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Expert Q&A

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Why are my OCD feelings so intense?

Asked by Susan, Oklahoma

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I have OCD. When I hear the sink faucet turn off, it makes a squeaking noise, and I feel tense and need to use antibacterial wipes on my hands. I also feel tense and need to use antibacterial wipes when I hear someone say the word "gas," when I see a red gas tank anywhere, when I see a gas nozzle at a gas station (or on TV), and the red color of a gas tank on anything plastic similar to a red gas tank. I also hate looking at sinks in the bathroom and kitchen because I feel tense and literally walk around the apartment covering my eyes so I do not see those objects when I am passing them. Why do I feel so intensely about these things? What can I do?

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Mental Health Expert Dr. Charles Raison Psychiatrist,
Emory University Medical School

Expert answer

Dear Susan,

I am sorry to hear about your very intense and disabling struggles with sinks and red tank-like objects.

Your issues might sound odd to folks who don't know much about OCD (obsessive-compulsive disorder), but for anyone who suffers with the condition, or has treated it, your problems are very typical.

This is good news indeed, because it means that your problems can very likely be improved significantly.

Although OCD is one of the most disabling of psychiatric conditions, it is also one of the most treatable. And although many patients are not able to rid themselves of symptoms entirely, almost always, the symptoms can be brought down to a manageable level, allowing people to resume their normal lives.

Given the intensity of your symptoms, I would recommend you see a mental health clinician, who will recommend a specific type of behavioral therapy, a serotonin antidepressant, or both.

I wish I had space in this blog to tell you any of the myriad cases I've seen of people whose lives have been turned around by these interventions.

But in the meantime, because you've asked me what you can do, let me make a few simple suggestions

All effective psychotherapies are based on the discovery that the intense discomfort caused by obsessions (in your case the fear of germs) fades if a person can resist doing the compulsion that the obsession sparks (in your case, using hand wipes or avoiding looking at sinks).

On the other hand, compulsions -- while giving immediate relief -- actually make the obsessions worse over time.

Here's an analogy: We've all had the experience of having a place that itches. When you itch, you scratch, but we all know that the scratching, while relieving the itch briefly, only makes it worse over time.

On the other hand, if you ignore the itch, it fades over time. Obsessions are like the itches, and compulsions are like the scratching.

So the way forward is not easy, but it is doable if you take it a step at a time. What you need to do is purposely expose yourself to the things that cause the mental torture and then tolerate them for as long as you can without doing any compulsions.

You could start with any of the obsessive triggers. I might start by saying the word "gas" over and over again for as long as you can stand without wiping your hands. Another simple -- but far from easy! -- approach might be to sit in front of a sink in your apartment, staring at it without looking away.

The longer you can do this, the more you'll notice that the anxiety is fading.

If you are saying to yourself that these activities are too difficult to even contemplate trying, then I doubly recommend that you seek professional help.

Believe me, I know from experiences with patients and family members how terrible this disease is. But remember: I also know well the sweet relief in people's eyes when they take action and begin to heal.

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