"Pure OCD"

[Shell B]

With the popularity of the Anxiety/Depression/Mental Illness Support Thread http://atheistforums.org/thread-10302.html, I thought it might be good to have separate threads so that people with specific issues can discuss them. It will lend a more linear experience for those seeking advice on a specific topic. I would love to see the support thread stay active for those who want to interact there. I just enjoy that so many people are opening up and want to give them more opportunities to do so.

So, with that said, I'm going to start this thread and an anxiety thread because these are the two issues that I am familiar with. I encourage anyone to go ahead and start threads on different mental illness topics as well.

Here goes . . .

Pure OCD is essentially obsessive compulsive disorder without obvious compulsions. In other words, the person experiences the distressing thoughts that drive people to compulsive behaviors, but they do not have compulsive behaviors that are obvious. We deal with avoidance, mental checks, etc., but do not engage in the more physical compulsions that have made OCD such a known illness.

Distressing thoughts differ from person-to-person. If you worry about your family or have fleeting weird thoughts, don't stress. You don't have OCD. When they are repetitive and cause severe anxiety, then you might have a problem. Anyway, I don't know if anyone else here has this. It is my understanding that it is less common than OCD with outward compulsions, but, if you do, my inbox is open and I'm willing to chat in this thread.

ETA: I just learned that this is a neuropsychological condition, rather than just a mental illness. Nonetheless, I think the anxiety it creates is enough to warrant calling it a mental illness. It is my understanding that the "neuro" part is what makes the thoughts repeat and become intrusive. The mental part is where it freaks you the fuck out.

Oh, and I should mention that this is for support and sharing of experiences. Please do not give out medical advice, such as cessation of medication or self medicating. It is absolutely fine to offer up behavioral advice or coping mechanisms, but handing out medical advice to people with mental illnesses can have terrible consequences. Leave that to doctors. Offering up your experience with medicine is fine too.

[Annik]

Yeah, there are a lot of mental illness that have brain chemistry imbalance as a root (or supposed root) cause. I don't have OCD, but I am sick and tired of people claiming they are because they like to be neat. Cleaning is a compulsion that not all OCD sufferers have. It's about ritual, not cleanliness.

[Shell B]

Agreed.

Mental checks are a weird compulsion. I'll describe them sometime.

[Angrboda]

ETA: I just learned that this is a neuropsychological condition, rather than just a mental illness. Nonetheless, I think the anxiety it creates is enough to warrant calling it a mental illness. It is my understanding that the "neuro" part is what makes the thoughts repeat and become intrusive. The mental part is where it freaks you the fuck out.

I am not a doctor, but it's my understanding of what I have been taught that all or most Axis I disorders are believed to have an organic, biological, or neurological basis. This is opposed to Axis II disorders which are typified by the personality disorders, which are presumed learned behaviors. (Note, this is not an absolute distinction, as persons with borderline personality disorder can experience psychotic symptoms more typical of Axis I, and while the affective disorders such as depression and manic-depression are Axis I [IIRC], it's not uncommon to see serious depressive episodes [if one wants to call them that] which are caused by situational factors such as the death of a loved one, or stress, or sleep deprivation, but in an otherwise normal subject.)

And unfortunately I lost my breadcrumb, but there was a phrase in something I passed over which described OCPD as OCD without the obsessive behavior component. I'm not well read on either OCD or OCPD, but that sounds a lot like what you are referring to as "Pure OCD" (though OCPD often presents with symptoms in addition to those you describe). Anyway, worth looking into, perhaps.

[Shell B]

http://en.wikipedia.org/wiki/Purely_Obsessional_OCD

http://en.wikipedia.org/wiki/Obsessive%E...y_disorder

They aren't very similar.

[Autumnlicious]

Holy crap. The Pure-OCD description fits me to a tee.

[Shell B]

I'm sorry to hear that, Syn. I'm not a fan of it.

If you want some more information or just want to talk about it, you know where to find me.

[Angrboda]

The fourth edition of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) requires that a patient have either obsessions or compulsions that are a significant source of distress; are time-consuming; or interfere significantly with the person's normal routine, occupational functioning, or usual social activities or relationships. At some point during the course of the illness, the adult patient must recognize that the obsessions or compulsions are excessive or unreasonable. According to DSM-IV, obsessions are defined by the following features:

1. Recurrent and persistent thoughts, impulses, or images that are experienced at some time during the disturbance as intrusive and inappropriate and that cause marked anxiety or distress.
   
2. Thoughts, impulses, or images that are not simply excessive worries about real-life problems.
   
3. Attempts to ignore or suppress such thoughts or impulses or to neutralize them with some other thought or action.
   
4. Recognition that the obsessional thoughts, impulses, or images are a product of one's own mind, not imposed from without as in thought insertion.
   

Clinically, the most common obsessions are repetitive thoughts of violence (for example, killing one's child), contamination (for example, becoming infected by shaking hands), and doubt (for example, repeatedly wondering whether one has performed some act, such as having hurt someone in a traffic accident).

Compulsions are defined as follows:

1. Repetitive behaviors that the person feels driven to perform in response to an obsession or according to rules that must be rigidly applied.
   
2. Behaviors or mental acts aimed at preventing or reducing distress or preventing some dreaded event or situation. Those behaviors or mental acts are either unconnected realistically with what they are designed to neutralize or prevent, or clearly excessive.

