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Living with obsessive compulsive disorder

Vancouver Island Free Daily - 7/15/2018

Growing up, Tina's son Matt always seemed like a normal kid.

He was happy, outgoing, and was a little ball of energy that couldn't sit still.

But certain things bothered him – he never wore jeans because he didn't like the feeling of them on his skin, and didn't like going to the beach because he hated the dusty feeling of sand on his hands.

As Matt, a Vancouver Island resident whose name was changed to protect his identity, got older, he was diagnosed with anxiety and attention deficit hyperactivity disorder. But it wasn't until he turned 12 when things changed – and quickly.

Matt started over-worrying about things and then his focus turned to contamination. Matt would wash his hands several times in a row, and if he washed his hands and went to do another task, would wash them again. He worried about touching his game controller, in fear he would contaminate that and would be forced to wash his controller. He only used a towel once and as soon as it hit the floor Matt thought it would be dirty and would contaminate the floor.

Shortly after, Matt was diagnosed with obsessive compulsive disorder (OCD). According to the International OCD Foundation, OCD is a mental health disorder that occurs when a person gets caught in a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images or urges that trigger intensely distressing feelings.

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The Canadian Psychological Association reports between one and two per cent of Canadians will have an episode of OCD. It describes the condition like this:

"Obsessions are recurrent and persistent intrusive thoughts, images or impulses that are unwanted, personally unacceptable and cause significant distress. Even though a person tries very hard to suppress the obsession or cancel out its negative effects, it continues to reoccur in an uncontrollable fashion.

"Obsessions usually involve upsetting themes that are not simply excessive worries about real-life problems but instead are irrational concerns that the person often recognizes as highly unlikely, even nonsensical."

According to the CPA, OCD can be chronic — waxing and waning with life's stresses. It seldom disappears without treatment, and can have a profound negative impact on functioning — interfering with jobs, schooling, social interactions and relationships.

"It exploded on us, it came out of nowhere. It was very confusing for him as well," said Tina, who is calling for more mental health services on the Island.

"It [contamination] was transferable almost. Say I touched the car door that he thought was contaminated, then I touched something else, then that would be contaminated. It's just that snowball effect."

After the diagnosis things became more severe. His fears of contamination escalated to the point where Matt would use his sleeves to open car doors. If he thought a part of the car was contaminated he would move to another seat, and then another, until he would finally ask his mother to wash the whole car.

The disorder began to affect his relationships as well. If he was hanging out with friends and his clothes got dirty he would have to go and change his clothes a bunch of times or they would want to go for a bike ride and he felt he couldn't do it. As a result, he lost some friends in the process.

Tina said watching the disorder take over his life was difficult.

"Watching him and how debilitating it was for him and how much it was hurting him emotionally, that's the worst part," she said.

Shortly after, Matt received treatment at the Ledger House at Queen Alexandra Centre for Children's Health, where he received therapy for seven weeks.He went on to participate in the OCD program through the B.C. Children's Hospital in Vancouver for another six weeks.

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According to the BC Children's Hospital website, treatment for OCD typically consists of psychological and psychiatric assessments, after which the assessing team meets with the family to discuss its findings and implement a treatment plan.

The evaluation includes a look at the patient's medical, developmental, family and school history and his or her mental state, with attention to the potential presence of other psychiatric disorders.

First-line treatment for mild and moderate cases typically consists of cognitive behavioural therapy — basically, getting a better understanding of, and control of, the issues through talking.

"The aim of CBT is not about learning not to have these thoughts in the first place, because in essence…intrusive thoughts cannot be avoided. Instead it is about helping a person with OCD to identify and modify their patterns of thought that cause the anxiety, distress and compulsive behaviours," reads a statement by the OCD-UK, a British charity dedicated to those affected by OCD.

"What therapy will teach the person with OCD is that it's not the thoughts themselves that are the problem; it's what the person makes of those thoughts, and how they respond to them, that is the key to recovery from OCD."

For more serious cases, where the patient distress is severe, or ability to function significantly impaired, or where there is resistance to CBT, drug treatment is also recommended.

"Poor insight into the irrational nature of the obsession and/or compulsion can lead to resistance to CBT," the Children's Hospital practice parameter document states. "The need for close family involvement will make successful implementation of CBT more difficult in chaotic or non- intact families."

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Tina said Matt, now 17, has good and bad days. While school had been put on the back-burner, Matt is busy with a job and hangs out with his co-workers.

Despite the fact that her son was able to get treatment, Tina said there aren't enough mental health services on the Island.

"We don't have any of those programs here," Tina said. "There's a big lack of services."

— with files from Black Press


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kendra.wong@goldstreamgazette.com