OCD: A Provider’s View

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We caught up with Dr. Labellarte and asked him a few questions about OCD.  Dr. Labellarte has been treating children, adolescents, and adults since 1990, very nearly 30 years.  OCD can be a devastating illness that disrupts and overwhelms people at any age or stage of their life.  He has studied OCD, worked on clinical trials for medications to help treat OCD, and have successfully treated a thousand cases in that time. 

What question are you most often asked about OCD?

People most often ask me about medication regardless of the diagnosis.  Does medication really help? Is it worth the side effects? Will I have to be on it forever? People often think of medication as the last option, to be used when other interventions have failed.  Some psychiatric symptoms and disorders improve quickly with the proper medication at the right dose, which then allows a patient to either go back to their lives or access other therapeutic interventions more effectively. Anxiety and OCD are often helped with medication.  It makes therapeutic interventions more effective and helps the patient achieve results or return to their lives faster.  Medication is often not forever.

The second thing they most often ask is about side effects of the medication.  OCD can be a devastating illness that disrupts and overwhelms people at any age or stage of their life.  While very few people experience side effects of medications, they are often no where near as debilitating as OCD.

Is OCD hard to treat?  Do people ‘recover’?

I know how to treat this condition with medication but am fortunate to work with two incredibly talented CBT/ERP providers, Dr. Theresa Shank, and Dr. Magda Rodriguez.  Together and individually, we have helped people that have improved and even eliminated OCD distress.  While it is difficult to treat, it is equally rewarding when symptoms are alleviated.

Is OCD genetic?

Marco Grados, M.D., the Clinical Director at KKI and Associate Professor of Psychiatry at JHU, and a friend and colleague from my Child and Adolescent Psychiatry fellowship at JHU, proved a genetic link between Tourette’s and OCD.  He has done extensive research on the genetics of OCD. 

What would people be surprised to know about OCD?

More people suffer from OCD than from bipolar depression. Most people don’t understand how someone can suffer with OCD. OCD is characterized by recurrent intrusive thoughts (obsessions) that may result in repetitive behaviors (compulsions). OCD can interfere with social and occupational functioning and cause disability. It affects over 2% of the population, more than one in 50 people.

OCD is a term that is often used casually.  Can people have traits of OCD without suffering from OCD?

Some of you know that I often vacuum the office after everyone leaves in the evening. It relaxes me and meets my need for cleanliness.

When people casually talk about being “obsessed” or even use the term “OCD” in a casual context such as liking a very clean house or things to be orderly, they tend to be talking about characteristics of someone with Obsessive and Compulsive personality traits. 

Are you admitting to having some personality traits of OCD?

Obsessive and compulsive personality traits have made me a world-class psychiatrist.  I pay attention to minor details, I am very conscientiousness, and in some cases, I show an unreasonable degree of exactness.  Most of you have seen it in the time I spend with you and the details I notice and in the information I share about medications.  I pride myself on what some would call perfectionism of knowing every nuance of psychotropic medication.  What some of you don’t know is that when I have to write a report, I could write the report in 1 hour, but it takes me 5 hours, because I have to have every fact and figure exactly correct – which means I have to research it, annotate it, and write it in a way that will be irrefutable. 

While I have obsessive and compulsive characteristics, including repetitive motor tics, I do not suffer from OCD.