Women and Obsessive Compulsive Disorder: An Analysis
Introduction
“Imagine that your mind got stuck on a certain thought or image . . . Then this thought or image got replayed in your mind over and over again no matter what you did . . . You don’t want these thoughts - it feels like an avalanche . . . Along with the thoughts come intense feelings of anxiety” (International OCD Foundation, 2014; p. 2). It is normal for people to become anxious regarding their safety and life. However, when these anxieties exceed beyond the normal limit this is the sign of OCD which is a serious mental illness characterized by obsessions and compulsive behaviors. One example of the traits of OCD is the constant desire to repeat the actions that were already done. For people with this illness, it is best to consult with a therapist to diagnose and treat the illness. Anxieties are the brains security control. This means that ‘feeling anxious’ is normal because the brain signals the body about something that might cause harm.
The brain as the control center of the body regulates everything from actions to behaviors, and the secretion of hormones all of it are governed by the brain. Now the bugging question for the researches of many decades is to determine whether women are more prone to having risks of OCD behaviors. This paper will attempt to summarize and answer this hypothesis based on the medical literature provided by the scholars and experts in psychiatry. Although men are also prone to OCD in the earlier stage, it was the women who suffer the consequences of OCD symptoms because women in general undergo hormonal changes. These hormonal changes happen monthly during the menstrual cycles to prepare the body for pregnancy. All claims stated herein will be summarized for further discussions establishing the nexus of hormonal changes versus the OCD symptoms in women.
When a person experiences a certain need to feel secure even up to the point of repeating their actions, it is a signal to ask for help. Anxiety disorders such as the obsessive compulsive disorder or OCD is manageable but not treatable as of the moment. Studies show that the disease symptoms are mostly triggered by the hormonal changes, genetics, stress, and personality. Although the origins of the OCD spectrum is not yet discerned, researchers found that OCD in women is triggered by the hormonal changes that occurs during the perinatal phase and depends on the situation, this might continue for a lifetime. Maggini et al., (2001) noted that girls are more vulnerable in having OCD symptoms because of the dirtophobia; characterized by the unwanted desire to remove the dirt on their clothes (qtd. in Sullivan, n.d). Similarly, some women exhibit mild symptoms of OCD whenever they are inside the house. Some women often wanted to see their houses or rooms spotlessly clean because they tend to feel much more comfortable working or resting in an environment with a neat arrangement. According to Fleischman and Fessler (2010), women in general are more prone to behavioral and physical changes compared to men. Every month, they incur the menstrual cycles which prepares the body for possible pregnancy. During this phase, it is common to women to experience irascibility, mood swings, and physical changes due to the hormones secreted by their bodies. As stated by Hatcher and Namnoum (2004):
“Highly elevated during pregnancy, progesterone is also produced during the latter portion of the menstrual cycle in anticipation of pregnancy. The menstrual cycle consists of functionally distinct phases marked by characteristic variations in hormonal levels. The highest levels of progesterone outside of pregnancy occur during the luteal phase; the period after the rupture of the ovarian follicle during which the corpus luteum secretes progesterone” (qtd. from Fleischman and Fessler, 2010; p. 1). In addition, during their menstrual period, women are also prone in constant panic episodes. Abramowitz et al., (2005) conducted a study examining prospective fathers and mothers in order to analyze if they will exhibit signs of OCD. In their experiment, the researchers studied 85 individuals for a course of time. The results of this study indicated that first time parents showed mild symptoms of OCD such as being over attentive to their newborns. It is not surprising especially for mothers to become fully attached to their infants upon childbirth because pregnancy is a bond of mother to her child. Therefore, since the mother carried her baby for nine months, she is obliged to take care of her child and ensure their well-being. “The majority of these new mothers and fathers experienced intrusive infant-related thoughts and performed neutralizing behaviors similar to, but less severe than, those observed in OCD” (Abramowitz et al., 2006; p. 1361). According to the American Psychiatric Association (2015), there are a number of 2.2 million Americans were affected by the OCD spectrum. Some of them report changes in their behavior, actions, and even in their social lives. Shackman and Masline (1999) commented that OCD occurs when the brain is triggered by anxiety-causing events that cause distress. People with OCD have a difficulty to control their actions because they due to the fact that they needed to do their routines in accordance with the usual time; like for example, checking locks in order for them to satiate their compulsions. Like in men, women with OCD tend to overdo their work more than the usual. This is because women often find it depressing to see a room in disarray; therefore, female sufferers frequently spend half of their time in cleaning their rooms and houses just to make sure that no one in the family will get infected. This is also similar to the women who just had childbirth. As noted by Russell et al., (2013) new mothers might feel obliged to secure their child’s health by constantly checking the needs and concerns of the infant to show their love for them. In some ways, this might be seen as a form of motherly love of a mother to her child but some women goes overboard to check their child from time to time to reassure them that their infant is alright. Furthermore, Abramowitz et al., (2006) also explained that some women after childbirth have fleeting thoughts about their child. Although these thoughts might seem as inappropriate for a mother to think of, women who had showed some signs of OCD symptoms might think of unwanted thoughts about their babies.
