April Mooney remembers a life governed by rituals.

She had to pack lunch for her younger son the same way every day "or something would happen to him," she recalled thinking.

She would put a grocery item back on the shelf if it didn't feel "right."

And if she opened a soda or water bottle, she had to hear that "crackle," as she described it, of the seal breaking. And once that bottle was opened, she couldn't finish it, because now that the seal was broken, the contents could be contaminated. That fear extended to almost everything Mooney ate and drank.

This was Mooney's life with obsessive-compulsive disorder, also referred to as OCD, where sufferers endlessly repeat actions and rituals in order to keep fearful, obsessive thoughts at bay.

"You're always doubting everything," Mooney said. "People with OCD want to be certain, and we can't."

That was before Mooney, 50, of Maytown, took charge of her life last year, by deciding to appear on "The Oprah Winfrey Show," in an episode about OCD.

Titled "Dr. Oz Goes to OCD Camp," the episode, featuring Philadelphia-area therapist Dr. Jonathan Grayson and "Oprah's" Dr. Mehmet Oz, pitted Mooney and five other OCD sufferers against their fears.

It changed everything for her. While Mooney doesn't claimed to be cured, life "after Oprah" is much better — and busier — than it was before, she said.

Today, Mooney runs a support group, L.A.U.G.H., or Learn to Accept Uncertainty and Gain Hope, and has a Web site, http://laughwithocd.com. In August, she attended a three-day conference on OCD, where she reunited with some of her "Oprah"- episode co-stars, in Minneapolis.

Back here, the L.A.U.G.H. group, which Mooney said averages six or seven members but sometimes attracts as many as a dozen participants, meets the first and third Tuesday of each month at Mount Joy's Milanof-Schock Library.

Humor, which Mooney says is something OCD "hates," is an integral part of the meetings. Sometimes, Mooney said, "we laugh so hard I'm afraid the library is going to throw us out!"

But Mooney hasn't forgotten the recent past.

The National Alliance on Mental Illness defines OCD as a disorder comprised of obsessions — irrational, intrusive thoughts and unwanted ideas that repeatedly well up — and compulsions, or repetitive rituals that compel a person to do something over and over again.

Celebrities such as Cameron Diaz and Howie Mandel have dealt with OCD, Mooney said, adding it's not unusual for OCD to manifest itself in creative types. But it was another famous person — Winfrey — who helped Mooney take on OCD, a disorder she did her best to keep hidden.

"I didn't tell anyone I had OCD except my husband [Jack, 53], and even then I didn't tell him everything."

The May 2008 episode, in which Mooney appeared, described a woman afraid that her food was poisoned. Mooney said it wasn't quite that simple.

"I really didn't think my food was 'poisoned,' but I had an issue about contamination of food," she said.

Her OCD was rooted in past maladies and traumas. As a child, she suffered from hypochondria, the fear of illness. Mooney's first marriage, at age 17, was very troubled. She had her first son, Justin, now 32, when she was 18.

That's also when she had her first anxiety attack. She also knew her family had a history of chemical imbalances in the brain. But Mooney wasn't sure just what she could pin down as the source of her anxiety. At one point, Mooney was diagnosed as bipolar, and put on lithium. "It didn't do the trick," she said.

Mooney's second daughter, Kristine, now 30, was born two years after Justin.

Mooney divorced and eventually remarried, and had another son, Jack Jr., now 22. Over the years, however, Mooney's anxiety became more complex. "It wasn't going away," she said. "I had an anxiety attack every time I was going to eat."

It was the 1982 Tylenol scare, in which several bottles of the popular painkiller were poisoned with potassium cyanide, killing seven Chicago-area people, "that pushed me over the edge," Mooney admitted.

"I wouldn't eat capsules. I wouldn't give my kids capsules," she said, adding that she became obsessed with "anything I heard in the media about cyanide."

That morphed into a fear of food contamination, among other things. At the family dinner table, "I ate kind of slow, and they just kind of made fun of me," Mooney said. "I was an overprotective mom, and they thought that's the way I was."

In other words, nothing they would have considered too out of the ordinary. But Mooney would often go to bed hungry and crying. She also had problems keeping food down. "It was not anorexia — I knew I wasn't fat," Mooney said.

Her fears extended beyond the house. When she picked up canned goods at the grocery store, she would "touch the top to make sure the top was sealed," Mooney said.

"If I picked up a can of Pringles and it didn't 'feel right,' I'd put it back." Any can with a dent also found its way back to the shelf, Mooney said.

Last year, Mooney saw the invitation on Oprah Winfrey's Web site.

"She put out a call [asking], 'Do you have OCD or know someone with OCD?' At the time, I was really bad," Mooney recalled.

She traveled to Philadelphia and joined five others, therapist Grayson and "Dr. Oz" before heading to a New Jersey Boy Scout facility for a kind of OCD boot camp.

There, they were asked to confront their fears; one participant, Brian, had a fear of germs. With great difficulty, he managed to touch a garbage Dumpster during a boot camp side trip to downtown Philadelphia.

