Author: Teena Jain

The Connection Between OCD Psychosis

OCD or obsessive-compulsive disorder has some traditional symptoms which assumes that the patient is aware about the obsessions or compulsions are excessive and they are more than the normal range of feelings. It is often present in the category where the person suffering knows about the condition he is in., i.e. Neuroses. There are some points of contention though. The patients of OCD displays varying degree of insight into their condition. DSM-IV (American Psychiatric Association, 1994) has some mention to this where it is stated that there are cases of people “with poor insight” who “for most of the time” while experiencing an OCD episode do not recognise about their compulsion being excessive or unreasonable. ICD-10 (World Health Organisation, 1992) has no mention of such obsessional symptoms in the presence of schizophrenia.

There are many cases where person suffering from OCD is also diagnosed with some form of borderline Psychosis. Here the OCD is present along with out of touch with reality behaviour. The person suffering is not fully aware about their reactions/behaviour and actions being unreasonable or non-realistic. Psychosis makes anyone think about schizophrenia, although the doctor never mentioned this name. But psychosis in itself is a big symptom of schizophrenia, making things tougher for people who are less aware. The connection of OCD here with psychosis can be described in one line as OCD with poor insight.

People with OCD with Poor Insight

Most of the time people with OCD knows that they are suffering from some kind of obsession which is not normal and there is certain amount of hyper criticality in their behaviour. They are aware that if they tap a wall for 5 times is not going to change anything, but they still do it. They although could not control it, but they are aware about it.

On the contrary if there is OCD with poor insight, such people do not clearly believe that they are irrational or illogical in any way. They think their thoughts and behaviours are not unreasonable, and consider the obsessions and compulsions as normal and stay safe behaviour. The important inclusion in DSM5 says it all. As per Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, OCD should be seen with good or fair insight, poor insight, or delusional beliefs.

Why it is important to differentiate OCD with Psychotic Disorders?

The answer to this question lies in the fact that the treatment of Psychotic disorder has some drugs and therapies which enhances the symptoms of OCD. They tend to induce or exacerbate OCD. There are many side effects as well both firm physical and mental aspects.

There is a lot of work for caregivers here to find the comorbid existence of OCD with Psychosis due to obvious readons like the presence of Depression with ADHD. Do not jump to conclusions and specially think about the treatment you think would be suitable for the comorbid conditions. The treatment options of one condition can adversely affect the other condition.

How to help people handle perfection urge?

Perfection is good, but it is good if it is not impacting your life and making you go nuts over getting things in perfect shape and order. Nothing in this world is going to change if things are not done the way you would have thought them to be. So relax, take a break and leave that perfection nature making good amount of breathing space for you and people near you.

Here are some of the top ways and tips to combat the urge of being perfect.

Top tips for Handling Urge of Perfection

1. You need to expose your worries – You need to be talking about your worries and what will happen if the things are not perfect. You can talk to your parent, spouse, friends, co-workers, etc. This will help you build the emotional definition to all your worries and you will get a different perspective of things. The exposure will help you in getting in terms of your worries and recude them to a great extent.

2. Change your perspective about the outcome. Think that out of many outcomes and possibilities, there is only one dire consequence which you are too much worried about. If you judge the possible outcomes and think rationally about the perspective, you will be able to counter the urge of perfection.

3. Try and examine the evidence against your worst fear. Let us assume that you think if your shirt is not pressed perfectly you will have a big set back. Now try doing this one day and try to wear a wrinkled shirt. Check on your day and find out what went bad and what not. For all the things that went bad are worth so much of anxiety you are picking up in life due to this? Check on your own.

4. Mistakes and failures are opportnity to learn and move on. Have this thinking and start improving yourself rather than spending days and nights worrying about the final goal and its outcome. It’s not always the case that your worst nightmares come true. Have faith and move on.

5. Keep your focus on learning new things and skill, rather than being the best in everything you do. Every person in this world cannot be Pele and Ali at the same time. You cannot be a movie star and a Governor at the same time.

6. Take help to find the faults and unhealthy logic in your thinking. You can discuss with support groups, professionals and therapists if you cannot find solace in your relatives, or family members.

7. Watch movies and read boooks on how people have struggled and had multiple failures before they eneded up doing something which brought changes in people’s lives. There are many such personalities which helped us in every possible aspect of life and they taught an important lesson too – that things do not come easy. There are failures, mistakes, set backs and hardships along the way. And not all the stories are part of books and movies – there are cases where the end result was not that bright. And I mean it, these cases are far too many, than you think.