Obsessions can lead to depression

Jane wakes up at precisely 6:20 a.m. each morning. But every night she checks the accuracy of her clock many times. To assure that the alarm is correctly set, she checks it three, four or even more times.

When she awakens in the morning she always gets out of the bed on the same side and puts her left foot on the floor first. If for some reason her right foot touches the floor first, she feels she must get back under the covers and start all over. The left foot must be first.

She cooks her breakfast on an electric hotplate, even though her apartment is equipped with a modern gas range. She has taped the oven’s door shut and has disconnected it from the gas outlet. Jane has a recurring fear that she might place her infant nephew in the oven and turn on the gas when she is babysitting for her sister.

When she gets to work she takes the elevator to the floor below her office and walks up one flight of stairs. She believes that if the elevator stops on her floor, a number she considers to be unlucky, it might become stuck, and she would be trapped for hours.

Jane goes through the day ruled by obsessional thoughts and ritualistic behaviors. She, along with an estimated 5 million to 6 million other Americans, suffers from obsessive-compulsive disorder, a frightening and potentially debilitating problem. OCD usually begins in adolescence or early adulthood, although it may begin for some people in childhood. Causing moderate to severe impairment, OCD victims may spend the majority of their waking hours in compulsive routines. OCD seems equally common in males and females.

Many of us follow certain routines in life, such as sitting in the same pew week after week in church, carrying our handkerchief in the same pocket most of the time, and usually putting on the same shoe first. These mild eccentricities are not normally bothersome, and some routine in daily activities is helpful. Consider, however, the life of the individual who secretly washes his hands 50 to 60 times a day. Because of a fear of germs, such an individual might arrive at work 30 minutes early each morning to swab with alcohol all the furniture, desks, pencils, typewriter and anything else they might touch.

Pathologically, obsessive compulsive individuals live in a hell in which they repeat and rehearse normal doubts and daily routines, sometimes hundreds of times a day. OCD seems to run in families.

Obsessions are persistent ideas, thoughts, impulses or images that often begin quite innocently and spontaneously.

“What if I slap my mother while she is talking to me?”

“What if I stab my child with a butcher knife?”

Victims know these thoughts are irrational and begin to believe themselves crazy, which they are not. The ideas simply get stuck in their minds, somewhat like a needle stuck in the groove of a record. The individual tries to ignore the thoughts or neutralize them with competing thought or action. The most common obsessions are repetitive thoughts of violence, such as killing one’s child; contamination, such as the fear of germs or infection; or doubt, such as whether one has poisoned his or her dinner guests.

OCD frequently leads to severe depression and can rule an individual’s life. Next week I will discuss compulsive disorders and talk about treatment for the unfortunate victims.

Copyright c 1990 Harold H. LeCrone, Jr., Ph.D.