ASK THE THERAPIST

Do you have a question about OCD, scrupulosity or other related topic? Do you have questions or concerns about therapy? Feel free to e-mail your question to Lori and she'll post your question and her answer here for everyone's benefit. (Don't worry, we won't post your name.)

You can also ask questions anonymously at the Community Forum.

Q. I have music playing over and over in my head. Is this a symptom of OCD and how is it treated?

Yes, this is a common symptom in people with OCD. However, I have known some without OCD that report music running through their head.

The most frequently recommended treatment for excessive and anxiety-producing intrusive music related to OCD probably is medication.

Flooding (extensive exposure to the actual song) is also used at times for anxiety reduction, not necessarily to get rid of the music. Some have had success in reducing this symptom by deliberately starting a new song in their head. The new song often tends to be less "sticky" than the original.

Also, if you work on other symptoms that produce anxiety, you may find that the music will diminish after your overall anxiety level decreases.

Q. Is there such a thing as adult-onset OCD? Is that what happened to Howard Hughes?

A. According to the DSM-IV (Diagnostic and Statistical Manual of Mental Disorders) OCD usually begins in adolescence or early adulthood. Most frequent onset in males is between ages 6 and 15 years and between ages 20 and 29 for females. Onset is usually gradual but acute onset has been noted in some cases.

I cannot comment on Howard Hughes' specific case without having evaluated him, however, some internet sources indicate that he did have mild symptoms as a youth.

Q. I've heard that people can get OCD from the flu. Is that true?

A. Streptococcal infections have been linked to acute OCD onset in some children. It's called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections). Ongoing research shows that certain medical treatments may reduce symptom severity. The National Institute of Mental Health (NIMH) has studies underway to better understand the disorder.

See http://intramural.nimh.nih.gov/research/pdn/web.htm for more information.

Q. What do you think about using medication to treat OCD?

A. Research shows that cognitive-behavioral therapy (CBT), with or without medication, is the best treatment for OCD. However, medication can be useful in certain circumstances, especially when a client needs help to reduce the anxiety about exposure therapy. For more information on CBT and medication, see What is CBT?

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Information on the Ask the Therapist page or any page on this Web site should not be considered a form of diagnosis or therapy.