QUESTION:
Dear Dr. Heller,
For most of my adult life (I'm 48 years old), I've suffered with obsessive-compulsive disorder. Repeated handwashing and checking are typical problems. In the last couple of years, I've also become "obsessed" with my handwriting. It has to be "perfect," or I feel the need to do it over and over again. (This can be a problem when you have to write out ten checks in order to get one that looks "perfect" enough to send out!). My doctor says current medical thinking is that OCD is caused by a chemical imbalance in the brain. He has me taking Paxil. It does seem to help a little. Do you have any thoughts or suggestions?
ANSWER:
The OCD is a malfunction of a normal brain process. This normal process is part of
checking one's activities or possessions to make sure they are safe. In the OCD this
process is a severe problem.
Brain imaging technology has shown definite abnormalities in those suffering from the OCD.
Some cases are caused by strep infections. It's not really a chemical imbalance,
although that phrase is commonly used to make it easier for people to understand.
It's a malfunctioning brain system.
It doesn't have to be treated, but the patient's life is usually unbearably
painful and difficult if untreated. The anxiety associated with the OCD can lead to many
medical disorders such as heart disease, irritable bowel and cancer.
The usual medical treatment is high doses of SSRI medications like Paxil and Prozac. A
study in Israel showed that high doses of the vitamin "inositol" can be
effective. Unfortunately 18,000mg daily is needed. At 500mg per dose, it means taking 12
pills three times daily.
Most individuals with a mental health diagnosis have more than one diagnosis. The
screening test I use for my patients can give you clues regarding
additional diagnoses that are worsening your OCD.
