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My Story When I was 15 years old my dad drowned in a boating accident, the doctors tell me that is what triggered my obsessive compulsive disorder. The fact that he died when I was so young changed my life forever, in more ways then I can possibly explain. I have been diagnosed as a "checker". I constantly would check stoves and doors,40-50 times a day, even if they hadn't been used. I constantly worried about the house catching on fire, someone breaking in, someone dying. I was driving myself crazy. When my daughter was younger I would constantly be checking on her while I was at work, even though I trusted the person who was watching her I still had to call to make sure she was ok. I wouldn't allow her to play outside without me being there and the few times I did, I was constantly looking out the window. I found every error in life I could possibly find and wanted it corrected immediately. I had zero tolerance for anything. I have been taking medication for almost 3 years. I am currently taking 75 mg of Effixor. So far it seems to help with the "checking" part of my disorder but I have still a long way to go. I encourage anyone that has OCD or who thinks they might have it to get help. This is not something that will just go away. What is OCD? by Jim Chandler, MD, FRCPC To be diagnosed with OCD, a person must have obsessions or compulsions or both. Besides this, the obsessions and/or compulsions must be disabling. Obsessions These are thoughts which are invisible to anyone else. The thoughts bring some distress to the person. The person wishes they did not have these thoughts. They are not based on what is realistically worrisome in that person's life. These thoughts occur over and over, usually hundreds of times a day. A person spends so much time thinking about these things they have a hard time doing their work, taking care of themselves, or relating to others in a normal way. Common Obsessions The most common ones in children are fears of bad things happening to family members, exactness and symmetry, bodily functions, lucky numbers, and less likely, sexual and aggressive thoughts. Religious obsessions are less common. Here is the official definition. Obsessions are: 1. Recurrent and persistent ideas, thoughts, impulses, or images that are experienced at some time during the disturbance as intrusive and inappropriate and cause marked anxiety or distress. 2. The thoughts, impulses, or images are not simply excessive worries about real-life problems. 3. The person attempts to ignore or suppress such thoughts, impulses, or images to neutralize them with some other thought or action. 4. The person recognizes that the obsessional thoughts are the product of his or her own mind (they are not hallucinations. They are not felt to be inserted into your mind by someone or something else) Obsessions are usually in some way extremely private, embarrassing, or disgusting. Rarely will an adult or child with OCD tell all of their obsessions. Rarely are obsessions present alone. Usually there are also related compulsions. Examples Reading about descriptions of obsessions doesn't give you much feeling for what they really are like. Examples do. Here are some. Jonathan - unlucky numbers This 11 year old boy started doing badly in school. This was pretty surprising as he had always been a good student. Jonathan knew why, but he was afraid to tell anyone. He was worrying that he might loose his temper and hurt someone. He never had, but he felt like he might just do it some day. For some reason that he can not explain, if he does anything with the number "9" he thinks he will loose control and attack someone. So the more number "9" he sees, the more he worries about losing control and attacking someone. He wishes he didn't have to think about this all the time, but he can't help it. It takes a lot of energy out of a person to avoid reading or saying the number "9". It means that he is very slow to do his homework (especially math) and has a hard time playing games with his friends. His parents are about to kill him. He will not go to bed at the usual time (9:00 O'clock!). He refuses to ride the bus, is slow to get ready, and never seems to listen. He is in a world of his own. Kim - sexual When Kim was 11, she started seeing pictures in her mind of kissing boys in her class. She pictured kissing their genitals. She also pictured kissing girls. She had never been abused, and she had never even heard of oral sex before. The thoughts scared her. She thought she was going crazy. She couldn't sleep at night. She was afraid to go to school. She had severe headaches. Finally, she told her mother and she was brought to her family doctor. Richie - counting Richie doesn't know when it started, but he has always been a big counter. Now that he is in seventh grade, it is a lot worse. He thinks he will probably fail the year if he doesn't count things just right. What things? Well, how many tiles is it to his locker from homeroom? How many steps are there to the basement? How many children