SINGAPORE: Ms Alina has a mobile phone, but she does not turn it on. She fears that her private information is being shared.
Her first job lasted only months. She did not trust the photocopier she had to use frequently in her administrative role.
Speaking to Channel NewsAsia, Ms Alina said: “I found it ridiculous.” But she could not stop herself.
Ms Alina who is in her 30s is not strange. She has a mental condition called Obsessive Compulsive Disorder (OCD) which she has been suffering from for the past eight years.
WHAT IS OCD?
People with OCD experience obsessions in the form of intrusive persistent thoughts, images or urges, combined with feelings of doubt or danger, senior clinical psychologist at the Institute of Mental Health Department(IMH) of Mood and Anxiety Dr Jackki Yim told Channel NewsAsia.
The recently released Second Mental Health Study found that 1 in 28 Singaporeans suffers from the condition, making it the third most common mental illness after major depressive disorder and alcohol abuse.
Dr Yim said OCD sufferers carry out compulsions in the form of repetitive physical and mental acts in order to reduce their distress or prevent the catastrophic consequence from actually coming true, she added.
"Some common obsessions are fears about the consequences of contamination, worry about harm, unwanted sexual thoughts, discomfort with asymmetry or unevenness, and need for perfection or completeness," she said.
She added that some common compulsions involve checking, washing and cleaning, counting, repeating, arranging things so that they are “just right”, mental reviewing or analysing, and touching or tapping things.
"People are diagnosed with OCD when these obsessions and compulsions take up a significant amount of their time and begin to impair their day-to-day functioning," she said. It was this that Ms Alina experienced.
“I THOUGHT I WAS GOING CRAZY”
Ms Alina was fresh out of university and five months into her first job when she started experiencing issues she did not understand.
She started to feel the need to check the copies that came out of the photocopier against the originals. It was just scanning the photocopied pages against the originals at first, but she soon found herself checking every word.
She said: “I was worried of making a mistake and the consequences that would have.” She even roped in a close friend to help. While the friend did not question her behaviour, her boss was not happy as her work inevitably suffered. She did not tell him about the issue she had.
"How do you tell someone you don't trust the photocopier?” she asked rhetorically. At the time, Ms Alina did not know she was suffering from OCD.
“I thought I was going crazy,” she said.
AUNT NOTICED DEPLETING SOAP AND SHAMPOO
She quit after about 10 months. Unemployed, she stayed at home, but her fears did not go away. They shifted. She became fearful that her private information was being shared. To relieve the anxiety she felt, she started washing her hands frequently, and showering for longer, which was noticed by an aunt who lives with her.
“She noticed that the soap and shampoo were depleting too quickly and came to ask me about it,” Ms Alina said. Her aunt encouraged her to seek the help of a counsellor but this did not resolve the problem.
"I remember vividly once, after washing my hands five times, I felt like something was wrong. I realised I need professional help,” she said. With her aunt by her side, she plucked the courage to seek help from IMH.
HEART “SANK” WHEN TOLD SHE HAD MENTAL CONDITION
Her heart sank when she was told she had a mental condition by the IMH psychologist. “I knew there was a stigma attached to having a mental illness,” she said.
Nevertheless, she got better with the help she received and medication.
As a next step, she was advised to try Exposure and Response Prevention (ERP) therapy. It works by deliberately exposing patients to obsessional cues, and then preventing them from engaging in the associated repetitive behaviour.
She tried it once, but was too afraid to continue with the therapy. At the time, she had landed a full-time administrative job.
Given that her condition was stable, she decided to go off her medications, which typically calmed her down. She also stopped seeing a psychologist. She learnt the hard way that she in fact was not okay.
INTRUSIVE THOUGHTS OF SELF-HARM
She became alarmed when she started getting intrusive thoughts of harming herself, unaware that it was also a more severe facet of her condition.
She did however know she needed help. She returned to IMH. This time, with the persuasion of another psychologist, she decided to try ERP therapy. She remembers the words that got through to her.
“She told me I was on a sinking boat. It made me feel like it was time to try the treatment,” she said. The therapy involved Ms Alina attending her sessions at IMH on her own, as she had fears of doing that.
“I couldn't go on my own. I was always accompanied by my aunt or dad,” she said.
Her psychologist would take her around IMH, introducing her to the different parts of the building on Buangkok Green. By the third session, Ms Alina found the treatment was working for her.
“IMH did not seem dark, creepy and scary anymore. When I thought about IMH, the first word that came to my mind was ‘bright’,” Ms Alina said, the triumph and joy in her voice clear.
OCD OFTEN MISUNDERSTOOD
Despite its high prevalence, OCD is still often misunderstood, said Dr Yim.
When OCD is used loosely and becomes synonymous with words like “clean”, “perfect”, or “organised”, it could trivialise the seriousness and complexity of the condition.
It may seem to suggest that obsessions and compulsions are just something annoying or amusing that a person could get over. But for people with OCD, it is not simply a question of annoyance - it entails a great deal of suffering and produces extreme distress and major loss of quality of life, she said.
Dr Yim, who described OCD as a “common and treatable condition”, advised people to learn as much as possible about the condition and if they notice themselves displaying the symptoms. There are effective ways to keep OCD at bay, she said.
“However, if you have difficulty managing these symptoms and they are interfering with your daily functioning, do make an appointment to see a general practitioner,” she said.
She cautioned that when family members accommodate a patient’s OCD behaviours, they unwillingly contributing to the maintenance of OCD symptoms.
Dr Yim shared anecdotes of two challenging cases she has come across. In one, a woman who had a fear of contamination had not entered her room for eight years, sleeping instead in a cockroach-infested living room.
In another, during therapy at a supermarket, a patient had obsessive fears that she might commit some horrific act on herself, her family members or other people. She became housebound, avoided sharp items including pens and toothbrushes, and avoided people generally, including her own young child, Dr Yim said.
“These two cases highlight the fact that the sufferings of patients with OCD can be real, crippling and disabling, and can affect the quality of life not only of a patient, but also of their families,” Dr Yim said.
She encouraged people with OCD to seek treatment early. “Although OCD cannot be cured completely, with appropriate treatments, however, a patient can learn to manage his or her OCD symptoms more effectively and thus can live a functional and meaningful life” Dr Yim said.
Ms Alina, who is currently unemployed, but coping well with her condition, had similar advice.
“It’s for you, for your health. It doesn’t matter what others think. It’s your life and your family that matter. Don’t be on the sinking boat.”