FARGO – Tamara Wagner’s obsessive-compulsive disorder was so severe that for a while she refused to leave her home.
“It took such a good chunk of my life that I really didn’t have time to do anything else,” she says.
The 36-year-old Fargo woman wouldn’t use public bathrooms. She couldn’t have friends or family over. If she touched a doorknob, she felt dirty.
“It’s very strange how it tricks the brain into thinking you’ve done something when you haven’t or thinking you’ve touched something when you haven’t,” she says.
Contamination-related OCD may be the most recognizable, but it’s only one of many types. Others concern losing control, harm, perfectionism, unwanted sexual thoughts, or scrupulosity (religious obsessions).
“There are a lot of types of OCD that people don’t even identify as OCD,” says Renae Reinardy, a psychologist with a private practice in Fargo who specializes in the disorder.
But no matter what form they take, obsessions and compulsions can have serious effects.
They often start off as little “quirks” and grow so severe they can impair daily functioning.
“OCD is a bully within your nervous system, making you do things that you don’t want to do,” she says.
The International OCD Foundation estimates that as many as 2 million to 3 million adults and 500,000 kids and teens in the U.S. have OCD, but Reinardy says those numbers are likely underestimated.
She adds that it occurs in about the same frequency in women as in men, and although it can develop at any age, it oftentimes starts in childhood.
Wagner showed obsessive behaviors as a child, but it wasn’t until her 20s that they became germaphobic.
Her excessive cleaning and hand-washing got so bad that the skin on her arms and hands started to crack.
“I had no clue what was going on with me at first. I kind of thought I was crazy,” she says.
She didn’t realize what she was dealing with until she saw a TV show about OCD, and it took another year and a half to get an accurate diagnosis.
“I was kind of relieved because if it has a name, there’s something you can do about it,” she says.
Reinardy says it’s common for patients to go a long time without getting diagnosed, the average being 14 to 17 years.
Usually, she says, they hide it well or they’re too embarrassed to talk to someone about it.
Like Wagner, Jodi Urlacher first showed symptoms in her childhood.
The 27-year-old West Fargo woman’s OCD, which falls under the perfectionism category, started with classroom reading assignments.
If she didn’t think she read “accurately” enough or didn’t pronounce the words correctly in her head, she couldn’t go on.
“It would sometimes take me an hour to read a page,” she says.
Reinardy also refers to this type of perfectionism OCD as “academic OCD.”
“Their grades don’t reflect their actual knowledge because they’re spending hours and hours and hours doing homework,” she says.
Although Urlacher’s case is considered mild, it still presents challenges.
“Even though I feel like my OCD is now controlled, I still notice the symptoms often and, as is with any disorder, have some days that are worse than others,” she says.
Sometimes she’s not as efficient as she’d like to be because of her overwhelming urge to double- and triple-check her work.
When her brain gets stuck in a cycle, she has trouble moving on to the next task.
“On the positive side, work is accurate and thorough, but most of the time I already know the work is accurate because I vividly remember the process I used the first time around,” she says.
Urlacher’s OCD also affects her personal life because of her overwhelming urge for instant resolution.
“Sometimes people just want to take time to think about things and process things, and you’re not able to give them that time because you need to know,” she says.
Like many other sufferers, Urlacher experiences higher levels of anxiety because of her OCD, and with that can come physical symptoms like stomach upset.
But with professional help, she’s learned to recognize when her thoughts start to get out of control and redirect them.
She uses relaxation techniques, like trying to regulate her breathing, putting on relaxing music, dimming the lights and closing her eyes.
“It doesn’t take me an hour to read a page anymore,” she says.
Psychologist Reinardy says OCD used to be one of the most difficult conditions to treat, but with specialized training, it’s now one of the most successful.
Both Wagner and Urlacher try to manage their symptoms with antidepressants and anti-anxiety medication along with therapy.
Reinardy says regular talk therapy can actually be harmful and exposure and response-prevention therapy is typically the most effective.
Reinardy calls OCD a greedy disorder – the more you give in to the compulsions, the worse they get.
“OCD spreads. Something that was once good enough no longer is,” she says.
With gradual exposure, patients can learn to manage their responses to irrational fears.
“We’re approaching the bully rather than the bully approaching us,” she says.
But it’s still a struggle for both women, especially when things like stress trigger symptoms.
“When I get overly stressed out, it acts up. I find myself developing new fears or compulsions,” Wagner says.
She encourages anyone suffering from OCD to seek help sooner rather than later.
“The longer you wait, the worse it gets and the harder it is to treat,” she says.
She’s often bothered by flippant attitudes toward OCD, knowing from experience it’s nothing to be laughed at.
“We know it’s not normal, we know this stuff is crazy, but we can’t stop it,” she says.
Reinardy recognizes that most people with OCD have good insight.
“They know these rules are unnecessary, but because a high level of anxiety is associated with them, they have to engage in the compulsions even when they know that they’re silly,” she says.
Readers can reach Forum reporter Meredith Holt at (701) 241-5590
Common compulsions in OCD
Washing and cleaning:
• Washing hands excessively or in a certain way
• Excessive showering, bathing, tooth brushing, grooming or toilet routines
• Cleaning household items or other objects excessively
• Doing other things to prevent or remove contact with contaminants
• Checking that you did not/will not harm others
• Checking that you did not/will not harm yourself
• Checking that nothing terrible happened
• Checking that you didn’t make a mistake
• Checking parts of your physical condition or body
• Rereading or rewriting
• Repeating routine activities (examples: going in or out doors, getting up or down from chairs)
• Repeating body movements (examples: tapping, touching or blinking)
• Repeating activities in “multiples” (examples: doing a task three times because three is a “good,” “right” or “safe” number)
• Mental review of events to prevent harm (to oneself, others or to prevent terrible consequences)
• Praying to prevent harm (to oneself, others or to prevent terrible consequences)
• Counting while performing a task to end on a “good,” “right” or “safe number
• “Cancelling” or “undoing” (example: replacing a “bad” word with a “good” word to cancel it out)
• Collecting items that results in significant clutter in the home (hoarding)
• Putting things in order or arranging things until it feels “right”
• Telling, asking or confessing to get reassurance
• Avoiding situations that might trigger obsessions
Source: The International OCD Foundation