What We've Learned About Obsessive Compulsive Disorder

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Well, there're kind of standard, kind of society which would see classics symptoms of OCD, people who are worried about germs and hand washing or kind of needing things be lined up in a certain way or certain order, but the're 100 of different symptoms within OCD so the symptoms don't always match by the reason and don't always match our logic, so I can't tell you how many times a parent would 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 yet his room is so 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 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 function 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 and people with OCD it's compared to people without, so we know where OCD lives and we know that through the treatments, whether through medicine or through the cognate 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 expose with response prevention, consider 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 are afraid of without allowing them to engage in their 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 while of dunked under after a little bit of time our bodies will adjust and we'll get used to the temperature.

So we see this same thing is true for anxiety if we allow ourselves to feel anxiety without trying to push it away, we get used to it, it doesn't bother us any more, so exposure with 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 that is a biochemical component to it, so we thought about that section in the brain is affected by OCD and sometimes OCD can be learnt, so if there's a parent in the home who has OCD or possibly a sibling in the home who has OCD and are kind of watching how those people are reacting to different situation's 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 really, not really 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 their'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 honestly seeing an increase of those disorders but I think we're getting better at detecting them. I think, when I was 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 worked quirky.

Now we understand what those quirky things are and that they're not actually quirks but they're actually parts of anxiety or depression.