The recent death of two twin sisters who had battled obsessive compulsive disorder (OCD) their entire lives has cast a spotlight on the challenges of living with the illness.
Sara and Amanda Eldritch, both 33 years old, of Broomfield, Colorado, were found fatally shot in a vehicle parked at a rest area at Royal Gorge Bridge and Park.
According to police, their deaths were believed to be the result of a suicide pact.
The twins’ OCD was so severe that at times they would rarely leave their house. Both also previously shared stories about taking 10-hour showers and using entire bars of soap to get clean.
They would go through bottles of rubbing alcohol and hydrogen peroxide to disinfect their skin.
If the two wanted to leave the house, they would stop eating and drinking hours in advance, so they could avoid public restrooms.
“It’s like listening to someone who’s holding you at gunpoint,” Amanda Eldritch told 9 News. “You absolutely have to do what they say.”
That description is, perhaps, the defining and most distressing element of OCD.
“It is incredibly debilitating,” Eric Storch, a professor of psychiatry at Baylor College of Medicine in Texas, speaking on behalf of the International OCD Foundation, told Healthline.
“So, if you could imagine going through life where every day you lost an hour to three hours to things you knew made no sense, but you couldn’t help but do them because you are deathly afraid of a feared outcome and you went day in and day out doing that, knowing you were ritualizing your life away,” he explained.
More than just obsession
Indeed, the Eldritch sisters’ deaths are a reminder that mental illness is rarely what we expect it to be.
OCD is defined by repetitive thoughts and actions that either cannot be controlled or can only be controlled for a short period of time.
Actions, known as rituals, are performed habitually due to some kind of trigger. Fear of germs and persistent handwashing is an obvious example.
Obsessions are intrusive thoughts that could include sexual images and desires, harm, and moral rightness. These thoughts often continue to persist despite the individual’s attempts to confront them.
“The general idea is that there is some trigger that takes place, it makes the person anxious, the person then does something to try and get rid of their anxiety like a ritual,” said Storch. “They temporarily succeed, but that temporary success actually rewards them and makes them more likely to do the same thing the next time it happens.”
"The more severe someone is, which often coincides with not responding to intervention, the more likely they are to start thinking about suicidality." – Eric Storch, Baylor College on behalf of the International OCD Foundation
Five ailments that can emerge from OCD
Because of the impairment that OCD can have on someone’s life, the disorder has numerous associated conditions.
“The rule rather than exception is that a person with OCD has other co-morbid problems going on. Some of the most common ones include depression. Other anxiety conditions can be quite common. Then, you see a variety of other features that come into play,” said Storch.
The following are five serious symptoms and conditions common among people with OCD:
Body dysmorphic disorder
Body dysmorphic disorder is characterized by the persistent thought that one’s body is flawed or ugly.
These negative thoughts, like OCD, can cause severe emotional distress and problems in daily functioning.
The disorder is also often characterized by certain repetitive behaviors similar to OCD, including skin picking, excessive grooming, and excessive exercising.
Hoarding disorder is a condition that is also closely associated with OCD.
This is where an individual is incapable of or has a persistent difficulty in discarding possessions.
The disorder is characterized by anxiety related to possession. The individual may not want to get rid of their possessions, but they may also be embarrassed by them.
As the hoarding becomes more serious, daily life impairments can occur.
These include loss of physical space, social problems, and even health hazards due to unsafe sanitary conditions.
The co-occurrence of OCD and social anxiety can also affect an individual’s relationships, including dating and marriage.
So-called “relationship OCD” is characterized by persistent thoughts of doubt about one’s partner.
These can be related to levels of attraction and questions of worthiness of being with a certain individual.
These kinds of persistent thoughts have the capacity to harm a relationship, if untreated.
Awareness of one’s OCD and time spent “trapped” in certain behaviors and rituals can lead to a perceptible decline in quality of life, which can lead to depression.
“That’s one of the reasons you see such a high incidence of depression with OCD because it disrupts their life in such a significant fashion. A lot of times it will impair relationships or ability to work effectively or go to school,” said Storch.
Risk of suicide
Suicidal thoughts are also more common among those living with OCD.
“It can become so debilitating that people think that death may be their only salvation, their only escape from the distress,” said Storch.
“We tend to see that as severity increases. The more severe someone is, which often coincides with not responding to intervention, the more likely they are to start thinking about suicidality,” he added.
There are effective treatments for OCD.
These include cognitive behavioral therapy and antidepressant medication.
According to Storch, about 85 percent of patients respond to these therapies or a combination of both.
“We really have a very good chance of a very successful outcome,” said Storch.