The woman was diagnosed with this condition in which she couldn't stop herself from logging in and out of the computer every five minutes for several nights.
Representative pic of Woman with OCD
The urge was strong, burning, and constant. The overwhelming urge came with such a force that sent Jyotsana Rajashekar* scrambling to her email’s inbox. No new emails, the software engineer with a prominent tech firm in Bengaluru felt relieved.
The relief, however, was short-lived. The urge once again enveloped the hapless woman, who repeated the process again — and again. So much so that it started affecting her sleep, health, personal and professional life. The enemy within was too strong for her to handle all by herself.
“It was like clockwork. Every two minutes she had to dive back into the inbox, checking emails obsessively,” Dr. Satish Ramaiah, Consultant Neuropsychiatrist and Sleep Disorders Specialist of Bengaluru-based Maarga Super Specialty Psychiatry Hospital, said. Rajashekar is now under his care.
At first glance, Rajashekar’s frequent email checking may appear ordinary, Dr Ramaiah told South First.
Jyotsna was diagnosed with Obsessive-Compulsion Disorder. (Representational pic/Wikimedia Commons)
“It is even relatable in today’s connected world. We all have to stay on top of our digital communications. All of us are glued to mobile screens. But what differentiates Jyotsna’s behaviour is the intensity and frequency of her compulsion,” he said.
Rajashekar, who visited Dr Ramaiah at her husband’s insistence, was diagnosed with Obsessive-Compulsion Disorder (OCD).
OCD is a complex disorder, often rooted in a combination of genetic predisposition and environmental factors. In Jyotsna Rajashekar’s case, her profession as a software engineer, combined with an underlying vulnerability to anxiety, may have contributed to her condition, Dr Ramaiah, who is also the Medical Director of Maarga, said.
Due to this disorder, Rajashekar kept logging in and out of her email every five minutes. “She feared that she might have sent inappropriate messages to someone,” Dr Ramaiah explained.
Rajashekar’s disorder is characterised by intrusive thoughts that compel her to revisit her email history, searching insanely for any emails that could put her in trouble.
“Despite having no evidence to support her fears, she is plagued by an overwhelming sense of doubt and anxiety. People with checking behaviour OCD can’t shake off the feeling that they might have sent something inappropriate,” the neuropsychiatrist said.
“It’s a never-ending cycle. The anxiety builds up, compelling them to check email again for reassurance,” he said.
For Rajashekar, it started with sleepless nights spent in front of the computer, unable to “quiet the racing thoughts that flooded her mind”.
“She constantly feared she might have sent an inappropriate email that could cost her the job. These thoughts amplified her anxiety,” Dr Ramaiah said.
“The anxiety made her repeatedly check emails and it provided her temporary relief from distressing thoughts. This vicious cycle further disrupted her sleep, led to fatigue and diminished daytime functioning.”
“Her personal life also got affected, compelling her husband to bring her for treatment,” the doctor explained.
Dr YC Janardhan Reddy, Professor, and Head, Department of Psychiatry at NIMHANS in Bengaluru, felt Rajashekar’s was a classic manifestation of OCD, specifically related to the sub-sect of checking behaviours. “Her fear of sending inappropriate emails is irrational, yet they have an impact on her daily life,” he said.
Obsession with cleaning. (Creative Commons)
OCD manifests in various forms, each with its unique set of symptoms and characteristics. Speaking about common types of OCDs Dr Reddy said there are contamination obsessions and cleaning compulsions. “This means they will be obsessed with a thought and then they will compulsively initiate an action,” the doctor explained.
Many individuals with OCD experience obsessions related to contamination and fear of germs or dirt. This can lead to compulsive cleaning rituals, such as excessive hand-washing or disinfecting objects to alleviate anxiety.
“People with contamination obsessions may believe that certain objects or surfaces are contaminated, leading them to engage in repetitive cleaning behaviors to neutralise their anxiety,” Dr Reddy said.
For those with checking obsession, their thoughts revolve around the fear of harming oneself or others due to negligence or mistakes. Common checking compulsions involve repeatedly ensuring that the doors are locked, appliances are switched off, or emails have been sent correctly.
Representative pic of Arranging and Symmetry OCD (Wikimedia Commons)
“Individuals with checking OCD may have a recurring doubt that they have not performed certain actions, leading them to check repeatedly to prevent any potential harm,” the doctor further said.
Some others are obsessed with symmetry or keeping everything in order. “It’s the need for symmetry, perfect order. People with these obsessions often feel intense discomfort or experience anxiety when things are not arranged or aligned properly as they think they should be,” he elaborated.
He explained that such people may engage in repetitive behaviors to create a sense of balance and order, providing temporary relief from distress.
There is also an obsession with intrusive thoughts and mental rituals. These people experience distressing intensive thoughts, which are often unwelcome and could be violent or sexual. They may engage in mental rituals, such as counting or repeating phrases silently to neutralise distressing thoughts.
“Intrusive thoughts can be extremely distressing for individuals with OCD. They may resort to mental rituals to counteract or suppress these thoughts and reduce their associated anxiety,” Dr Ramaiah added.
Doctors stressed that OCD presentations vary from person to person, and individuals may experience a combination of different obsessions and compulsions.
“Understanding these different manifestations helps in recognising the complexity of OCD and tailoring effective treatment approaches,” Dr. Reddy explained.
Dr Ramaiah said that OCD symptoms should be assessed by a qualified mental health professional, who can provide accurate diagnosis and appropriate treatment options, including cognitive-behavioral therapy (CBT) and, in some cases, medication. With proper support and understanding, individuals with OCD can manage their symptoms and lead fulfilling lives.
Doctors insist that OCD, often misunderstood and stigmatised, requires a multifaceted approach. Jyotsna Rajashekar is now on anti-anxiety medications along with therapy where they use certain techniques to help her manage her fears.
Dr Ramaiah explained that a combination of approaches is typically employed. Medication may be considered for severe cases, as certain medications have shown effectiveness in managing OCD symptoms. However, the cornerstone of treatment lies in therapies to work with the behaviour.
In the case of email checking, the treatment may gradually reduce the frequency of checking, resisting the urge to check, and learning healthier coping mechanisms.
The timeline for progress in OCD treatment varies depending on the individual and the severity of the disorder.
While stress can trigger the disorder, it needed to be noted that it is not usually caused by specific incidents. Instead, it arises from the interaction between an individual’s personality and environmental factors. Identifying OCD involves understanding the underlying traits and personality characteristics of individuals.
“It is essential to assess the impact of the behavior on an individual’s life and daily functioning. For example, if someone in a professional setting, such as a cashier, takes an extended amount of time to count money, it can impede his work and cause significant problems,” Dr Reddy said.
(*Name changed to protect the patient’s identity).
May 15, 2024
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