What we've learned about obsessive compulsive disorder
We have learned a lot about obsessive compulsive disorder (OCD), including where it lives in the brain and the type of disruption it can have on a child's life, says HealthMaker Jerry Bubrick, PhD. In this video, he discusses the disorder in detail.
We want kids to understand the treatment and to realize that, by participating in the treatment,
they become their own advocates. [INSTRUMENTAL MUSIC PLAYING]
Well, there are kind of standard, kind of, as society would see, classic symptoms of OCD, people who are worried about germs and hand-washing,
or kind of needing things to be lined up in a certain way or a certain order.
But there are hundreds of different symptoms within OCD. So the symptoms don't always match rhyme and reason,
and don't always match our logic. I can't tell you how many times a parent will say, my son washes his hands 30 times a day, but his room is a mess,
and so it doesn't make sense that he should be so worried about cleanliness if his room is messy. So there's no two cases of OCD that are exactly the same.
We understand a lot more about where it lives in the brain. We understand a lot more about the level of disruption
it can have in a child's life. And we also understand a lot more about how to explain it to children. We want kids to understand the treatment
and to realize that, by participating in the treatment, they become their own advocates, so the more
they learn how to fight for themselves, the better they get. So, if you look at functional MRIs, you look at pictures of the brain,
you'll see more activity in certain parts of the brain known as the "limbic system," or the "basal ganglia," in people with OCD
as compared to people without, so we know where OCD lives, and we know that, through the treatments, whether through medicine or through the cognitive
behavioral therapy that we provide, that if you took a picture of that same person's brain 12 weeks later, you would see changes
in those sections of the brain in terms of activity, so we know the treatments work. The treatment that we use psychologically
for OCD is something that's called "exposure with response prevention," considered the gold standard of treatment for OCD.
So that's kind of a fancy way of saying that we expose someone to the things that they're afraid of without allowing
them to engage in the rituals. So the principle works very similarly to,
for example, swimming, right? If we jumped into a relatively cool pool on a warm day,
we would feel the temperature of the water, and if we stayed in the water for a while, or dunked under, after a little bit of time, our bodies would adjust,
and we would get used to the temperature. So we see the same thing is true for anxiety. If we allow ourselves to feel anxiety without trying to push it away, we get used to it
and it doesn't bother us anymore. So exposure and response prevention systematically, in a very structured way, helps kids to face their fears
without allowing them to engage in the rituals to push it away temporarily. So we know there's a genetic component to it. We know there's a biochemical component to it.
So we've talked about that section of the brain is affected by OCD, and, sometimes, OCD can be learned. So if there's a parent in the home who has OCD, or possibly
a sibling in the home who has OCD, and they're kind of watching how those people are reacting to different situations, they can actually
kind of learn OCD behaviors. So we believe that, for most kids, it's kind of dormant in their system for a long time,
and as they age, something might kind of set it off, a traumatic, stressful event, or an illness,
or a move, or a divorce, or, in many cases, it's nothing, not really a pronounced trigger, but just
kind of, at some point, the illness starts. For most kids with OCD, the progression
is slow and stable over time. So there might be a few symptoms here and there. The pediatrician will say, don't worry about it,
the kid will outgrow it, and then it kind of grows, and grows, and grows, to the point where parents will come in and say, we can't take it anymore, there's too many symptoms.
It's about 2% to 3% of the population, so we see about one in 40 adults and one in 200 kids.
I don't think we're necessarily seeing an increase of those disorders, but I think we're getting better at detecting them. You know, when I was a kid there,
were lots of kids who had anxiety, there were lots of kids who did kind of a variety of unique and kind of quirky things, and we just
thought they were quirky. Now we understand what those quirky things are, and that they're not actually quirks, that they're actually parts of anxiety or depression.
mental health behavior
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