Link Time

Here are some educational videos for those either with OCD/TS, or wanting to learn more.

Tictionary has some interesting videos on YouTube. There are only a few, but most of them provide clear, concise, and highly interesting information on Tourette’s Syndrome and OCD. I recommend “Tics and Compulsions”, “The truth about Tourette Syndrome”, and the visual representation of “evening up” most.

If you have the patience to watch it, this 53-minute video about TS and OCD is intriguing, too. It discusses the apparent genetic linkage between the disorders, as well as going into detail about different clusters of OCD symptoms and tics. As you can see, my idea of a link between TS/OCD is by no means original, and there are others who sense this, too.

PANDAS

PandaBroom

It’s a little-known fact that pandas also suffer from OCD. Here we see a panda engaged in obsessively gnawing on a broom used for grooming other pandas. Pandas are experienced ninjas, and were responsible for the invention of many of our modern-day conveniences such as: the electro-magnetic induction motor, radiation, SPAM, volcanoes, and auto-tuning.

OK, not really. But in all seriousness, there is a connection between PANDAS, OCD, and Tourette’s. Just not those kinds of PANDAS.

Many of you will already know what PANDAS is — but for those who don’t, PANDAS stands for Pediatric Autoimmune Neuropsychiatric Disorder Associated with Streptococcus. In a nutshell, it means: some kids who get strep infections also end up with a sudden onset of OCD and/or tics afterwards. Here are the five diagnostic criteria:

  1. Presence of a tic disorder, and/or OCD;
  2. Onset of these symptoms was before puberty;
  3. There is evidence of a temporal link between when the symptoms began/worsened, and the strep infection;
  4. Sudden onset of symptoms and/or they wax and wane, alternating between partial or complete remission and sudden exacerbation;
  5. Hyperactive motor movements OR rapid, jerky movements.

I believe one has to meet all five in order to theoretically have PANDAS — and, although some strong clinical evidence points to it, some people still don’t believe in PANDAS. But in their defense, I’m sure they do believe in pandas.

In my case, on both sides of the family I see signs of what is likely a strong genetic predisposition towards OCD and tics — so any suspicion I have of PANDAS to explain my own symptoms, is very slight. I did have a mysterious infection as a child, probably about 4 years old, and it did produce a Scarlet Fever-like rash — however, I was tested at the doctor’s office and it came up negative for strep. So, that seems to rule out PANDAS since as far as I know, I’ve never even had strep. If there is an infection-related disorder that explains my condition, it would have to be something like PANDASE (Pediatric Autoimmune Neuropsychiatric Disorder Associated with Something Else.) Mmm… sounds like mayonnaise. Sounds like an organic, panda-friendly mayonnaise — we all do worry about those pandas being harmed in the making of mayonnaise.

My breathing tic might have appeared around the age of 4 or 5, but according to Mom I was showing signs of OCD even at 2 – 3 years old (she says I was worried about catching Dad’s back problem. o.o)

Again making a long story short, the mechanism of PANDAS seems to be this: during the infection, the child’s immune system mistakenly produces antibodies which attack the basal ganglia part of the brain (like an allergic reaction), leading to damage or at least impaired functioning.

It’s interesting to think about PANDAS because it implies several things:

  • In the future, treatment may be different for those who have OCD/tics as a result of PANDAS versus having them for genetic/environmental reasons, since the cause would obviously be different.
  • Will only people already genetically predisposed (even if only by a small amount) develop PANDAS?
  • Again, a link between OCD and tics/Tourette’s.
  • Could non-strep infections ever be to blame? Are these cases existent, but rare?
  • PANDAS involves not only onset of symptoms, but worsening. Are children with pre-existing OCD/TS more likely to develop PANDAS?

Maybe we will find these answers soon. One day, in the future… perhaps when our greatest panda engineers are finding out how to cultivate Mars… perhaps then we will know. Until that time comes, we should sit with our fellow panda friends, extending our hands and a smile of kindness, for if we are cruel to our ninja friends, we shall surely perish.

Monk and the Lamp

The other day, a Monk marathon was on TV. I like the show, and it can actually be very accurate about portraying OCD. But, something kind of bugged me, and just didn’t “feel right” about the episode. (Aaaaggghhh…)

Monk bought a new (old) house, and there was a light fixture that was slightly off-center in one of the rooms. He noticed this, and it bothered him. Now — maybe that’s accurate and OK. People with OCD do tend to be detail-oriented, and perhaps notice small things that others wouldn’t. However… if this were the extent of OCD, everyone would want to have it, and it wouldn’t be a disorder, it would just be this really cool thing, like being smart or super-athletic.

Now, keep in mind, I do like the show, and it can at times be very accurate. But what I worry about sometimes are people’s perceptions of OCD, especially based on what they see in media. And what’s sometimes not conveyed is that someone with OCD is not only likely to notice things that actually are off-center, but someone with OCD is even more likely to think something is off-center when it is not, and no matter how much it’s moved they will still feel that it’s off-center.

That’s because the nature of OCD is that of false alarms. So OCD is not: “Hey my brain tells me cool details.” OCD is: “Hey my brain tells me some cool details but mainly decides that things are screwed-up when they’re actually just fine.”

For example, when I’m cooking… I find myself constantly worrying that the pot/pan I’m working with is not perfectly centered on the burner. So I move it a little… but then it seems too far the other way. So I move it. Over, and over… until finally I realize that no matter how much I move it, it always seems off-center, so I should just give up. Sometimes I also walk around the stove, visually assessing the situation from different angles. You can imagine how difficult this makes cooking. It’s even worse if I’m in the kitchen when someone else is cooking — if I didn’t place the pot there myself, somehow, it seems ten times more off-center just because of that.

