About Comorbidities

An introduction to Obsessive-Compulsive Disorder (OCD)

Susan Conners Med, renowned educationalist and the foremost recognised expert on Tourette Syndrome worldwide, often refers to OCD as ‘tics of the mind’.

She herself lives with both TS and OCD and describes how the mind gets “stuck” on thoughts and ideas and/or has a compulsion to repeat a movement over and over again – manifesting much like Tourette Syndrome.
Hence it can often be difficult to ascertain the difference between the two.

 

What is OCD?

Obsessive compulsive disorder (OCD) is a mental health disorder defined as having obsessive, uncontrollable thoughts and performing deliberate repetitive actions (compulsions).

To have a few obsessional thoughts or minor compulsions is extremely common, but the thoughts and actions of OCD can disrupt people’s lives in a most distressing way.
Obsessions are repetitive and unwanted thoughts, images or impulses that cause anxiety and are hard to stop. In fact, trying to stop them causes more distress. You know these things come from your own mind, just like other thoughts and impulses, but you find them hard to control.
Compulsions are repeated actions or behaviours that you feel driven to do, even though you know they are unnecessary or don’t make sense. The compulsions are usually linked to the obsessional thoughts. For example, obsessional thoughts about your hands being dirty lead you to feel anxious about catching a disease. This leads to repeatedly and excessively washing your hands.
Some actions become rigid or like a ritual. You may touch things or wash your hands in an exact way or an exact number of times. Compulsions can also be unseen to others and may include counting or praying silently, feeling that you must think particular thoughts, or see particular mental images. When you perform the compulsive action you do feel a little better initially. But then the anxiety returns. This can lead to more and more compulsive behaviour in an attempt to control the rising level of anxiety.

(Source: Mental Health Foundation of New Zealand)

OCD is not a personality issue

It’s important not to mistake OCD for a personality issue. Many people have an obsessional personality. They may need to be overly cautious and check things more thoroughly than others. Ot they may be perfectionists who very high standards about certain things like labels all facing out on a shelf the same way. Usually these tendencies do not cause great problems.
OCD is very different. Habits, thoughts or rituals tend to start gradually and can be a minor irritation for years but eventually get to the point where symptoms can no longer be denied.
You may, for example, deal with an obsessional need to walk to a destination using a specific number of steps. Taking more or less steps may require walking the route until the right number of steps are taken and it “feels” right.
If this takes an hour or more to satisfy that need then this is an indicator that your life is affected by OCD.
OCD is an unusual, frustrating and often frightening condition. Many people with OCD are afraid that they are “going mad” and worry about completely losing control of themselves. This does not happen. OCD also does not lead to other severe illnesses, like schizophrenia, but it can be just as disabling.
Ongoing research however indicates that people living with OCD who engage in cognitive behavioural therapy can successfully manage their OCD symptoms.

An introduction to Attention Deficit Hyperactivity Disorder (ADHD)
Research has found that between 60 to 80 per cent of children diagnosed with Tourette Syndrome also have ADHD. ADHD is often diagnosed first and some children do develop simple motor tics when beginning pharmaceutical treatment.
However if both vocal and motor tics persist then a diagnosis of Tourette Syndrome often then follows.

 

What is ADHD?

Attention deficit hyperactivity disorder is a lifelong mental health disorder that begins in childhood.

Children with ADHD are easily distracted, act without thinking and are very active. They may understand what’s expected of them but have trouble doing it because they can’t sit still, pay attention or attend to details.

While it is a behavioural issue it is not a case of a child behaving badly. They simply are not aware at a young age that how they act is different to the ‘norm’.

Most young children are busy, distracted and energetic way at times, particularly when they’re anxious or excited. But the difference with ADHD is that symptoms are present over a longer period of time and occur most of the time. They affect the child’s ability to function socially, at school, and at home.
If undiagnosed children with ADHD can develop poor self-esteem as a result of being constantly criticised by their family/whānau and teachers who have not recognised their behaviour as a health concern.
These children often talk about themselves as being dumb, stupid or naughty. They are none of these things.
With proper treatment, kids with ADHD can learn to successfully live with and manage their symptoms.

More information can be found on the Mental Health Foundation of New Zealand.

FAQS

What is Tourette Syndrome?

Tourette Syndrome (TS) is characterised by vocal and motor tics that range from mild to extreme in severity. Individuals can have singular tics, however both vocal and motor tics have to have been present for at least a year for an individual to be diagnosed with TS.

Why is it called Tourette Syndrome?

The syndrome is named after Georges Gilles de la Tourette, a French physician and neurologist. He was credited with defining the syndrome in 1885 after spending many years studying why certain people displayed sudden twitches and vocalisations.

What causes TS?

Tourette Syndrome (TS) is a genetic, neurological disorder that occurs during childhood. Not all children that inherit the TS gene display the traits that are associated with the disorder. Boys more commonly inherit the gene associated with TS. The ratio of girls vs. boys being diagnosed with TS is 1:4.

Is there a cure for Tourette’s?

No. At the moment the exact gene and neurons that cause TS are not known so there is no cure. Medication can in some cases help with suppressing the tics associated with TS.

Do the tics go away?

Remission can occur in adulthood. Some literature reports that 1/3 of adults have no tics; 1/3 still occasionally have mild tics and 1/3 will continue to have the same level of tics.

How many children in New Zealand are diagnosed with Tourette Syndrome?

The New Zealand Organisation for Rare Disorders endorses the Australian Tourette Syndrome Association statistics of 1:1000 children having TS. Not all of those with TS will be diagnosed with TS due to the mild nature of their symptoms.

Is Tourette’s a mental health disorder?

No, TS is not categorised as a mental health disorder. However many of the disorders that co-exist with TS like ADHD, OCD or depression are recognised mental health disorders and the psychological impact or issues associated with TS are treatable by mental health practitioners.

Does everyone who has TS swear?

No. Only a small percentage of those diagnosed with TS have coprolalia – an extreme vocal tic that causes the person to repeat inappropriate words.

What does ‘comorbid’ mean?

This term is used when a disease or disorder occurs simultaneously with another disease or disorder.

Will having TS shorten my lifespan?

Those diagnosed with TS can expect to live to normal life expectancy.

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