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Re: mild ocd maybe yes katekite

Posted by mike21 on April 16, 2002, at 19:24:07

In reply to mild ocd maybe yes mike21, posted by katekite on April 14, 2002, at 10:48:16

For starters, I had OCD when I was about 8 years old. I've heard that when it occurs at such a young age it generally does not go away with behavioural/cognitive therapy, but that a med is probably required. The two symptoms I remember were washing and showering repeatedly, and choosing not to speak for periods of time.

I think the mutism was due to the anxiety from talking, and I think the washing helped to take away the anxiety. After a shower I would not talk for as long as possible. Sometimes I would even go to extent of using hand gestures alone to try to communicate.

I saw a psychologist which did nothing for me except to convince me that this behaviour was not really acceptable. So I remember one day deciding that if I ever hoped to stop seeing this guy, I would have to convince him I was cured. So I did, but I'd say that much of the anxiety I felt then is still present.

My current thinking is that OCD is based on a deficit in the pleasure centers of the brain. I seem to derive some sort of relief from my own general state of discomfort by repetitive thoughts, so much so that it is more uncomfortable to discontinue them. Maybe getting a circuit in the brain going generates more endogenous opioids, I don't know. But that kind of theory explains why some compulsions involve self-inflicted pain like hair-pulling or cutting. I've read about how treatment-resistant OCD'ers have had complete relief from their symptoms from just one weekly dose of morphine. Conversely, an opioid antagonist like naltrexone also works.

In the same respect, maybe a lack of attention could be due to a lack of positive feedback from certain dopaminergic pleasure centers of the brain. For example, social interactions are too variable to give a predictable reward, and the brain disengages itself. Like you, I find comfort in dealing with things in my own little contained world, like working on the computer. But after awhile, I get so locked in that groove, that getting out and interacting with others is difficult. I also get burned out and depressed- I think my brain just gets too tired from working at the same thing.

On the other hand, maybe OCD is an adaptation to ADD. It would make sense for someone with ADD to repeatedly check the curling iron to make sure it is turned off- it's probably been left on on more than one occasion! And obsessing could be the brains attempt at disciplining itself when it starts to wander. Perhaps people just have two opposing tendencies to react to the same basic brain chemistry- some people become AD/HD-manic while others go the route of OCD with comorbid depression, while others alternate between the two.

Given your success with ritalin and others success with opioids, it's suprising that I haven't heard more about a dopaminergic med for OCD. I've tried SSRI/SSNIs, they seem to make me even more capable of ocd behaviour.

Guess a stimulant would be worth a try.


> Well that's an interesting question. My newest therapist (last six months) was just about to call my psychiatrist to discuss how much more like OCD he felt my thinking was than like pure anxiety. I say just about because I was being evaluated for ADD by a specialist, and then last week I walked into his office on ritalin and that theory went right out the window.
> I used to pull my hair out as well, a 'soft' ocd trait. When I was working at the computer or reading or on the phone, but not while watching tv or while doing something 'fun'. I can not explain why I did it, but as of the day I started ritalin I have stopped. I started when I was 13 and have battled it ever since. Now its just gone.
> I do not have traits like checking or washing etc. I did 'ruminate' or think repeatedly about the same subject. My mom seems to check things a lot, like whether the curling iron is on, and worry about those things and I suspect she has ADD (since my father does not, and my brother and I both do and it is so heritable).
> I also found, and still find, the internet soothing. I think because its a manageable little world where distractions are predictable. I used to have a very very hard time stopping emailing, if I needed to do something or go somewhere. To the point my husband would ask if I needed the computer physically taken away and I would reluctantly say yes. Then he would, and I would feel very upset about it for some minutes until I switched tasks. Having trouble switching tasks can be a sign of ocd.
> So I definitely have/had some ocd traits. I don't know how common that is in ADD, I don't know what purpose it served. It does seem to be much much different and better on ritalin in the course of a week. I feel much more relaxed.
> I'm not sure to what extent these traits exist in general in untreated ADDers. Its possible that it simply is something unique to me, like I have a threshold for ocd behavior and when stressed by my untreated ADD it comes out.
> Hope this helps.
> kate




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