are on the bus? The problem is, he isn't quite sure he hasn't missed a number here, so he has to go back and count it again, and again, and again. Once someone bumped him just as he reached tile number 278 or was it 279? He got so mad, he screamed at the other boy. When the principal asked what was going on, Richie decided saying nothing was best. Ashley - disease Ashley once went to Halifax and was walking along the sidewalk with her friends. She stepped on something yucky, but didn't think much about it until they got to the hotel. The idea came to her that it was a condom, and probably she would now get AIDS from it. She asked her friends what they thought. She asked her mom. Ashley was 15 and had never even kissed someone and was at zero risk for AIDS. She called the AIDs Hotline at least twice a day for assurance. She begged to go to the doctor for more tests. She read every book she could about AIDS. When she started talking about her funeral arrangements, her mother took her to the doctor who sent her to the psychiatrist. Andrea - did I do something horrible? Like most 16 year olds, Andrea was very excited to get her driver's license. She was a careful driver and her instructor and the testing person both commented on what a careful and mature driver she was. Looking back, she maybe was a little too careful. The first week she had her license everything went fine. Her Dad was quite excited that she would be able to drive down to her dentist appointment in Yarmouth all by herself and then pick him up at the fish plant on the way home. Well, Andrea's Dad was about to call the RCMP after an hour of waiting for Andrea. When she arrived she was in tears and exhausted. Her father assumed she must have been in an accident, but that was not the case. Andrea drove by the Port Maitland school during recess. She got a kilometer down the road and started wondering, could she have accidentally run over a child in the road and not noticed it? So she drove back to check. No, all the kids were now inside. So off she drove again another couple of kilometers. Maybe she should have asked the school secretary just to be sure. She could hardly drive with these thoughts going over and over in her mind. The moment she got to the dentist, she was on the pay phone to the school. No, they said, all the children were fine. And so were her teeth. Unfortunately as she drove home she passed a bunch of kids on their bikes, a couple of dogs, and a group of kids playing hockey in a driveway. She figured she had hit them all and each time had to go back and check at least once to make sure she hadn't. Ann - mental acts Ann is a quiet girl who always seems worried. Over the last year, she has had a lot to worry about, at least in her own mind. She sees different shapes in her mind, and has to cut them exactly in half or turn them exactly half way around. If she doesn't her Dad's boat will go down with him. She doesn't know how it started, and she certainly doesn't know how to make it stop. No one would ever have known about this if she hadn't mentioned to her Aunt that she wished she would go to sleep and never wake up again Darrel - order, evening up and symmetry If you asked Darrel's brother Tony what kind of person Darrel was, Tony would say he is a great brother, as long as you don't mess with his stuff. Darrel was always tidy, but now it was worse. At age 10 he had his half of the room just right. Exactly half the legos were on the one side of his bed, the other half on the other side of the bed. The Gargoyles were lined up perfectly. The books and videos were absolutely even. His clothes were sorted by color. His posters were perfectly lined up. All the furniture was lined up with the lines in the wall paper. Tony himself was not like this, and most everything else in his life was a mess. Darrell told me that he felt that if he didn't keep things just right, something bad was going to happen to his Dad. His Dad was usually out fishing. Darrel thought that if he didn't keep his things just right, his Dad's boat might go down. Darrel's father couldn't care less what his room looked like. Darrell was on the verge of failing as he was not doing his homework. Why? He could not make the letters just right and had to keep starting over. He spent a good three hours a day organizing his room. Kelly - doubt Kelly met her boyfriend last year when she was 16. He is 18 and they are madly in love. Or at least she thought so until about a month ago. She started to wonder if she really did love him and if he really did love her. So she asked him, and he reassured her that he loved her. That helped for about a half an hour, so she asked him again. After telling her this about 30 times a day for a week, he was starting to wonder if maybe he had choose the wrong woman! He shared this burden with Kelly's mom. Kelly asked her most of her waking hours the same thing. Do I really love him? After a few weeks of this, Kelly's mom was going out of her mind. When Kelly's friend Tanya called and said she was worried because all Kelly ever talked about was you know