"No one made us do anything," Mooney said. "We all did what we wanted to. We were all desperate. That's why we were there."

For April, boot camp meant consuming something she had no control over: the contents of a soda bottle that had been opened by someone other than herself. She did so; but, on the show, confessed her unease.

"It's not over yet because it's in me," she said on the episode.

"Now the fear is coming of what's going to happen now."

She managed to keep the soda down, but her struggle continued to be depicted for the remainder of the episode.

"I hate it so much. I want it to stop," April said at the time.

"I want to be free."

On the second day, she ate breakfast, but remembered feeling like she wanted to throw up. " 'What if there was something in it?' " she recalled thinking. She also felt as if she would pass out, but kept in mind that the cameras were rolling.

Mooney said none of it was easy, but today she's a firm believer in what is called "exposure and response prevention therapy," a treatment championed by Dr. Grayson, who has since become Mooney's therapist.

"That's the key word — exposure," she summed up.

Mooney recalled she "couldn't wait" to get home from the Oprah-sponsored OCD boot camp. Not because it was so unpleasant, but because Mooney felt a burden had been lightened. More than a year after her experience, she recalls the reaction from people around her who discovered her secret when it was revealed on the Winfrey show.

Some reacted with " 'Oh, stay away from her; she's a little nuts,' " she said. Others, however, were "like, 'wow! I didn't know!' " She welcomes the latter attitude.

"I want to educate people," she said.

At the Minneapolis OCD convention, Mooney was reunited with three of her "Oprah" OCD camp participants.

The large gathering also hosted hundreds of doctors and experts, but it was Mooney and her co-stars who were sought out by OCD sufferers or those who knew one. Mooney found herself a little amazed at that — "here we are, just regular people," she said — but, she added, "we've been there.

"I'm not saying doctors don't know what they are doing, but they get their experience from books. We have life experience."

At home, Mooney takes the medication Luvox, which she calls "the miracle drug." But she's also learned to rely on her own will.

"I eat stuff. ... I've already opened bottles of water that didn't 'crackle.' I go out to dinner."

She also takes care of husband Jack, who is on disability, and lectures to students at area high schools with the goal of "breaking the stigma of mental illness." Plus, "I am writing a book," Mooney said. It's titled, "Snap, Crackle, Pop," a joke on the sounds Mooney had to hear when opening containers. Mooney started a new job as a certified peer specialist at Philhaven, a Mount Gretna-based behavioral health care organization, in July.

And, reflecting the name of her support group, Mooney maintains a sense of humor. She isn't bothered by the television show "Monk," a comedy-drama about a detective with OCD, saying it provides an injection of humor into dealing with the disorder. After all, she said, "it's funny, some of the things we do! If we don't laugh at it, we would go nuts!"

Mooney cherishes one memory from last year's "Oprah" experience that's both inspiring and comes with a punchline. Just before her boot camp, Mooney injured two fingers on her left hand, including her middle one, in a fall. She was determined not to let that stop her.

"When I was picked, there was no way I [wasn't] going," she said. That earned her the admiration of an Internet pen pal. "He said, 'You gave OCD the middle finger!' "

The next L.A.U.G.H. meeting will be held at 6:30 p.m. Tuesday, Oct. 6, at Milanof-Schock Library, 1184 Anderson Ferry Road, Mount Joy. Call April Mooney, 604-1409.

OCD facts and figures
Examples of obsessive-compulsive disorder behavior, the National Alliance on Mental Illness notes, might be an obsession with contaminated hands, or a recurring worry that one has left the house without turning off the stove. This leads to the compulsion aspect: repeated hand-washing, returning to the house again and again to check the stove. Some feel compelled to hoard or arrange things just so, NAMI said.

The cruel, dual nature of this "disease of doubt," as NAMI calls OCD, is that sufferers know their fears are irrational, but they are too afraid to let go of them.

OCD sufferer April Mooney can relate to NAMI's definition. "It's like a cycle," she said.

It's easy to confuse OCD with a phobia. But Dr. Jonathan Grayson, a clinical psychologist with the Anxiety & OCD Treatment Center of Philadelphia, and Mooney's therapist, said there's an element of control with a phobia — a person is afraid of something, and he or she avoids it.

With OCD, Grayson said, uncertainty is the rule. An OCD sufferer "wants to be 100 percent certain of something," an impossible task.

"They problem is, they don't want 'probably,' they want 'zero,' " Grayson said of OCD victims' desire for zero doubt.

OCD might manifest itself physically, as noted in the above examples, or mentally, such as obsessively violent thoughts, for instance. The OCD victim has the thoughts and worries about having them, which, in turn, causes him to think of them in a never-ending spin, Grayson said.

It's an exhausting malady. OCD sufferers, Grayson said, are "multitasking all the time, and they are in terror."

NAMI estimates that more than 2 percent of the American population — nearly one out of every 40 people — will suffer from ODC at some point in their lives.

The disorder is two to three times more common than schizophrenia and bipolar disorder, according to NAMI.