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Originally published Sunday, February 1, 2015 at 3:03 AM

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‘The Man Who Couldn’t Stop’: living with the mystery of OCD

In “The Man Who Couldn’t Stop,” British author and editor David Adam offers a compelling first-person account of what it is like to live with Obsessive-Compulsive Disorder.


Special to The Seattle Times

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‘The Man Who Couldn’t Stop: OCD and the True Story of a Life Lost in Thought’

by David Adam

Farrar, Straus and Giroux, 325 pp., $26

Early on in this remarkable account of obsessive-compulsive disorder (OCD), author David Adam cites a study in which two groups — OCD patients and “normal” people — were asked to write down their “intrusive thoughts,” unpleasant scenarios that might involve, say, pushing someone under a train, or driving one’s car off the road, or committing an act of violence during sex. Turns out even experienced clinicians had trouble matching the scenario to the group.

As unnerving as these results might be to “normal” people, who can shake these scenarios and move on with their lives, intrusive thoughts can be soul-crushing to OCD sufferers, who build elaborately weird behaviors to counteract those scenarios.

For OCD sufferer Adam, now an editor with Nature magazine, it all began in November 1990, when he was a university student. He’d had a date with a young woman and the next day a friend was asking if he’d had sex. Adam confirmed that he had (he lied) and had not used a condom. The friend responded, “You could have AIDS.”

“Don’t be daft,” Adam replied.

For months, he could let go of the thought that he might easily get AIDS — even absent unprotected sex — until, in August 1991, he couldn’t. There followed a downward spiral of incessant phone calls to the local AIDS hotline and irrational fears of blood contamination that had him pulling all the used paper towels from a public washroom, taking them home and inspecting them. It was an obsession that he says took over his mind from the moment he awoke until he went to sleep. The clincher was this incident, many years later:

“One night I showed [my baby daughter] my electric toothbrush and woke with a start the next morning to intrusive thoughts that I had flicked my blood from its bristles into her eyes. I was compelled to check if I could have done. I locked myself in the bathroom, drew a face on the mirror with shaving foam and held the buzzing wet toothbrush at various distances to analyze where the water sprayed. It didn’t help.” What did help was sertraline hydrochloride, a selective serotonin reuptake inhibitor (SSRI) more popularly known as Zoloft. Adam reports that he takes 200mg every morning.

While Adam’s account could hardly be more personal, it is bolstered by a very good survey of current research into the nature, causes and therapies regarding the disorder, however imprecise those are.

For example, it can be very difficult getting an accurate diagnosis of OCD and other such mental illnesses since the symptoms are self-reported: “No blood test can detect OCD.”

And the origins are all over the map, Adam admitting that he might have exhibited milder symptoms of the disorder long before his fateful 1990 date. But he also cites studies indicating brain malfunction, physical trauma, environmental factors (including, interestingly, a linkage with religious belief), and even possibly genetics to be contributors. But nothing certain.

Likewise, remedies are varied, from behavior therapy to drugs to surgery, which has evolved from crude lobotomy (a needle stuck up through the eye socket and waggled around in the brain) to more-precise methods. Zoloft notwithstanding, Adam argues that finding a drug that would be universally effective for OCD is difficult due to the condition’s elusiveness and to drug companies’ unwillingness to invest heavily in drugs that are likely to fail.

What might give comfort to sufferers, and empathy to nonsufferers, is research that places OCD on a spectrum, rather than an either/or basis. It gives hope that symptoms can be tweaked to tolerable levels for those with OCD. And for those persons everywhere who operate at a subclinical level of OCD, it might transform their perception of sufferers from “them” to “us.” That’s a start.



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