what, Kelly's mom decided to do something before Kelly ruined every relationship she was in. Deb - religious Deb did not come from a religious family. They rarely attended church on Sundays. When she was 13 she started wondering if there was a God and what he might think of her, which is not uncommon. The same thought kept going through her mind, "Am I doing what God wants?" She finally started asking people what they thought. She asked her parents, a friend's youth pastor, and a teacher. No one could reassure her. Then, almost overnight, the thoughts changed to wondering, "Will I be forgiven for what I have done wrong"? Now Deb hadn't committed any unusual sin. She had never thought of this before. She started to do worse in school as she spent more and more time thinking about this. Sometimes she tried to find the answer, but mostly she just sat and thought about this question over and over and over. Finally, her Mother confronted her and told her that she was going for a urine drug screen for street drugs. After a big, big fight, Deb finally told her parents what she was thinking. They thought she was going crazy and brought her to the hospital. Compulsions Compulsions are things that people do or acts they perform in their heads. They are repetitive and senseless, just like obsessions. In many people, the compulsion is linked to an obsession. Here is the official definition. Definition 1. Repetitive behaviors are mental acts that the person feels driven to perform in response to an obsession. 2. The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive. Common Compulsions The most common ones in pediatric OCD are: washing, repeating, checking and ordering. (1) Less common ones are rituals to protect themselves from bad things, counting, hoarding and slowness. Examples Sean-Cleaning rituals Sean's mother first started to wonder what was going on when Sean was spending so much time in the bathroom. So one day she decided she had better found out. While he was in there she quietly came up to the door and listened. She heard water running. She opened the door just a crack but could only see her son's hands in the wash basin, scrubbing and scrubbing. She shut the door and waited. A few moments later out he came, as if nothing was going on unusual. She watched the bathroom door that day and made some notes. Sean made 20 trips to the bathroom that day and none was less than 5 minutes. So she showed him her notes. At first he just screamed at her for bugging her. Eventually, he started crying but all he could say was, " I just feel dirty all the time" I can't help it". Rob-Checking When Rob was 8, his mom was always reminding him to check the door, make sure he had his coat, and similar things. Now Rob thinks to himself, "I think I have made up for that about 100 times worth now!" When Rob goes out the door, he has to check just about everything. Was his CD player turned off? Did he turn off the lights? Did he lock the door? Did he accidentally turn the TV on? Did he hang up the phone? So, Rob is very anxious and worried that maybe the house may be broken into, or there might be a fire, or something, and goes back and s it again. But by the time he is done checking the last thing, he wasn't absolutely sure he had checked the first thing. The solution? Rob doesn't leave home much, and when he does, he makes sure someone is there. Once he is at school, he is mostly checking his pants. He keeps wondering if maybe his fly is down. So he checked it. About every 30 seconds. Robin- touching Everyone thought Robin was weird at school. As soon as she came into a room she would walk down the desks and lightly touch every third one, or was it every other one? Once she was seated, she would work, then touch, work, then touch. There were round bolt heads that attached the desktop to the desk. They stuck up a little bit off the top of the desk. Robin felt like she had to touch them. She half realized that everyone knew she was doing this, but she didn't want to say anything because then everyone would know she was crazy. Why did she do it? To keep from becoming a lesbian. She knew this was stupid, but she couldn't help it. Randy-slowness Randy got up every morning at 6 am. The bus did not come until almost 8:30, and he missed it about half the time. His mom was always trying to get him to hurry. Well, says Randy, you would take a long time, too, if you had to get ready perfectly each day. What does that mean? To start with, it means when you get out of bed, both feet touch the ground at exactly the same time. It means you brush your teeth 30 times on the top and exactly 30 times on the bottom. It means after you use the soap, you line it up perfectly parallel with the soap dispenser. The order for taking a shower and combing your hair is as complicated as getting ready to fly a plane. Every month it seemed there was one more thing that had to be done just right. Once he was dressed, he was fine. Randy finally got help because he was on the verge of being expelled. No way was he going to change his clothes for Gym, shower, and put