Dr Max Pemberton For The Daily Mail
We’ve all heard it. ‘Oh, don’t mind me, it’s just my OCD!’ as someone rearranges the pens on their desk. ‘Oh God, you’re sooo OCD!’ as someone straightens their compact disc collection. Everyone laughs with a collective roll of the eyes.
But there’s nothing funny about genuine Obsessive Compulsive Disorder. And having had many, many patients with the real thing, I’m sick to death of people making light of this crippling condition.
If people had seen what real OCD looks like, they wouldn’t be so quick to lay claim to it. Some of the worst culprits are celebrities who seem to think it’ll make them sound more interesting and quirky than they really are.
David Beckham claimed to have it because he likes to keep the Diet Coke cans in his fridge neatly ordered
David Beckham claimed to have it because he likes to keep the Diet Coke cans in his fridge neatly ordered. But so do I! That’s a perfectly sensible thing to do — keeping your fridge tidy means there isn’t a yoghurt sitting at the back quietly going out of date.
Of course, Becks may genuinely have OCD. But being a tad fussy about lining up his soft drinks doesn’t even begin to merit the diagnosis.
The latest star to climb aboard the bandwagon is Paul Hollywood, from The Great British Bake Off. He claims to have OCD because he’s ‘obsessed’ with cleaning his sports car and gets upset if he thinks there’s a scratch or dent on it.
Oh, please. He has an Aston Martin DBS Volante, which is apparently the convertible model of James Bond’s car from Casino Royale and Quantum Of Solace. If I owned that car, I’d be ‘obsessed’ with it and get angry if it got scratched. That’s not called mental illness, that’s called having an expensive car.
And while we’re at it, double-checking you’ve locked the front door or turned off the cooker is not OCD. Nor is being a bit nerdy about ordering your wardrobe according to the colour of the clothes.
Real OCD involves obsessive thoughts and compulsive behaviours that wreck your life. By obsessions, I mean thoughts, images or urges that enter your mind unbidden and bring horrible feelings of anxiety, disgust and distress.
Compulsions are repetitive rituals that sufferers can’t resist or think will relieve the agony of their obsessions. The trouble is, the compulsions get out of hand and increase the anxiety and distress, rather than reducing it.
OCD is a living torture, leaving many sufferers with a sense that they are trapped in their own minds, out of control and spiralling into madness. There is no known cause, although studies on twins suggested there’s a genetic link.
There’s even some evidence that certain infections by a type of bacteria known as group A streptococcus can trigger an auto-immune reaction that results in the symptoms. Brain scans show differences in those with the condition compared with those without.
The latest star to climb aboard the bandwagon is Paul Hollywood, from The Great British Bake Off
Research has also shown that people with OCD have imbalances in serotonin, an important chemical in the brain involved in emotions. But there’s indisputably a psychological element, too, with symptoms often getting worse in times of stress. For this reason, treatment typically consists of both medication and psychotherapy.
Trust me, it’s a terrible condition. I had one patient who had to get up at 3.30am every day in order to get to work for 9am because her rituals took so long to perform before she could leave the house.
She had to check everything she did, not once or twice like the rest of us, but endlessly. She’d turn the light switches in every room on and off dozens of times, then go round and round the house, again and again, checking each electrical socket was off and everything was unplugged. And then do it again. And again. For hours and hours on end.
A nother patient of mine had to count everything he saw — chairs in the room, people at the bus stop, books on the shelves — and then perform complex maths equations with the numbers.
He was utterly preoccupied with this and had a constant sense of impending doom if he missed anything, but the process was so exhausting and all-consuming he could hardly function.
Another patient was so obsessed about her fear of vomiting, and the complex food-cleaning rituals she hoped would save her from it, that she eventually stopped eating entirely, developed kidney failure and had to be admitted to a hospital’s high-dependency unit.
Trivialising OCD — making it all seem a bit of a laugh, something daft and superficial — is such an insult to people like these.
You don’t hear anyone saying they’ve got ‘a bit’ of cancer, do you? ‘Oh, don’t mind me, I’m feeling a bit cancery today.’ We all know cancer is out-and-out terrible and not something to be glib about.