“For instance, picking up a knife while in the kitchen may evoke an intrusive image of stabbing one’s child. Instead of interpreting this image as just a fleeting thought and resuming supper, a woman at risk of developing OCD may interpret the event as revealing her “true” feelings for her infant and may begin avoiding her infant for fear of inflicting actual harm (Russell et al., 2013; p. 383).
Meanwhile, Wisna et al., (1999) first argued the comorbidity of panic with obsessive-compulsive disorder on new mothers. They argued that some of the factors that trigger the OCD symptoms are based on the experience of the mother (qtd. from the footnote of Abramowitz et al., 2006; p. 1363). For an instance, if the mother had a very unpleasant experience in her childhood like she contracted malaria and nearly died, she might get overprotective with her child by doing rounds of daily cleaning, disinfecting the house as well as checking her child for any possible bites from the mosquitoes. On the other hand, Abramowitz et al., (2006) theorized that both genders, male and female collectively may experience a mild signs of OCD symptoms if they previously had episodes of depression, anxiety, and history of OCD in the family. The postpartum symptoms experienced by women after childbirth is pretty normal since the pregnancy alters the hormonal secretion of the body. For males, the episodes of previous experiences that caused them to be anxious and fear in the past might trigger them to show deep protection to their children. Abramowitz et al., (2006) explained in their study that the common thoughts that new parents have on their child were as follows: infant suffocation, losing the baby, contamination, and accidentally harming the baby. The research explanation is that distressing intrusive thoughts were reported by participants. It was also indicated that parents also kept these compulsions in check by constantly checking their newborns which at some point became their obsession to re-assure themselves about the safety of their child. Abramowitz and his team of experts conducted this research on 50 men and 50 women; the authors interviewed them as soon as possible also to know their emotions and thoughts about having a fragile baby to hold. Nevertheless, Abramowitz pointed out that: “postpartum period (particularly, we believe, for first-time parents) represents an ideal occasion to study the development of obsessive–compulsive symptoms since it is associated with unwanted intrusive cognitions and an increase in the rate of OCD onset” Abramowitz et al., (2006; 1373).
Additionally, females with OCD symptoms also have a high risk in developing depression attacks such as binge eating characterized by excessive eating of food. Fleischman and Fessler (2010) claimed that behavioral changes in women are also caused by the high levels of progesterone which enhances their sensitivity towards things. Other findings concerning the prevalence of OCD symptoms were reported by experts. Kessler et al., (2005) cited the findings of the National Comorbidity Survey that there was an estimated 1.6% rates of OCD; meanwhile, Weismann et al., (1994) posit that according to the data of the Epidemiologic Catchment Area also noted that cases of OCD in the US prevailed with 2-3% rates and showed that OCD chooses no gender as it can affect boys and girls as early as the pre-puberty (qtd. from Kinrys and Wygant, 2005; p. 546). By the ages 20-25 Neziroglu et al., (1994) observed that by the start of the age twenties and up some symptoms of OCD that are not prevalent in the early age might show up. (qtd. from Kinrys and Wygant, 2005; p. 546). Other research conducted by the National Comorbidity Survey stated that OCD attacks regardless of age and sex; however, although the illness is the same, the symptoms can be different. OCD had gone beyond its limit from a rare to a well-recognized illness. Murray and Lopez (1996) notes that OCD affected many lives regardless of gender and race. It was also the 5th cause of disability in females within the ages ranging from as early as 14- to 44 years old (Howell et al., n.d. qtd. from Castle, Kulkami and Abel, 2006; 67). Ad hoc, females with obsessive compulsive disorder tend to exhibit fear of germ contamination (compulsion) which leads to frequent application of hand sanitizers and cleaning for longer hours until they are satisfied. This was especially true in the experiment conducted by Fleischman and Fessler (2010) that women exhibit OCD symptoms when they high levels of progesterone. Progesterone is a chemical secreted by the reproductive organs and this chemical was responsible for eliciting OCD symptoms in women. Fleischman and Fessler (2010) also added that women with high levels of progesterone might struggle whether they will use the public restroom or not. Aside from this, women with OCD in public also faced with another struggle if they will wash their hands for a long time. Fleischman and Fessler et al., (2010) explained that: “Results from our cross-sectional study support the principal prediction derived from the compensatory prophylaxis hypothesis, namely elevations in self-reported disease-avoidance behaviors and attitudes as progesterone, the hormone responsible for reproductive immunomodulation, increases” (Fleischman and Fessler, 2010; 4).