his clothes back on. He didn't tell them why. Erika- doing and undoing Erika started crying when she came home from a birthday party. She was blowing up a balloon and then letting the air out so it would shoot all around the house. She blew too hard and the balloon exploded. It seemed as if Erika did, too. An hour later she sort of explained to her Mom that she was crying because she couldn't "undo" the balloon. All of a sudden, it all made sense in her mother's head. That is what her daughter had been doing these last few months! Erika would go in and out and in and out of her door. She would only go one way through the doors in the house, so she was always going the longest way around. Her mom thought it was just a game. While she would talk on the phone she would carefully put her hand through the hole in the cord back and forth, plus a number of other things. It turned out that the compulsions that her mother could see were just the tip of the iceberg. There were many mental compulsions, too. She would lie in bed wanting to go to sleep but couldn't until she could open this box in her mind and then shut it up just the same way. Erika usually cried her self to sleep thinking that she was obviously going crazy. Justin-repeating and perfection At parent-teacher night Justin's teacher showed Justin's mom his work. The teacher's question was, do you think he is doing this on purpose? When you looked at Justin's papers, it looked like they had been either hit with a shot gun, or attacked by a very vicious eraser. Almost everything had been erased over and over and over. As a result, many places were erased through the paper. Then it was folded and unfolded many times. When Justin sat down to work, he worked hard, and became more and more frustrated. However, when asked to do things orally, there was no problem. The teacher suspected a learning problem and sent him to the resource teacher. This is what finally convinced Justin to say what the problem was. It wasn't that he couldn't write or print, he just couldn't get it perfect. He knew that his first attempt was okay, but it wasn't perfect. It made him so anxious to see that imperfect letter or number that he felt he had to fix it. It turned out that at home, each sheet of homework consumed about 10 other sheets before he got it right. Mary - hoarding Lots of children like to collect things, and now with recycling, it is even more common. Mary started out that way and everyone at school was so happy to have her there. Mary would pick up trash, wrappers, old milk cartons, and anything she saw. She told the teachers she was bringing it home to go to their recycling. When her father saw Mary coming each day after school, he counted to 10, said a prayer, and greeted her. " Have any home work, Mary?" Of course she did, but as she pulled the homework out of her pack, out came about a half a trash bag of garbage. "Are you going to throw that junk out Mary?" No, not right now, she might use it to make something later on and she wanted to make sure she had it sorted properly. Mary's father knew what that meant. It meant she would squirrel away that with the rest of her trash, or collections, all around their farm. Mary and her Dad knew what was coming next, the showdown. "Mary, you are not coming into this house until you let me have those things. "After a lot of screaming and "you don't understand", Mary would give up her junk. Each Friday Mary went to the school and cleaned out Mary's desk. She never said she did it, and Mary was afraid to ask. Treatment There are three categories of treatments for OCD. 1. Treatments which have been carefully researched and have been found to be effective. This includes cognitive-behavior therapy and medications. 2. Treatments which have been studied some and are useful in certain circumstances. This includes family therapy, relaxation techniques, and surgery. These are not of interest to the general reader and I have not included information about them. 3. Treatments that have not been carefully researched but are still used by people anyway. This includes diet and nutrition therapy, psychoanalysis, all sorts of other psychotherapies, group therapy, and many, many more. Many of these treatments in this third group may be effective and they may be safe, but I don't know. Usually I don't know because there isn't enough careful scientific research on the treatment. The fact that something worked for OCD in 10 people in one clinic doesn't mean it is time to try it on others outside of a research setting. Sometimes I don't know about the treatment because it is just too new. Then my approach is to find out, or find someone who I respect who knows. Up until about 20 years ago, OCD was thought to be a very, very, rare disorder. It wasn't important to find OCD anyway - little was known about it and there were no effective treatments. Over the last decade, everything has changed. We now know that OCD is one of the most common neuropsychiatric disorders. It is also one of the most treatable ones. 
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