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| Sunday, 22 May 2005 |
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Features |  |
| News Business Features Editorial
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When a habit becomes a compulsion Do you check on locked doors repeatedly or wash your hands more than you need to. Are these daily routines or rituals? Or is it Obsessive Compulsive Disorder (OCD)? How many of us are victims of OCD and how often do we dismiss the compulsion as mere habit and how often do we camouflage it as something else? Dr. Rani Goonewardene answers some questions one should ask about OCD but don't.
Not all repetitive behaviours eg. (religious activities, brushing our teeth, combing our hair every day, several times) represent an illness. But when it becomes a mental hiccup, when the brain replays these thoughts, over and over again, resulting in repeated compulsive actions, then it is OCD. Most OCD sufferers will not confide in anybody due to the sense of shame and stigma of being deemed a 'freak'. This disorder will interfere with your daily life causing distress, resulting in poor efficiency and performance at school, office, or home. OCD is an anxiety disorder, it can be debilitating if untreated, and can run a chronic course that lasts a lifetime. Early treatment will help you to lead a satisfying life. How could one know if one is suffering from OCD? Have you been bothered or worried by repeated, senseless, disturbing thoughts, images, fears, or unwanted ideas entering your mind resulting in compulsive actions? eg. You think "My hands are contaminated, I must wash them"; "I may have left the cooker or gas on", "I must eat the same lunch everyday, even eat in the same order". In normal people these thoughts enter the mind once in a way and are annoying. People will worry for hours, even the whole day about bad things, and try to make sure that the bad things don't happen. If you have OCD you cannot control your thoughts and actions. What is the cause of OCD? No cause is identified, but brain imaging, Positron Emission Tomography (PET), show different brain activity patterns suggesting a derailment of brain circuitry in OCD. There is an increase in energy levels resulting in overheating in the orbital and frontal cortex, mainly the emotional area, leading to defective information processing in the brain. Insufficient levels of Serotonin, the brain's chemical messenger which responds in a 'fight or flight' reaction may be another cause. At times OCD can start when the immune system is weak after a streptococcal infection. Then the symptoms of OCD comes, suddenly and severely. Is it correct to assume that OCD is due to one's fault, or that one's crazy? No, it is beyond your control. It is not your fault or due to a weak or an unstable personality. It is nothing to be ashamed of embarrassed or to hide. What is the incidence and prevalence of OCD? This can occur at any age - boys between the age of 6 to 15 yrs. and females after 20-30 yrs. Males and females are equally affected. OCD is more common among people of higher education and socio-economic status. What are the risk factors? Genetic, pregnancy and post partum (after delivery), environmental stress, (if you have a biological tendency to react strongly to stress, this can trigger intrusive thoughts, and rituals, of OCD) abuse, changes in living situation, illness and relationship problems. Can OCD run in families? Studies show a genetic predisposition. A person with OCD has 25 per cent chance of having a blood relation who has OCD. More in identical twins. What are the signs and symptoms of OCD? Obsessions and Compulsions or at times one or the other. (In response to their obsessions one engages in repetitive behaviour or compulsions). Obsessions: Recurrent, unwanted, involuntary senseless thoughts ideas, worries, fears, that you feel and are beyond your control, when you are engaged in other activity. These obsessive thoughts don't leave you and keep worrying you. Common obsessions : fear of contamination; of hand with dirt, germs. Radiation, fear of harming a friend or family member, pushing some one in front of a vehicle, poisoning your dinner guests Fear of sinful thoughts, Concern with symmetry, order and exactness (arranging clothes, tools, groceries in perfect order), disgust with bodily fluids and waste, constant morbid thoughts, about death, sounds images and numbers. Compulsions: Will help the person's fears and nervousness to go away only for a short time. The routines are repeated when the nervousness recur in person with OCD: washing hands(more in women), checking doors, stoves, counting, ordering (more in men), cleaning (more in women) grooming eg. showering, brushing teeth, over and over again, hoarding, (more in men) newspapers, old cans when it is no longer needed, mental problems; repeating words phrases numbers, checking your body for any signs of illness, constant reassurances about the correct actions or words of yours. The OCD pregnancy and Post partum: Studies show that the incidence of OCD is more due to fluctuating hormones. Common symptoms; obsessions, compulsion, fear of contamination, repeated washing of hands, need for reassurance, repeated calling doctor, recurrent fear of baby's safety, checking the baby, recurrent thoughts of bad mothering, recurrent thoughts of harming the baby, avoiding and neglecting the baby, recurring thoughts of disturbed order, ordering and rearranging baby's cot. What can you do to help yourself? Talk to your doctor, or therapist, about your unwanted thoughts, fears, and repeated actions. How can the doctor help you? Medications that will help you to be less