There was no cure for OCD but there are some treatments. According to Shackman and Masline, some scholars argue that OCD was probably the cause of malfunctioned serotonin which causes physiological issues. Serotonin aids the brain in passing along information to other neurons. However, malfunctioned serotonin leads to communication failure on all the parts of the brain. This results to the serotonin being engulfed and the entire communication is lost. When the vital chemical messages are lost, sooner the mild of Tourette’s syndrome and OCD symptoms were already known in Japan (Shackman and Masline, 1999). Based from the readings, women are more vulnerable to OCD and other health illnesses because their body changes every month. Parents are also protective and afraid of their children for the fear that they might hurt them unintentionally because they were still observant of how they should raise their children. OCD attacks anyone regardless of age, gender, and ethnicity. As a conclusion, Obsessive-compulsive disorders in women are triggered by the past events, their personality, and their monthly cycles. The chemical progesterone affects women’s behavior and the change of the bodily hormones also causes their mood swings, panic attacks, anxiety, and these also triggers the symptoms of OCD, especially in perinatal stages. Indeed, women and men are complex; but it was the women who are highly at risk of having an OCD illness because of the hormonal changes that they undergo every month.
References
Abramowitz, J.S., Khandkera, M., Nelsona, C.A., Deacomb, B.J., & Rygwalla, R. (2006). “The role of cognitive factors in the pathogenesis of obsessive–compulsive symptoms: A prospective study.” Behaviour Research and Therapy 44 1361–1374. http://www.uw-anxietylab.com/uploads/7/6/0/4/7604142/postpartum_ocd_prospective_study.pdf
American Psychiatric Assocication. (2015). “Obsessive-Compulsive Disorder.” Retrieved from: http://www.psychiatry.org/obsessive-compulsive-disorder
Fleischman, D.S. & Fessler, D.M.T. (2010). “Progesterone's effects on the psychology of disease avoidance: Support for the compensatory behavioral prophylaxis hypothesis.” Hormones and Behavior 1-5. http://www.sscnet.ucla.edu/anthro/faculty/fessler/pubs/Fleischman%20&%20Fessler%20H&B%20in%20press.pdf
Howell, H., Castle, D., & Yonkers, K. (n.d.). “Anxiety Disorders in Women.” Castle, D., Kulkami, J., & Abel, K. (Eds.). Mood and Anxiety Disorders in Women. (18). Retrieved from https://books.google.com.ph/books?id=Eqzf0JQQbcgC&pg=PA59&dq=are+women+more+prone+to+ocd&source=gbs_toc_r&cad=4#v=onepage&q=are%20women%20more%20prone%20to%20ocd&f=false
International OCD Foundation. (2014). “What You Need to Know about Obsessive Compulsive Disorder.” 1-24. http://iocdf.org/wp-content/uploads/2014/09/WhatYouNeed_09.pdf
Kinrys, G., & Wygant, L.E. (2005). “Anxiety Disorders in Women: Does Gender Matter to Treatment.” Revista Brasileira de Psiquitaria, 27 543-550. http://www.scielo.br/pdf/rbp/v27s2/a03v27s2.pdf
Shackman, L. & Masline, S. (1999). Why does Everything have to be perfect: Understanding Obsessive Compulsive. Retrieved from https://books.google.com.ph/books?id=Dh-aerYBmO4C&pg=PA47&lpg=PA47&dq=are+women+more+prone+to+ocd&source=bl&ots=NwnmLlSLx3&sig=mbc_eiKYGA-BKjMPT9JeM-TdpAA&hl=en&sa=X&ei=jnE0VczoIs_-sAT794HwBg&ved=0CE4Q6AEwCA#v=onepage&q=are%20women%20more%20prone%20to%20ocd&f=false
Sullivan, N. E. “Factors Related to Obsessive-Compulsive Disorder.” (n.d.). Web. Accessed date 18 April 2015. http://www.mckendree.edu/academics/scholars/issue10/sullivan.htm
Russell, E.J., Fawcett, J.M., & Mazmanian, D. (2013). “Risk of Obsessive-Compulsive Disorder in Pregnant and Postpartum Women: A Meta-Analysis.” Journal of Clinical Psychiatry, 7(4): 377-385. http://www.researchgate.net/publication/236260180_Risk_of_Obsessive-Compulsive_Disorder_in_Pregnant_and_Postpartum_Women_A_Meta-Analysis
