Autonopedia

OBSESSIVE COMPULSIVE DISORDER

OBSESSIVE-COMPULSIVE DISORDER Is a fairly common psychiatric disorder, and one that many people harbour misconceptions about. We've all heard the words 'obsessive' and 'compulsive' used blithely and interchangeably, as in 'She's obsessive about keeping her car clean' and 'He's a compulsive shopper'.

In reality, obsessive-compulsive disorder is a type of anxiety disorder. People who have it experience unwanted, recurrent, insuppressible thoughts that drive them to perform ritualised behaviours repeatedly. The repeated, troubling thoughts are obsessions; the resultant feelings of distress drive the compulsive behaviours. Usually, the behaviours temporarily relieve the thoughts. Then the thoughts recur and demand that the behaviour be repeated. It's as though the brain is stuck in a groove, like a needle caught in a scratch on a record.

Many people have had symptoms of obsessive-compulsive disorder at some point in their lives.
No one knows exactly what causes obsessive-compulsive disorder. It can run in families, which indicates a genetic component. In addition, brain scans of obsessive-compulsive patients show actual abnormalities in certain nerve circuits. These circuits use serotonin, a mood­controlling brain chemical, as their messenger, and insufficient serotonin levels seem to play an important role in obsessive-compulsive disorder. In fact, drugs that increase the brain's concentration of serotonin often alleviate symptoms.

If you think you may have this disorder, talk to your doctor. Some people with obsessive-compulsive behaviour need medication. Others may do well with specific types of psychotherapy. Many people will need to combine drugs or herbal remedies with psychotherapy. Drug treatment usually involves antidepressants, which may take several weeks to reach their full effectiveness.
No herbs have undergone testing in people with obsessive­compulsive disorder. Although anecdotal information and traditional use suggest that some herbs may reduce symptoms, there aren't yet enough statistics for patients to rely on them as a sole treatment.

It is absolutely crucial that people taking prescription antidepressants do not add herbs to their regimen or change their medication routine without their doctor's supervision. Some antidepressants, when abruptly discontinued, cause withdrawal symptoms. Others may interact with herbal remedies to produce negative, even dangerous, side effects.

DRUG TREATMENT

Selective Serotonin Re-Uptake Inhibitors (SSRIs)
Fluoxetine (Prozac), fluvoxamine maleate (Faverin), paroxetine (Seroxat), sertraline (Lustral). Function: increase brain levels of serotonin, a mood-controlling brain chemical, to relieve symptoms. Side effects: insomnia, anxiety, nervousness, headache, drowsiness, diarrhoea, increased sweating.

Tricyclic Antidepressants
Clomipramine hydrochloride (Anafranil), others. Function: reduces depression and obsessive-compulsive disorder by influencing brain chemistry. Side effects: tremors, headache, dry mouth, unpleasant taste in mouth, excessive sweating, nausea, constipation or diarrhoea, fatigue, weakness, drowsiness, anxiety, insomnia, cravings for sweets.

HERBAL REMEDIES

St John's Wort (Hypericum perforatum)
It's well known that this herb has been shown in many studies to ease mild-to-moderate depression. As of this writing, no trials have investigated whether St John's wort can help people with obsessive­compulsive disorder. Some doctors and other health practitioners have reported that some of their patients have responded positively to the herb. Many products are standardised to contain 0.3 per cent hypericin, one of the constituents of St John's wort. Typical dosage (based on usual guidelines for depression): 900 milligrams in standardised pills or capsules per day, divided into two or three doses; or 15 to 40 drops of tincture up to three times per day. St John's wort can take as long as six weeks to produce benefits; increasing the dosage doesn't shorten this time. Caution: on rare occasions, people who take St John's wort may experience gastrointestinal irritation, allergic reactions, restlessness, dry mouth, fatigue or increased skin reactions to sun exposure. Do not substitute St John's wort for prescription antidepressants or take it with such antidepressants or L-dopa unless under the guidance of a doctor. Consult a doctor before taking it if you are pregnant or breastfeeding.

Kava-Kava (Piper methysticum)
German doctors commonly prescribe this herb for anxiety and stress. Because obsessive-compulsive disorder is a type of anxiety disorder, kava may help reduce some of the symptoms. Typical dosage: up to six 400- to 500-milligram capsules of a non-standardised product per day, divided into three doses; or 70 milligrams of kavalactones in a standardised extract one to three times per day; or 15 to 30 drops of tincture in water one to three times per day. Caution: large doses of kava can induce a euphoric state, muscle weakness and dizziness. Do not use if you're pregnant or breastfeeding. Do not combine with alcohol or with drugs that depress the central nervous system, such as sedatives and antidepressants.

Valerian (Valeriana officinalis)
Valerian soothes anxiety when given in small doses, while larger doses make most people sleepy. Laboratory tests have shown that components of valerian root bind to the same brain receptors as benzodiazepines, the family of drugs that includes Valium and other tranquillisers. (Remember, however, that you can't substitute valerian for these tranquillisers: abruptly discontinuing them can produce dangerous withdrawal symptoms.) Some practitioners reserve valerian for evening use and prefer kava for daytime. Typical dosage: 300 to 400 milligrams of product standardised to 0.5 to 0.8 per cent valeric acid per day; or 20 to 60 drops of tincture per day. Caution: may cause stomach upset.

California Poppy (Eschscholzia californica)
This herb can decrease anxiety and, in larger doses, insomnia. Typical dosage: 2 to 3 cups of tea per day (steep 1 teaspoon of dried herb and/or roots in '/, litre of boiling water for 15 minutes); or 30 to 40 drops of tincture two or three times per day. Caution: may interact with monoamine oxidase (MAO) inhibitor antidepressants. Not recommended for
use if you are pregnant.

Bergamot (Citrus bergamia)
The essential oil of this herb, used in aromatherapy, can discourage compulsive behaviours, soothe anxiety and lift the spirits. So say herbalists Kathi Keville and Mindy Green, authors of Aromatherapy:
A Complete Guide to the Healing Art. To use bergamot essential oil, put 3 to 5 drops in warm water and inhale; or add about 10 drops to warm bath water and soak. Caution: can increase skin reactions to sun exposure. Do not take internally.