anxious, and afraid. the medicine may take a few weeks to work and show results. How can the therapist or counsellor help you? Behaviour therapy 'specific exposure and response prevention therapy' is practised with OCD. Psychotherapy that helps the patient to realise the insight of the problem is not suitable for OCD. How can the family help you? Bring books and literature about obsessive compulsive disorder. Reading it, or encouraging it to be read. Be patient as the progress of the recovery time may vary. Praise small success. Reduce the number of times of hand washing, and the time taken. Refuse to take part in rituals. Trust him. Is OCD completely curable? In some people it is completely curable. Others will get some relief with long term comprehensive treatment. You may feel that you have no control of OCD, but proper treatment can help you to gain control over OCD. Treatments comprise medical, behavioral therapy and extreme cases of brain surgery. What are the other disorders that accompany OCD? Depression, any anxiety disorder, eating disorders substance abuse personality disorders. What is the difference between being a perfectionist and OCD? Getting the floors in your home, washed, cleaned and polished so that you could eat off them or getting your work done ahead of schedule, does not mean you have OCD. You belong to a high performance clan, that will help you to build up success and high self esteem. What is the difference between addiction and OCD.? Unlike in addiction, with OCD the compulsion does not give pleasure, but only relief from mental discomfort caused by obsession. ********** Tips to stop smoking Stopping smoking is not easy. Do persevere, as you are likely to soon feel a lot better and healthier by giving up. Don't despair if you have tried to stop before. People who keep trying to stop smoking often succeed. Below are some tips which may help you to stop smoking. * Write a list of all the reasons why you want to stop, and keep them with you. Refer to them when you are tempted to light up. * Set a date for stopping, and stop completely. (Some people prefer the idea of cutting down gradually. However, research has shown that if you smoke less cigarettes than usual, you are likely to smoke more of each cigarette, and nicotine levels remain nearly the same. Therefore, it is usually best to stop once and for all from a set date.) * Tell everyone. Friends and family often give support and may help you. * Get rid of ashtrays, lighters, and all cigarettes. * Be prepared for some withdrawal symptoms. When you stop smoking, you are likely to get symptoms which may include: nausea (feeling sick), headaches, anxiety, irritability, craving, and just feeling awful. These symptoms are caused by the lack of nicotine that your body has been used to. They tend to peak after 12-24 hours, and then gradually ease over 2-4 weeks. * Be aware of situations in which you are most likely to want to smoke (for example, the pub). Try changing your routine for the first few weeks. If drinking tea and coffee are difficult at times, try drinking mainly fruit juice and plenty of water. * Take one day at a time. Mark off each successful day on a calendar. Look at it when you feel tempted to smoke, and tell yourself you don't want to start all over again. * Be positive. You can tell people that you don't smoke. You will smell better. After a few weeks you should feel better, taste your food more, and cough less. You will have more money. Perhaps put away the money you would have spent on cigarettes for treats. * Food. Some people worry about gaining weight when they give up smoking as the appetite may improve. Anticipate an increase in appetite, and try not to increase fatty or sugary foods as snacks. Try sugar-free gum and fruit instead. * Don't despair if you fail and have a cigarette. You don't have to start smoking again. Pick yourself up and try again. Examine the reasons why you felt it was more difficult at that particular time. It will make you stronger next time. * Nicotine Replacement Therapy (NRT) can help if withdrawal symptoms are troublesome. Nicotine gum, sprays, patches, tablets, lozenges, and inhalers are available. Using one of these roughly doubles your chance of stopping smoking if you really want to stop. A pharmacist, GP, or practising nurse can advise about NRT. * A medicine called bupropion (trade name 'Zyban') is another option. It also roughly doubles your chance of stopping smoking if you really want to stop. It helps reduce the symptoms of nicotine withdrawal. It may be advised by your GP if you are determined to quit, but are finding it difficult. **************** Holistic Healing Fundamentals of Ayurveda Day-to-day health by Dr. Danister Fernando Modern allopathic medicine has undergone transformational changes during the last twenty-five years. Various technological breakthroughs in the form of diagnostic techniques; i.e., Computerised Axial Tomography Scan, Magnetic Resonance Imaging, Position Emission Scan, Pharmaceutical Compounds, Genetic Engineering, Organ Transplantation and many more. In spite of these advances, many diseases still have no available curative and symptomatic treatment, i.e., cancer, auto immune disorders, amyotrophic lateral sclerosis, AIDS, chronic degenerative disorders Land Alzheimer's disease. Various societal disorders like stress related disorders, substance abuse disorders, trauma, environment-induced disorders and many more have come into the picture. People are seeking alternative forms of 'remedies for many diseases. Inspite of advances, modern allopathic medicine has concentrated more on bodily diseases where the cause has been either known or idiopathic. The concept