition. We had an 18-year-old female patient who would constantly scratch and pinch her skin. She would try to level the skin. Some of the models too suffer from the problem,” said Dr Shyam Sundar, associate professor of psychiatry at Nimhans who works in the OCD clinic.
A 20-year-old woman from Tamil Nadu was upset with her skin colour and kept applying creams on her face to get fair.
“She suffered from body dysmorphic disorder, another kind of OCD, and suffered burning sensations owing to constant application of cream on her face,” said Dr Sundar.
RESEARCH ON OCD ORIGINS
Research to trace OCD’s roots to the brain in underway. Nimhans is involved in the research along with experts from the US, the Netherlands, South Africa and Brazil. All the five centres chosen for research will follow uniform protocol to understand the biology of illness. The research is funded by the National Institute of Mental Health in the US.