This condition couple obsessions, or persistent images, thoughts, doubts or worries that are intrusive and cause marked anxiety, with compulsions, repetitive behaviors such as counting or hand washing that are meant to prevent or reduce the anxiety. 

There is a prevailing need for order and an avoidance of situations that tend to provoke the obsessions and compulsions.  Social isolation worsens O.C.D. as the individual tends to 'spin his/her mental wheels'.  Social interaction allows the individual to focus on others.  Adults with Obsessive-Compulsive Disorder (O.C.D.) are usually insightful, aware that the manifestations are time-consuming, excessive, or unreasonable, but children often lack the cognitive development necessary for such insight. 

This condition is equally prevalent in men and women, and occurs in approximately 2.5% of the general population. 

• A schoolboy won't use his pencil because of fear of lead poisoning,  or open his math book because patterns vary from his 'lucky' patterns. 
• A man cannot leave home for work without following his ritual of turning off the coffee pot, patting the dog and searching for his keys, in exactly that order.  He will mentally review the routine after he has left the house to satisfy himself he has done it correctly.  He is unable to handle cash at work because of the germs on it. 
• A women avoids social events because she fears contamination from handshaking. 
• A women puts her clothes in a certain order in her closet. 
• A girl cannot borrow books from the library because they are contaminated. 

"There are two sure-fire ways to treat O.C.D.  One is with anti-depressants, the other is following the 4R's (from Brain Lock), as follows: 

• Re-label: recognize the intrusive obsessive thoughts and urges are a product of O.C.D. 
• Reattribute: realize that the intense thoughts and urges are related to a biochemical imbalance in the brain. 
• Re-focus: focus your attention on something else, at least for a few minutes.  Do another behavior. 
• Re-value. do not take the O.C.D. thought at face value.  It is not significant in itself. 

Characteristic of this condition is the presence of recurrent,  unexpected panic attacks and worry about having another panic attack, and/or the consequences of same, or marked changes in behavior related to having attacks. 

A panic attack: is a period of intense fear and discomfort, accompanied by physical symptoms including heart palpitations, shortness of breath, trembling and shaking, sweating, nausea, chills or hot flushes, or dizziness.  Blushing is common.  Persons frequently report thinking they are having heart attack or that they're "losing it".  A temporarily increased heart rate and a moderate rise in blood pressure are symptomatic of an attack; mitral valve prolapse and thyroid disease may be more common in persons with this condition. 

There is a sense of impending doom and an urgent need to escape.  There may be a feeling of dissolving into nothingness, of losing one's energy/identity, the point that one fears one may cease to exist.  One may well experience the fear of "going crazy" or dying.  

Agoraphobia: the fear of and/or avoidance of situations from which escape may be difficult or in which help may not be available (such as in crowded, public places), may or may not be present. 

Panic attacks that are related to specific situations are not generally thought to be of a true Panic Disorder, but symptomatic of some other condition.  Panic attacks frequently co-exist with Obsessive Compulsive Disorder (O.C.D.), specific phobias and Generalized Anxiety Disorder (G.A.D.), Separation Anxiety Disorder, and Major Depression; in some cases, diagnosis of these is more accurate than of Panic Disorder. 

The onset of Panic Disorder is typically between late adolescence and mid-thirties, although this can vary.  There may be periods of remission.  Panic Disorder without agoraphobia is twice as common and Panic Disorder with agoraphobia, and three times as common women than men. 

"There may be a hormonal connection, particularly during menopause.  Prior to menopause I did not experience panic attacks.  When a panic attack does hit, I 'cognitive-behaviour' my way through it.  I use affirmations like, 'This will soon be over' and 'I'm more powerful than you are.'  In the words of Fur Diesen Viel Dankbarkeit, 'Each time you get better at mastering fear, you get better at mastering fear.' 

"While panic attacks come out of the blue, research I've done suggests they may be due to random misfiring of a region of the brain called the locus coerleus or of another region called the amygdala."