Typical compulsions include handwashing, ordering, and checking. A significant change from DSM-III-R to DSM-IV is reflected in the addition of mental compulsions, such as praying, counting, and repeating words silently. In DSM-III-R, those were called obsessions, but because such repetitive mental actions generally serve to decrease anxiety, it was felt that they would be better characterized as mental compulsions. Obsessions are usually anxiety-provoking, whereas compulsions are usually anxiety-relieving (at least over the short term).

—

I'm not trying to start an argument here, but I'm somewhat confused. From this, it would appear that OCD without compulsions is already recognized as a form of OCD. I guess my questions would be, a) is Pure OCD recognized as an independent diagnosis in either the DSM or ICD, and b) why it is being separated out. I can understand wanting to highlight it as a form of compulsive disorder which lives in the shadow of OCD with compulsions, and I don't mean to slight that, or doing so. Nor to try to sweep it back under the rug with general OCD. But two thoughts concern me. First, diagnoses are, imo, geared towards guiding treatment, because similar presentations or syndromes tend to respond similarly to similar treatment interventions; does pure OCD differ from OCD with compulsions in terms of treatment and prognosis? Second, as a person with schizo-affective disorder, I see the concept of schizotypy and schizotypal personality traits being tossed around in relation to both schizophrenia and schizo-affective disorder, including using tests for schizotypy to diagnose children who show signs typical of pre-onset schizophrenia, and then being prescribed anti-psychotics and being separated out from their peers for special treatment. Unfortunately, the concept of schizotypy is still ill-defined and conjectural, and I would hesitate to use a scientific concept which isn't clearly defined or well proven (not saying Pure OCD is like this, but treating it separately might be).

I also know that persons with borderline personality disorder are prone to thoughts about hurting others that are similarly distressing. Again, not trying to argue against Pure OCD itself, other than to note that diagnosis can be somewhat tricky, and such. In my brief googling, someone refers to themselves as being diagnosed as Pure-OCD, so some people are making the diagnosis. But is it similar to the off-label prescription of drugs?

I apologize in advance if I offend or misstate or make ignorant assumptions as a consequence of not doing more research on the matter. None is intended. I'm just trying to learn, and unfortunately I don't have the time or inclination to research it myself at present. Mea culpa.

[Reforged]

My Mother has a mild case, I have it very slightly.

[Shell B]

I'm not trying to start an argument here, but I'm somewhat confused. From this, it would appear that OCD without compulsions is already recognized as a form of OCD.

Yes, it is. I don't know what in your statement contradicts anything I have said. Pure OCD or OCD without compulsions are the same thing with a different name. Now I'm confused. Did anyone here say it was not a recognized form of OCD?

I guess my questions would be, a) is Pure OCD recognized as an independent diagnosis in either the DSM or ICD, and b) why it is being separated out.

OCD is its own diagnosis. Pure OCD is separated out because the treatment is quite different, though along the same lines. Distinguishing between them is very important so that people like me get diagnosed. If you're looking for compulsions, you miss us.

I can understand wanting to highlight it as a form of compulsive disorder which lives in the shadow of OCD with compulsions, and I don't mean to slight that, or doing so. Nor to try to sweep it back under the rug with general OCD.

Hmm. I'm not quite sure what you are arguing here. This thread is not about gaining exposure for a condition. It is about people who have it being able to talk about it.

But two thoughts concern me. First, diagnoses are, imo, geared towards guiding treatment, because similar presentations or syndromes tend to respond similarly to similar treatment interventions; does pure OCD differ from OCD with compulsions in terms of treatment and prognosis?

No. It differs in diagnostic criteria. Diagnoses are meant to A. Determine what is happening to a person and B. Deliver treatment. If you were to try to diagnose me using the criteria for OCD, I wouldn't have a diagnosis.

Second, as a person with schizo-affective disorder, I see the concept of schizotypy and schizotypal personality traits being tossed around in relation to both schizophrenia and schizo-affective disorder, including using tests for schizotypy to diagnose children who show signs typical of pre-onset schizophrenia, and then being prescribed anti-psychotics and being separated out from their peers for special treatment. Unfortunately, the concept of schizotypy is still ill-defined and conjectural, and I would hesitate to use a scientific concept which isn't clearly defined or well proven (not saying Pure OCD is like this, but treating it separately might be).

What would the problem be with treating Pure OCD differently? It's different. It is very different. I don't count. I don't check. I don't flip switches. I think and I hide. The two are very, very different.

I also know that persons with borderline personality disorder are prone to thoughts about hurting others that are similarly distressing. Again, not trying to argue against Pure OCD itself, other than to note that diagnosis can be somewhat tricky, and such. In my brief googling, someone refers to themselves as being diagnosed as Pure-OCD, so some people are making the diagnosis. But is it similar to the off-label prescription of drugs?

Now I don't know what you are saying? Sure, some people have negative thoughts that are distressing. Pure OCD are repetitive, intrusive, distressing thoughts. Now, in your brief googling, you determined that people with Pure-O were diagnosing themselves how? And what does that have to do with drugs?

I apologize in advance if I offend or misstate or make ignorant assumptions as a consequence of not doing more research on the matter. None is intended. I'm just trying to learn, and unfortunately I don't have the time or inclination to research it myself at present. Mea culpa.

I'm just confused as to what your confusion is and why we are having this conversation. You stated in the very beginning of your post that it is a recognized form of OCD and then went on to say it could be mistaken diagnoses. If you don't have the symptoms of borderline personality disorder and do have symptoms of OCD, should you have to go undiagnosed and not have a chance at reaching out to others like you for fear that someone will not think it is a valid diagnosis?