Help for the Worried Warts - TheBody.com's Bulletin Boards

Many people after receiving their conclusive results continue to show symptoms of anxiety and depression. You need to understand that you are not alone. You are not the only ones, questioning your tests and questioning your symptoms. You need to understand that your illness excludes HIV, however, HIV is just a vector for you to use to continue whatever facit brought you here in the first place. If you find that you cannot accept your negative status please read the follow. I post this not to belittle what your are experiencing, but I do post it in the hopes that you learn to rationalize your thoughts and learn the gift you have been given and move on.

WHEN EPIDEMICS COLLIDE:
OCD AND AIDS

By Fred Penzel, Ph.D.

Our planet is currently in the throes of a major health crisis. I am referring to AIDS. The average person's life has been influenced in a number of ways by this modem-day plague. Unlike previous decades, individuals no longer feel as free to have unprotected or casual sex. Medical and dental facilities have become far more careful about disease control. Blood supplies must be constantly screened. Police now wear gloves when searching certain suspects, as do food workers when serving meals.

There is also a place where this epidemic unfortunately crosses paths with another, less well-known epidemic: Obsessive-Compulsive Disorder. There are those with OCD who have obsessive thoughts about contracting AIDS, and the results can be extremely punishing. These fears are actually part of a larger group of obsessions about contamination. One of the main features of OCD is that sufferers have difficulty in determining just how risky certain things are. Sufferers often confuse possibility with probability: if something can happen, it will happen, no matter how unlikely. Unfortunately, for those with fears of AIDS, there happens to be a lot of media hysteria concerning the disease and how it can be contracted. As a result, it is not unusual for even the average individual to have unreasonable fears of people with AIDS. Even so, the average person's worries still do not tend to be as exaggerated or illogical as those of someone with OCD.

OCD sufferer's notions of how the disease can be contracted don't usually stop at the three most common ways: sharing infected needles, having unprotected sex, and receiving contaminated blood transfusions (which all happen to be direct blood-to-blood contacts). For the obsessively doubtful, almost anything that anyone else has touched can become a potential source of the disease.

The following situations are quite typical of this type of OCD, and are seen as high risks for contracting AIDS:

- Touching any red specks or spots anywhere, because they could be blood from an
infected person
- Being near anyone who looks unwell or is very thin, or is disheveled or homeless, or who
could be an addict
- Having blood drawn or having injec-tions, even with new, packaged needles
- Going to hospitals, doctors' offices, dentists, medical labs, or any place where ill persons
gather or medical procedures are done
- Being near people who are, or who in the sufferer's mind, appear to possibly be,
homosexual
- Being near health-care workers
- Touching doorknobs, light switches, or handrails in public places
- Getting cuts or scrapes where the virus could enter
- Fearing that they may be stabbed or struck by someone carrying an infected needle, or
having thoughts that they may have stepped on a discarded syringe lying on the ground
(they may even have false body sensations that this has happened)

This list is by no means complete.

A common variation on the fear of get-ting AIDS is the fear of contracting it, giving it to someone else, and then having to live with the guilt of having caused an innocent person's death. These sufferers may also have other problems with feeling overly responsible for others, another main theme among those with OCD. For these people, you could add this to the list above:

- Touching loved ones or touching anything else in public or in their homes (if giving AIDS to family members is the problem).

Getting and staying uncontaminated can be an excruciating 24-hour-a-day job. When sufferers are contaminated, they worry about getting perfectly clean. When clean, they worry about staying that way. They can only begin to feel comfortable when they are in control of everyone and everything around them. They wash and shower to excess when they believe they have touched something containing the AIDS virus, and they can often be spotted by their bright red, chapped hands. They will usually only touch feared things using barriers such as tissues, paper towels, or gloves. Every little cut or scratch may have to be covered with medication and a Band-Aid to keep the virus out. Anything possibly contaminated must be washed or disinfected, or else it must be thrown out. (Actually, most of these descriptions could be applied to the majority of people with contamination fears.)

To try to make this impossible task easier to manage, sufferers create "dirty" and "clean" worlds for themselves. They have places they can go and things they can do only when they are in a "contaminated state." The same is true for when they feel "clean." Certain rooms or locations can only be entered when sufferers themselves are "clean." One of my patients even had a "clean" car and a "dirty" car. When family members fall under a sufferer's control, they have to wash and change clothes whenever they enter the house, or else face a lot of upset or arguing.

Obviously, all this gets to be debilitating as the disorder takes over. Leaving the house can become extremely difficult. Some people stop socializing, or stop going to work or to school. In addition, sufferers tend to avoid or put off needed visits to physicians and dentists, and they may develop other health problems. In reality, all of the above are solutions designed to escape the doubt and anxiety, but they only end up helping in the short run. Unfor-tunately, in the long run, as sufferers use these methods, they only train themselves to be better avoiders who keep their fears going. Avoiding only convinces them that the fears are real, and it prevents them from actually seeing that the dreaded consequences never occur. Ironically, what starts out as a way to help control the anxiety ends up controlling and damaging their lives via a downward spiral of fear and avoidance. For those who do not suffer from these anxieties, it is difficult to appreciate just how gut-wrenching and debilitating they can be.

Medication can often be important to overcoming OCD. It should not be an end in itself, but should be seen as a tool to help you take part in therapy. It can provide a level of improvement from which to begin working. Not everyone requires it, but there are many who could not carry out behavioral assignments without the symptom relief it provides. It may also reduce feelings of depression, which can then result in a person feeling energetic and having a more posi-tive and motivated attitude about working toward a recovery. Antidepressant drugs such as Anafranil, Prozac, Paxil, Zoloft, Luvox, Celexa, Serzone, and Effexor are all currently being used to relieve the symptoms of OCD and depression. There is no best drug as everyone responds differently to them. Medication for OCD has been discussed in other articles in past issues, so I will not go into further detail here.

Recovery from this problem is possible but it is up to the individual to do so.

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Red like love, as a symbol of passion and tolerance towards those affected

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