prevails that if we cannot visualise the organism under the microscope or we cannot replicate under experimental conditions, then the existence of the disease and causal factors are questionable. The interrelation of physical and mental illness (i.e., mind and body) has been questioned. The diseases in modern medicine are based on a system approach i.e., cardiovascular, nervous system, etc., rather than an integrated approach or a holistic understanding. About 80 per cent of the world population do not have access to western medicine and depend on traditional medical practice. Ayurveda provides you with a personalised and customarised health educational program that addresses your unique state of balance/imbalance and personal health goals. The advices and guidance provided empower you to effectively address prevention, longevity and a wide variety of specific health issues like weight loss, menopause, beauty and skin care. An individualised evaluation and lifestyle program according to Ayurvedic recommendations is used for a person with specific health goals and state of balance/imbalance. This kind of knowledge is educational in nature and not for the diagnosis or treatment of disease. But it is not advisable to discontinue following the instructions of modern medical doctors for any condition you have or modern medical diagnostic examination you might need. Health is won or lost in how we live our day-to-day life. It is our regular patterns of eating, sleeping, exercise and what we do for rejuvenation that determines if we get healthier day by day or fall ill. Before 40, health is nature's gift. Up to 40 health is a personal choice. After 70 it is an opportunity. As we reach mid-life it is essential to become educated on how to lead a life in a way that avoids the creation of imbalance and actually improves our resistance and healing ability day by day. Ayurveda contains a wealth of information to help you to individualise lifestyle, diet and rejuvenation practices to your specific constitution in order to prevent disease and reverse imbalances. It is our patterns of eating, sleeping, work, exercise and what we do to rejuvenate ourselves daily, that determines whether we stay healthy or fall sick and how gracefully we age. Health is an investment at younger age and profit will be gained at older age. Therefore you must have a plan for working out the realistic figures of success and failure. ************** You & your baby Maintaining a balanced diet Throughout the pregnancy your baby depends on you for nourishment. Its growth is based on what you eat. Remember, you are now eating for 'two', but, it does not mean that you should eat from 'dawn to dusk'. What is really needed is eating quality food that helps your baby to grow. As an expectant mother you do not need any more food than before the pregnancy. But your responsibility is to eat the right food in proper amounts which helps the growth of the unborn baby. Various local and international studies have proved that the baby's development can be seriously affected due to the mother's poor dietary habits. Nutrition deficiency in mothers will affect the baby's growth and these babies may weigh less and be too short in stature. The development of their bones and teeth may be impaired. They are more susceptible to illness than the babies of those who have been on a balanced diet during their pregnancy. It is important to remember that a poor prenatal diet will affect not only your baby but also you. It may result in a difficult labour and major complications. It will also affects your ability to nurse the baby. Your baby is developing continuously and needs food rich in vitamins and minerals every day. Many of the needed vitamins cannot be stored and few good meals would not help the growth of the baby. Therefore, what is important is some additional amount of calories and protein. A pregnant woman will need an additional 350 kilo calories depending on her weight, but a thinner woman would need less than that. This amount of calories can be simply gained by drinking two glasses of milk. Six grams of additional protein is needed and this can be met by eating an egg or fish or dried fish. Adequate amount of calories and protein with a balanced diet will lead to good body weight and the baby's sound growth. Women can gain additional weight of 5 to 12 kg during the pregnancy. But some women may not achieve this target. Some pregnant women get fat during the pregnancy and they need to reduce the weight. If you are a very fat person you need to reduce weight. But, your weight is not uniform and it may vary depending on the individual's body. With a balanced diet you can do some exercise under your doctor's advice. If your baby is small and your blood pressure is high, then you need rest. Otherwise, stick to your normal day-to-day activities. However, be vigilant. Some times your weight will suddenly increase by two kgs. This needs urgent medical care as this could be an indication of acute fluid retention due to increased blood pressure or due to some problems in the kidney. Before your final judgement you should verify the quality of the weighing scale and double check the weight. If there is an indication of sudden weight gain consult your doctor soon. Here is a simple diet chart * Extra 350 kilo calories * Extra six grams of protein * Extra five 5 grams of fat * Lots of mineral and vitamin * Fresh vegetables and fruits * Enough water |
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We all have rituals, superstitions, fears, worries, doubts, feeling of
contamination with germs, or dirt. These rituals are welcoming at times, and
an unavoidable part, in our daily life. 
