Obsessive-compulsive disorder, which affects roughly 3 million Americans, is much more widely understood than it was even a decade ago.
Eric McClendon’s earliest memories are of his obsessive-compulsive disorder.
“I was picking lint off the carpet,” said McClendon, now 49, of San Francisco. “Later I was making sure everything was really clean. I was straightening towels, brushing my teeth too long, taking too many baths.”
McClendon called himself a perfectionist and a neat-freak. Everyone he knew thought he was “strange.”
It took more than 20 years for McClendon to be diagnosed with obsessive-compulsive disorder, and another decade for him to go through treatment, which has improved his life dramatically but hasn’t cured him outright.
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Today, McClendon is talking about his condition and experiences to offer hope that even the most debilitating of cases can benefit from treatment — as long as patients are willing to ask for help and face their illness.
Thanks to popular culture — reality TV shows in particular — and a growing field of research, obsessive-compulsive disorder, which affects roughly 3 million Americans, is much more widely understood than it was even a decade ago. And the treatments — while often grueling for patients — can be very effective.
But OCD is rarely cured, and, like McClendon, most people still wait years to be properly diagnosed, doctors said.
“OCD is very treatable. It’s a chronic disease, but you can get significant improvements,” said Dr. Carol Mathews, director of University of California, San Francisco Anxiety Disorders Clinic. “Unfortunately, a lot of times the outside world doesn’t know about the symptoms and people hide them for a long time. The longer you go without treatment, the harder it is to overcome.”
Obsessive-compulsive disorder is defined by intense anxiety brought on by irrational fears, or obsessions, that drive people to do compulsive actions that offer temporary relief from the stress. It was once thought to be a psychological disease brought on by outside stress, but it’s now known to be a biological illness involving very specific areas of the brain, and there is clearly a genetic component, doctors say.
An OCD sufferer who has a fear of contamination may feel compelled to wash his hands over and over again after he touches a doorknob, even if a rational part of his brain recognizes that all the hand-washing isn’t doing any good.
Many people have experience with irrational thoughts or the temptation of compulsive actions. In fact, those types of behaviors probably have a root in early human survival — it would have made sense for people thousands of years ago to be “obsessed”with protecting their home or not getting sick.
“It’s not bad to check the cave entrance a few times. But if that’s all you’re doing, you’re not out gathering food or tending the fire,” said Dr. Don Mordecai, director of mental health and chemical dependency services for Kaiser Permanente Northern California. “OCD is probably kind of a human thing. It’s when it gets out of control that it’s a problem.”
In OCD patients, the obsessions and compulsions start interfering with daily life.
Treatment for OCD involves a combination of medications — usually antidepressants — and cognitive behavioral therapy. Over the past two decades therapists have developed a type of therapy, called exposure response prevention, that is deceptively simple: Patients are exposed to their fear, and then told to focus on not acting on the compulsions that their fear triggers.
The idea is to break down the “loop” in the brain between the obsessive anxiety and the temporary relief brought about by the compulsive behavior, doctors said. Over time, that loop becomes deeply entrenched in the brain, and it can be terrifying for patients to try to interrupt it.
But it’s definitely possible, said Jeff Bell, a San Francisco KCBS reporter who speaks around the country about his experiences with OCD. Bell used to be so afraid of hitting someone with his car that every time he’d drive over a pothole he’d have to turn around and check for bodies. His rational mind knew that he’d felt a pothole, but he couldn’t fight the compulsion to make sure.
That was just one of several obsessive-compulsive symptoms, Bell said. It’s been 15 years since he was in therapy, and there’s no doubt that treatment changed his life, he said.
“Treatment was the hardest thing I’ve ever done,” said Bell. “I don’t sugarcoat that when I talk to people. The good news is we have a treatment process in the OCD world that works.”