Worried sick? Mind-altering surgery may offer hope

Sanjay Gill had the fear of god embedded in him. The 29-year-old from Ghaziabad would spend hours chanting and asking for forgiveness; so much so that he seldom stepped out of his room. He would live in constant fear of “something bad” happening to his parents.He stopped attending to his wife and two children and got completely cut off from the family’s printing business.

Doctors treating Gill realized that an extreme case of obsessive compulsive disorder (OCD) had manifested itself in him; he had first been diagnosed with OCD when he was 15 and was put on medication from 2011 onwards. But the chanting and asking for forgiveness increased recently.

“Who would have known that such behaviour could be psychiatric illness? Initially, we thought that he was simply too attached to our parents and that was the reason he became paranoid about them. His behaviour worsened and he began praying and asking for forgiveness for hours and at times for days. He refused to come out of his room,” said Gill’s elder brother, Mohan. “The moment he stopped chanting, the thoughts came back. So he kept going back to chanting,” he added.

“Over the month, his medicine dosage went on increasing but his condition kept worsening,” he said, adding that his psychiatrist advised to consider the option of surgery. Last week, Gill underwent a surgery after being evaluated by Jaslok’s psychiatrist Dr Amit Desai. And he seems to be fine now.

Neurosurgeon Dr Paresh Doshi who operated upon Gill on March 14 explained that the surgery involved stimulating a group of cells in the brain that are nodal center of pathways responsible for a person’s thought processes. “The obsessive thoughts are thus controlled by stimulating these cells. The stimulation alters the OCD symptoms considerably,” said Dr Doshi.

The surgery involved making two 14 mm holes on each side of the skull and implanting two electrodes connected to a pacemaker implanted on the chest wall. “The pacemaker lets us vary the voltage for stimulating the electrodes. Initially, we had fixed it at 2.5 volts wherein the patient showed about 35 per cent improvement. We then increased it to 4 volts after which the patient has not had any negative thoughts in his mind,” explained Doshi.

The surgery cost the family around Rs 23 lakh but it was worth it. “He is smiling and interacting with us. He hasn’t gone back to his room to chant or pray,” said Mohan.

OCD, an anxiety disorder characterised by obsessive thoughts and compulsive actions such as cleaning, checking on things repeatedly, counting or hoarding, is a potentially disabling condition. Doctors say that the patient is trapped in a pattern of repetitive thoughts and behaviour that is senseless and distressing, but extremely difficult to overcome.

Gill is the fourth patient to have undergone a brain surgery for OCD in Mumbai. While the earlier three patients, including an Australian, underwent a procedure called bilateral anterior capsulotomy wherein doctors create lesions in the brain, Gill was the first patient to undergo a deep brain stimulation procedure. Psychiatric surgeries are rare, in the West too.