Dear Kelly,

You should definitely see someone about this. You have described almost all of the symptoms of Obsessive Compulsive Disorder. This is a condition that often is helped by therapy, but has a tremendous chemical component and therefore it is essential to see a psychiatrist. Since you are underage ask your parents to take you to one. It is also entirely possible that another member of your family has the same condition because there is a large genetic component to this disorder.

The problem you suffer from is called Obsessive Compulsive Disorder or OCD. This is a disorder in the chemistry of the brain that compels a person to have repetitive thoughts or perform repetitive actions to relieve anxiety. Usually a person realizes that the thoughts and/or behavior is rather senseless and has no real basis in reality, but still cannot get themselves to stop the cycle. It is probably quite apparent to you that washing your hands once would be sufficient to be clean after using the toilet, but cannot get yourself to stop. It makes a person feel out of control and lowers their self-esteem. No amount of logic seems to be effective and often secondary depression results.

Most people try and rationalize the condition as you do in your letter. You are right that in general it is great to be organized and clean, but the problem here is both the excess that occurs and they lack of control you have to modify it. Also if you don't follow through with the obsessions then great discomfort and distress usually result. The culture we live in is not much help as well. What makes us great is that we rely on ourselves so much, but what makes us naïve and self-destructive is that we damn ourselves on those issues we have very little control of. We are often out of touch with reality and think that anything can be changed by force of will. If that were true then people could change the color of their hair or stop the aging process by simple force of will. Some things nature has put beyond will power alone. The trick is to know when it is and when it isn't. When it isn't will power is essential.

I would suggest that you search your community for a reputable psychiatrist who is knowledgeable about Obsessive Compulsive Disorder. He or she will very likely prescribe an anti-depressant such as Luvox or Anafranil. These anti-depressants tend to be especially effective for obsessions and compulsions. The side effects are usually mild and temporary. These can include weight gain, headaches, anxiety, dry mouth, nausea, and sexual inhibition. It is not rare for these medications to be needed on a life long basis, but the benefits are significant.

I do not mean to suggest that there is no benefit from counseling for this problem. It is very helpful to seek out a counselor to add support and direction to deal with the self-esteem that invariably gets lowered from this disorder. They can also educate you and your family about the condition. There is also usually a need for behavioral strategies that can be effective in alleviating this distressing problem.

I hope this has been helpful and wish you all the best.

Jef Gazley, M.S. www.asktheinternettherapist.com