In 2014, an epidemic of Ebola began in Guinea and spread to several other African countries.

Isolated cases occurred in Europe and the US when people traveled from the affected countries. The invisible and often fatal virus created a situation where many people experienced what obsessive compulsive behavior felt and looked like. Should a traveler be allowed to return from Africa? How long should they be quarantined? Should they be allowed to eat in a restaurant? Did a doctor or nurse take off their gown correctly when they exited the disease ward?

Should I cancel my flight? Should I postpone my surgery? I’d just feel better if I didn’t go to the mall until this is sorted out … Ebola was a life and death situation, though most of us in the US were only exposed via television. People weren’t sure what level of precautions were required. Tremendous anxiety was generated while experts tried to sort it out.

People with obsessive compulsive disorder live with this type of anxiety daily. Ordinary doorknobs or trips to the mall can elicit fear and protective rituals meant for life and death situations. In some cases, these can take over the sufferer’s time and life.

Let me just say that “OCD” has become one of those words like “totally,” used for a lot more than its’ original meaning. In a society prone to exaggeration, OCD is a way to describe a perfectionist, a quirky behavior — or the experience of someone who actually suffers from Obsessive Compulsive Disorder. Since achievement and getting it right is valued in our society, a little bit of over checking or over cleaning seems to be admired. These are the people who can joke about their “OCD.” But for the person who spends hours retracing their driving route in case they ran over someone or the child who is afraid to go to school for fear of germs, the symptoms are embarrassing, distressing and serve no noble purpose.

OCD is believed by many scientists to be a sort of a “glitch” in the brain, showing up in PET scans in parts of the brain involved with decision making, detecting novelty, and, of course, anxiety. It seems to run in families and probably has a genetic component. It also can be influenced by learning.

There was no fear of germs prior to their discovery, but there were other types of anxiety and repetition that stemmed from the same process, such as superstitions to ward off evil spirits.

The hallmarks of OCD are the thoughts (obsessions) and the actions (compulsions). It is the invisible thoughts that cause the distress.

“If I don’t shower every time I come home, I will contaminate my baby and she will have brain damage. If I go through the doorway wrong, I have to repeat it until I am sure I haven’t brought bad luck on my family.”

Many OCD sufferers worry about society’s most advertised concerns: germs, taboo sexual thoughts, cleanliness, illness. Others worry about things that are so odd they can’t explain them — running out of air, fear of certain colors, obsessions with numbers. Howard Hughes, a famous millionaire who suffered from OCD, was said to sort his peas by size. Most of the time, checking, cleaning, repeating or avoiding is seen as a way to reduce the anxiety.

The key to managing OCD, like other types of anxiety, is realizing it is the experience of fear that keeps it going. Whether the obsession is checking locks or washing clothes, fear is the driving force. Most OCD sufferers realize that their fear reactions far exceed what might be logical.

Once a person decides to confront the fear by pushing back against it, they have taken the first step toward recovery. Some therapists explain OCD to children as a “bully”, others talk to adults about the glitch in their brain. But successful therapies usually have in common that you succeed by doing exactly what you have been avoiding.

To make this manageable, it is done in a planned way and sometimes accompanied by self-coaching or relaxation techniques. The process is often called Exposure and Response Prevention because the components are facing the fear and not doing the reassuring ritual. For some people, distractions take them away from the worry. For others, medications are helpful. Small steps and lots of repetition are required. According to Harvard’s website, 50 percent of people who seek treatment for OCD will experience improvement, though only 10 percent would be considered cured.

That makes OCD a chronic condition that responds best to treatment followed by lifestyle changes. The most difficult part is for people with OCD to find the courage to seek help and explain their issues to their therapist or physician so that treatment can be targeted where it is needed.

For more information, check out The OCD Workbook by Bruce Hyman PhD, which was a source for this article. You can also read books by Dr. Jeffrey Schwartz, who is an expert on both the brain and the treatment of OCD. Or visit the website of the International Obsessive Compulsive Disorder Foundation, at iocdf.org. If you are seeking treatment for OCD or other anxiety disorders, you can contact Family Service of the Chautauqua Region at 488-1971 or a mental health provider of your choice.

Dr. Kelly Burkhouse is a clinical psychologist who works for Family Service of the Chautauqua Region. Family Service is a United Way agency.