Anyway… that’s my opinion on one particular part of one particular episode of Monk that bothered me not because it was wrong but perhaps slightly misleading for some people.

“Evening Up”: Carts & Shoes

In the interest of not being OCD about my OCD blog, I’m making a quick, before-going-to-sleep post that will be possibly very disorganized and inaccurate. I’m just testing everyone’s exposure and response prevention therapy skills! 😉

I’m thinking of times when I go shopping, and accidentally kick the grocery cart with one foot. What does a normal person think? I don’t know; probably not much. What I think is: “Oh no. That’s uneven. Now my other foot needs to touch the cart.” I used to give in to this feeling and perform the action, but the problem was that almost every time, it wouldn’t “feel right.” The second foot would either hit the cart too hard, or too softly — or just not in the precisely correct spot. So I kept having to do it over, and over, and over…

I used to have a similar problem with tying my shoes. In the morning I’d put on my shoes, tie each one, and then… when I stood up, one would invariably feel tighter than the other. By a small amount, but this would bug me. So I’d re-tie my shoes, but then… the shoe that was too tight before became too loose, or vice versa. So I’d have to keep doing it over, and over, and over…

I’ve learned that when I get these feelings of unevenness, most of the time, it’s best to just ignore it. Sometimes it’s really difficult, but my odds are better with ignoring it, because if I give in, it’s almost never easy to satisfy that feeling. I find I’d rather deal with the effort of trying to ignore a false alarm from my brain, than having to repeat something over and over until it feels right for some weird, arbitrary reason.

List of OCD Fears

This is, by no means, complete. But just for fun, I’m going to type up a list of some OCD fears I have, or have had at some point in the past. A couple of these are fears that got left behind in my childhood; but I include them for the purpose of giving examples of fears that people might not expect.

  • Eating popsicles, corn dogs, or anything on a wooden stick (fear of eating splinters)
  • Accidentally eating/dropping and losing staples from catalogues, magazines, etc.
  • Accidentally eating/touching battery acid; even on fresh, clean batteries
  • Accidentally eating pesticides, or other poison; feel contamined just by looking at them
  • Accidentally picking up a pair of scissors and stabbing myself every time I look at them (non-suicidal; afraid because I don’t want to do it)

As you can see, none of these have to do directly with keeping things clean or neat, but specific contaminants/hazards.

Introduction

There’s a lot of misinformation out there about Obsessive-Compulsive Disorder and Tourette’s Syndrome. With the help of this blog, I hope to change that. I’d like to also preface my posting on this blog by saying, I do my best to fact-check, but from time to time I will probably end up posting something that ends up being wrong. I welcome criticism and correction, as long as it is done respectfully.

OCD is an anxiety disorder involving intrusive, obsessive thoughts/fears. Compulsions are performed to neutralize the fear.

Gilles de la Tourette Syndrome (or Tourette’s Syndrome) is a neuropsychiatric disorder involving tics, or habits, which often involve a premonitory urge just before the tic happens. Tics tend to worsen with increased anxiety.

They are classified as separate disorders, and there is also a correlation in some people between Tourette’s and ADHD. As I have TS and OCD, this blog focuses on TS and the theorized subset of OCD which is related to TS. From time to time, there may be discussion of ADHD, but that is not the focus here, because that has not been my topic of research. It is an interesting topic in its own right, however, and I welcome such discussion in the comments.

In this first post I’d like to discuss the similiarites (and differences) between OCD and TS. Here is a list:

  • Both OCD and TS symptoms tend to worsen with anxiety.
  • Both involve feeling an urge or compulsion to perform tasks, whether those tasks be physical or mental.
  • Both disorders involve behavior which often needs to be repeated over and over, until it feels “just right.”
  • In family members of people with TS, there is an equal percentage chance of having a relative with either TS or OCD.

So far you can see it is a short list. However, these similarities are striking. I wonder if one day, we might even discover that TS and OCD are the same disorder, expressed in different ways. This is a theory I have.

Here are some differences:

  • TS is more common in men than women. OCD is about equal between genders, but in families where tics are present, women are more likely to inherit OCD than TS.
  • OCD responds better to cognitive-behavioral therapy.
  • OCD is a disorder of thoughts and fears; TS is a disorder of physical feelings.

Some people believe that a specific subset of OCD is related to TS. I believe this could be true. People with OCD vary greatly amongst themselves, and here are some of the ways:

  • Some people with OCD are hoarders, wanting to collect items compulsively — or reversely, refusing to throw almost anything away.
  • Others are big on superstitious, or “magical thinking” — i.e., if I step on a crack it will literally break my mother’s back; if I don’t count to 10 after I do this activity then a loved one will die; if I don’t touch this object 4 times then I will die, etc.
  • Some are obsessed with keeping everything clean and neat; others are more obsessed with personal or relationship fears (will my husband leave me, cheat on me, etc.) which will not go away.

I experienced some “magical thinking” OCD as a child, but have never really had hoarding tendencies. It would be interesting to find out which OCD traits are most commonly associated with Tourette’s.

It should also be noted that almost any OCD trait can actually be reversed. For example, I experienced a compulsive hand-washing problem as a child. Once I got “over” this, I have also experienced a compulsive worry about whether I’m washing my hands too much. Likewise, some with OCD are hoarders; but in reverse, some with OCD are also obsessed with not keeping any junk and throw almost everything away.

No one symptom (or lack thereof) can characterize any disorder, including OCD and TS.