Let’s say her name is Alice. Her OCD was one of those cases where she needed to do checking rituals (Make sure several times before leaving the house that the windows and the door are closed properly, the fires are off, the fridge is in order…). His torture began as soon as the day began. He woke up with the intention of going to work but many days he couldn’t even get to the door to leave the house.
He went into the bathroom and his hygiene and makeup routines it could take hours. The result she saw in the mirror was never perfect: made and undone like Penelope and that perfectionism taken to the limit prevented him from continuing with the rest of his life. Her obsessive-compulsive disorder did not respond to the usual pharmacological treatments or psychotherapy sessions and she was referred to the Psychiatry service of the Hospital 12 de Octubre in Madrid where she began a pioneering treatment.
Suffering
There he was treated with transcranial magnetic stimulation, a non-invasive technology that has been used for decades to treat diseases that affect the nervous system. It has been used against migraines that do not respond well to other treatments, to alleviate the sequelae after a stroke or against the depressionanxiety and addictions such as compulsive gambling where the pathological impulse predominates. But it had never been tried before on this mental health problem that causes so much suffering and goes a long way. beyond washing your hands 10 timespanicking about germs, or maybe ordering everything by color.
Alicia, fictitious name, was one of the pioneer patients to receive it. The technology seems simple. It works with a portable device that is placed on the scalp to deliver a short magnetic pulse. “With it, you get certain neurons in the brain to synchronize their activity, stimulating or inhibiting them,” explains Gabriel Rubio, head of Psychiatry at the Madrid hospital.
This capacity offers wide versatility, but the difficult part is specifying with what frequency, intensity and in which areas of the brain it is necessary to act to achieve a benefit depending on the problem to be treated. “It has taken a lot to establish that protocol,” acknowledges the psychiatrist.
The treatment is painless, does not require any type of anesthesia and requires sessions of between 35 to 40 minutes.
The treatment he received consisted of sessions between 35 and 40 minutes Monday through Friday for two months. Stimulation it does not hurt, the patient is awake during the time that the session lasts and does not require rest afterwards. Some patients may need paracetamol because the skull muscles contract during the treatment and sometimes it leaves a strange sensation in the area where it has been performed, although all this is corrected quickly. It has no side effects and there are only some patients in whom it is contraindicated, such as those who have a hydrocephalus valve, have epilepsy or have a brain tumor.
Transcranial stimulation has not cured Alicia but two months after treatment he was able to return to work. Instead of spending three hours getting ready in the bathroom, she is able to shower and put on makeup in just 30-40 minutes. “He still has some checking ritual left, but he can get on with his life.”
absurd obsessions
The tragedy of OCD is that patients are aware that their obsessions and fears are absurd. “They are ashamed of them, but they cannot avoid them. Just reducing the number of times that, for example, they open a fridge to check that everything is in order and that it is properly closed generates anxiety that they prefer to enter the vicious circle to continue doing so,” says this specialist.
typical of perfectionist people
Perfectionists are fertile ground for suffering from OCD. Society understands it as a quality that must be recognized and this desire of those who want to do things extremely well is reinforced. Sometimes this turns into suffering and pathological behaviors.
The pandemic was fertile ground for obsessive-compulsive disorder. The head of the Psychiatry service of the Madrid hospital remembers how cases skyrocketed due to fear of contagion. “Very perfectionist people, including health workers, who, with the fear of contagion and the insecurity of a new virus, debuted with OCD,” he recalls. Those patients are the ones who have now increased the mental health waiting lists.