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Obsessive-Compulsive Disorders
My son went away to college and developed an obsession with cleanliness in his dormitory.
Many cases of obsessive-compulsive disorder respond to medicine and biofeedback.
My 18 year old son is in his 1st year at university and has been complaining that living at
school is too difficult. Sitting at his desk in his dormitory room, he starts thinking about how
dirty the common bathroom is, and this inspires him to get up from his studies and wash his hands
repeatedly. He claims to wash his hands at least 50-60 times a day, and is late for his classes
because he takes long showers to avoid contamination. Lately he's been biting and chewing his nails
obsessively. In high school he was a top student. I don't recall him being anymore than a excessively
clean and meticulously organized, though I do remember that he had this funny habit of checking and
double checking to make sure that all the doors and windows in the house were locked before he could
go to bed. I am really worried about him. He's getting worse. What can I do?
In the U.S., most all of us were taught to be concerned about personal hygiene and the cleanliness
of our surroundings. But those suffering from obsessive-compulsive disorder (OCD) spend at least over
an hour a day thinking about or acting on their impulse to clean. They agonize over this, because they
know their concern with cleanliness is excessive and unreasonable. At the same time, they find
themselves less an less able to devote themselves to work or studies, because of their excessive
preoccupation.
Obsession forces one to think about, imagine, or act on an idea or fear. A common obsession that most
of us can relate to is the anxiety over whether we have remembered to do something essential, like
locking the front door to the house, putting the parking break on the car, taking the keys with us before
locking the door, etc. Less common but quite prevalent among those suffering from this disorder is fear
of contamination, such as when we use a public restroom and irrationally obsess about contracting a
horrible disease from making contact with communal objects, like the washstand faucets. Then there are
those whose symptoms take the form of excessive attention to ordering objects or personal space, such as
the things on our desk, our clothing, appearance, etc. So much so that they suffer genuine anxiety and
an overwhelming sense of imbalance until their eccentric ordering is restored.
Compulsion, meanwhile, describes a repeated action to relieve the obsessive concern, such as incessantly
washing one's hands to dispel fears of contamination; manically arranging things in a specific order,
as previously mentioned, in order to relieve an unaccountable sense of chaos and doom; counting or
repeating certain words over and over in ritual fashion, unable to stop entertaining a disturbing thought,
in an attempt to momentarily exorcise it in this fashion. We all have experienced touches of such
distress, but the true OC is preoccupied nearly constantly, a prisoner of his own brain's revolt.
For example, one patient I've treated has an obsession with counting her change at least ten times before
feeling she hasn't been cheated, every time she buys something at the corner market. Another patient
must wipe everything first with a tissue before he will touch anything with his bare hand. Should he
accidentally touch something without performing this ritual cleansing beforehand, he has to wash his hand
several times to assure himself of not being infected with germs. A university coed spends her day
cowering in her room all day with the light off, to ward off feelings and thoughts of doom.
Though perhaps not so severe a case, clearly your son suffers from OCD. Freud once theorized that
obsessive-compulsive behavior is caused by unresolved mental strife left over from childhood over
controlling our physical functions (e.g., urinating, moving bowels). But modern research indicates
that the cause is hereditary, with approximately 2.5% of the population affected. Clearly, there is
a brain chemistry component, one happily responsive to medication.
The onset of OCD generally occurs in adolescence, but younger children can be affected. In most cases,
males start to show the symptoms between age 6-15, and females, 20-29. Generally, those with OCD are
not a threat to others, while they tend to alienate people with their extreme behavior, resulting in
depression, isolation, and suffering in private. This is one of the conditions that owes its relief
to modern science.
Biofeedback is helpful. But the real "silver bullet" of relief is clearly found in the SSRIs, specific
seratonin re-uptake inhibitors, such as Paxil, Luvox, and Prozac, the so-called "miracle drugs," which
intervene in the brain's chemical laboratory, short-circuiting the process that results in the typical
symptoms of OCD.
Life stress, such as experienced by your son living away from home for the first time, is not an uncommon
precipitator of OCD. Add to that the strain of his studies, and whatever unresolved psychological issues
he carried over from childhood and adolescence, and you have a pretty volatile mix for OCD onset, if the
genetic predisposition is there. And it very much seems to be.
Here is my advice to you and your son. He needs to relax more, exercise, and most importantly, he needs
to see a therapist for evaluation and treatment. With proper care, there's no reason why he can't finish
college with flying colors, and live a happy, productive life.
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