My name is Kevin Ma, and I've had obsessive-compulsive disorder since I was five years old.
My parents didn't know it at the time, they tell me; all they knew was that I was unusually quiet and withdrawn. But by Grade 2, I was spending whole periods erasing and rewriting assignments because I thought they weren't good enough. I was obsessed with perfection, flying into fits of violent rage whenever I didn't meet my impossibly high standards.
Junior high was the breaking point. I'd howl at the slightest mistake and smash my skull against walls and lockers, sometimes drawing blood. I'd hurl fists and loose objects at the local bullies when they baited me into a fit, and terrify my classmates with my tantrums. I was the top student in the school, and my antics had me inches away from expulsion.
It wasn't until 1997 that my family learned I had OCD, and it wasn't until last year that I felt comfortable enough to talk about it in public.
OCD is not a rare disorder; it's the fourth most common mental illness around, according to psychiatrists, and it affects thousands of Canadians every day. But like most mental illnesses, it's one that's stayed in the dark for years. Few people are aware of it, and even fewer will talk about it.
I figured it was time to shed some light on the situation.
The cop and the architect
Brent Bodnarchuk is a cop. The 42-year-old St. Albert man has the bulk of a linebacker and a love of hockey, and can talk for hours about life on the mean streets of Edmonton in his million-mile-an-hour voice.
He says he joined the Edmonton Police Service barely a year out of high school and spent about a decade patrolling the city's streets. He was one of the first Canadian cops to be trained under the D.A.R.E. program, got rave reviews from his bosses, and was on the fast track to become sergeant. "They'd always call me 'golden boy.'"
But by late 1993, he found himself writing 15-page reports and trashing them if he didn't like how he signed his name. He became terrified of showering at home, convinced that it would somehow give his kids leukaemia.
"It gets to the point where I can't even get out of bed."
Bodnarchuk says his disorder, plus other pressures, made it impossible for him to stay on the force. He's been on long-term disability since 2001, and now takes about 17 pills a day as part of his treatment.
"It's been a living hell," he says. "I feel I've disgraced myself."
Susan, who didn't want her last name used, is an architect and mother who lives in Edmonton. She scrapbooks and collects mugs, and reads voraciously.
She's also terrified of contamination.
"I don't like to touch doorknobs or elevator buttons," she says, seated in her floral-pattered kitchen. "I won't go into the meat department at Safeway."
This is more than a simple dislike, she emphasizes; it's complete, abject terror.
"There was this underlying thought that if I didn't wash up, somebody was going to die."
Her fears forced her to drop out of cooking class, avoid anything her friends touched if they touched meat, and to flee grocery stores whenever she saw a bloody apron on a butcher.
Susan says she'd wash her hands until they were red and raw to quell her fears. "It was a very trying time for everybody in my family."
The doctor
It was decades before Bodnarchuk and Susan learned they had OCD. Today, both coincidentally get help from the same psychiatrist, Lorne Warneke.
Warneke is a doctor at the Grey Nuns Community Hospital in Edmonton. He has 38 years of experience treating patients with OCD and is considered by many to be an expert in the field.
OCD is a mental illness centred on obsessions and compulsions, he explains. The obsessions are intrusive, distressing thoughts that often lead to compulsive, irrational actions meant to dispel them.
In my case, for example, I would obsess over doing everything perfectly, believing that lethal punishment would befall me if I did not. When I did something wrong, I would need to punish myself physically, and would rage at myself to the point of exhaustion — as if this would somehow undo my mistake.
Bodnarchuk tells me he would have to pack and repack his hockey bag 40 times as a kid to make sure he didn't forget anything. If he forgot to touch the fence latch six times to ensure it was closed, he'd have to sprint back home to do it.
OCD used to be considered rare, Warneke says, with estimates within the psychiatric community suggesting it affected around one or two per cent of the population. But psychiatrists now know that it affects about three to four per cent of the world's population. That makes it more common than diabetes, he points out.
Researchers aren't sure what causes OCD, Warneke says. They're pretty sure it's not a learned behaviour, and have identified several genes that could cause it. They know it has something to do with the neurotransmitter serotonin, as medications that interfere with it also affect the disorder.
OCD usually turns up in boys at ages eight to 10 and after puberty in girls, Warneke says. Brain scans suggest that the disorder originates in the caudate nucleus – a cluster of neurons that links the cerebral cortex to the inner parts of the brain.
"These areas of the brain are hyperactive," he says, which causes otherwise normal behaviours to become obsessive.
The compulsions this disorder causes can be all-powerful, Warneke says. He recalls one patient who spent almost 36 hours washing her hands. By the time her family found her, she was hungry and dehydrated – her need to wash overpowered the need to drink the water right in front of her. "It just shows you how strong [the compulsion] is."
One of the defining traits of OCD is that its sufferers often realize their compulsions make no sense.
"They realize how crazy what they're doing is, except they have to do it," Warneke says. "It's probably the worst illness in psychology, to be honest with you."
It's a disorder that can ruin lives, jobs and relationships, and that often goes unaddressed – just 60 per cent of those with it get treatment.
The cure?
OCD isn't something you can "snap out of" or fix with a pill, Susan says.
"You might think it's silly to be worried about a doorknob or the meat department at Safeway, but to me, those are real fears and they're really scary for me."
OCD is treated with cognitive behavioural therapy, Warneke says, which involves intense exercises to train a person to recognize and change their obsessive thought patterns. This usually means intentionally triggering a person's obsessions (e.g. by having someone who fears contaminants hold raw meat) and preventing them from acting on them (washing). This is a long, painful process, he says, and it doesn't always work.
These treatments are often combined with medications, Warneke continues, most of which are selective serotonin reuptake inhibitors. These drugs are thought to work by making serotonin stick around for longer in the brain, boosting the nerve signals it creates.
About 60 per cent of patients see a 40-per-cent drop in their symptoms with medication, Warneke says. More extreme cases may require intravenous drugs or brain surgery.
But researchers have yet to discover a complete cure for OCD, he says.
Susan says she doesn't think she'll ever be fully free of OCD.
"I used to pray that the Lord would take it away. Now, my prayer is that he would somehow use this to help other people."
She now tries to reach out to others to help them understand the disorder.
Despite everything that's happened to him, Bodnarchuk is still optimistic about his future.
"You have to make the most of it," he says. "Even though I can't get back the years I've lost, I still have many years left to live."
I still hope to be rid of my OCD one day, although I realize that may be impossible. But I'm beginning to realize that there's life beyond those three letters. For the first time in years, the future is starting to look bright.