So why is it acceptable to joke you’re ‘a bit OCD’ when that, too, is a curse that destroys people’s lives?
Hopeless NHS helpline nearly killed my patient
Thank goodness for the Mail’s exposure of the NHS 111 hotline fiasco this week
Thank goodness for the Mail’s exposure of the NHS 111 hotline fiasco this week. Finally, the public know what an utter shambles this so-called ‘helpline’ is.
It’s something that’s been worrying doctors and nurses for a long time. All too often we have patients turn up to AE for the most ridiculous things, apologising and looking sheepish, but saying they called 111 and were told to go to casualty.
But then there are the cases when patients are told everything’s fine when, in fact, they’re in real danger. Only this week I did an assessment on a young patient who explained that she accidentally took ten times the recommended amount of an over-the-counter drug last month.
She telephoned 111 and was told by the operator not to worry. My jaw hit the floor when I heard this.
My patient was already at high risk of having a cardiac arrest because she had bulimia, which causes disturbances in the chemicals in the blood and can cause the heart to stop. But the drug she’d taken is also well known to stop the heart if you overdose. It couldn’t have been more serious.
So had the call handler thought to ask about her medical history, which might have uncovered the bulimia? No.
Instead, this poor girl was told not to worry, but to call an ambulance if she lost consciousness. Quite how she was supposed to do that wasn’t explained.
My patient and I laughed at how ludicrous this was, but actually it’s horrifying. It was lucky she had the good sense to ignore the ‘advice’ and go to AE herself.
The lesson is brutally simple. If diagnosing life-threatening illness could simply be reduced to ticking off a checklist over the phone, there would be no point in studying medicine for years.
What do politicians think we’re up to at medical school?
It might be expensive, it might be irritating, but sometimes you need people who know what they are doing to assess a patient.
A call-centre worker ticking boxes just isn’t good enough.
Don’t sneer at my hero Jeremy Kyle
This has been ‘have a go at Jeremy Kyle’, left, week. Everyone’s lined up to stick the boot in after revelations that his wife Carla, right, had an affair with a polo player and they’ve now split up
This has been ‘have a go at Jeremy Kyle’ week. Everyone’s lined up to stick the boot in after revelations that his wife Carla had an affair with a polo player and they’ve now split up.
All the usual insults have been chucked in, about his TV show being cynical and exploitative. Well, I want to stick up for him.
A few years ago I was on Jeremy’s programme for a week-long medical special and I saw first-hand the good he does, and how much he genuinely helps people.
It’s easy to mock Jeremy and the guests who come on to bare all about their sex lives and family breakdowns. They’re often feckless, lawless and rowdy; the unsavoury underdogs of society.
But the guests I met saw Jeremy as someone who would really sort out their problems. It was apparent that, for them, appearing on the show to talk about their troubles is often the only opportunity they have to get help and upport.
Of course, Jeremy is confrontational and judgmental. That’s his style. But for many guests this provides a moral barometer and sense of justice and retribution that is often absent in their lives.
When I asked one woman why she hadn’t gone to see her doctor to ask for psychotherapy to help with her problems, she looked genuinely puzzled and replied: ‘Oh, they wouldn’t help. They don’t have time for the likes of me.’
And the sad thing — the really dreadful thing — is she’s probably right. These people feel alienated and disempowered.
If you’re a middle-class professional in Islington, getting psychotherapy is as easy and natural as buying a skinny latte at Starbucks. But for those stuck on sink-estates, unemployed and uneducated, the best hope they have of getting their problems heard is appearing on Jeremy’s programme.
I was immensely impressed with the follow-up the show offered. Behind the scenes is a group of dedicated psychiatric nurses who take it in turns to come from one of the nearby NHS hospitals in Manchester, where it’s filmed, to provide guidance and support.
Together with the show’s in-house psychotherapist Graham (who is utterly lovely and a real champion of mental health issues), they not only counsel the guests but help get them the NHS treatment they need.
Yes, the show chases ratings. Yes, it’s often crude and shocking. But it’s also providing an invaluable service to disenfranchised and ignored people.
So let’s all give Jeremy Kyle a break and hope he gets back to work soon.
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