Are You Monk-ish?
Actor Tony Schalhoub, the star of “Monk”, (a television series that lasted for eight
seasons) advocates for Obsessive Compulsive Disorder - OCD, a type of anxiety
disorder. Adrian Monk, for those not in the know, is a warm and brokenhearted
detective who has OCD; a disorder with specific traits that Shalhoub says is not all
that hard for him to identify with.
“I certainly have those kinds of feelings and preoccupations,” says the actor of OCD.
“And what I do with Monk is think of it as uncorking the bottle and letting everything
flow.” This helps Shalhoub, who has won three Emmys and a Golden Globe for Monk,
understand its challenges firsthand. “For a lot of people, there is a fear of
embarrassment. But people who suffer with the disorder don’t have to be outcasts.
They can be and are contributing members of society.”
MONK EXHIBITS SYMPTOMS OF OCD
• Brilliant crime fighter that Monk is, he struggles with distraction, focusing at times
on the inconsequential, such as dandruff on someone’s shoulder or the
arrangement of doughnuts in a box. He must touch every parking meter he passes
and wipe his hands after every handshake. For millions of Americans with OCD and
their families, Monk has become a source of empathy and inspiration. That’s why
Shalhoub and Monk co-creator David Hoberman recently teamed with the Anxiety
Disorders Association of America to launch an OCD awareness campaign called,
“Treat It, Don’t Repeat It: Break Free From OCD.”
Children and adults with obsessive-compulsive disorder (OCD) suffer from
unwanted and intrusive thoughts that they can’t seem to get out of their
heads (obsessions), often compelling them to repeatedly perform ritualistic
behaviors and routines (compulsions) to try and ease their anxiety.
Many OCD obsessions revolve around cleanliness or contamination. For
example, some people with OCD may constantly feel dirty, and may view
every surface as contaminated with germs or dirt. They obsessively worry
that they may be harmed when parts of their body such as their hands
come into contact with these surfaces.
Compulsions are the second type of OCD characteristics, or rituals that
people with OCD perform in response to their obsessions. They might keep
their food, drinks, cans, eating utensils, clothing, etc., facing in one
Many well-known individuals have struggled or currently
struggle with OCD, as do millions of other Americans.
OCD RUNS IN THE FAMILY
• Researchers are learning that anxiety
disorders run in families, and that they have a
biological basis, much like allergies or diabetes
and other disorders. Anxiety disorders may
develop from a complex set of risk factors,
including genetics, brain chemistry,
personality, and life events.
OCD CLINICAL RESEARCH
• Multiple Schools of Medicine have embarked on
clinical trials and studies to try and understand the
complexity of OCD. Yale School of Medicine, UCLA
School of Medicine, and Stanford University School of
Medicine to name a few.
• Yale School of Medicine founded the Yale OCD
Research Clinic in the mid 1980s by Drs. Wayne
Goodman and Dennis Charney, the Clinic fostered the
development of the fields standard instrument for
rating symptom severity.
• The Yale-Brown Obsessive Compulsive Scale (Y-BOCS), as
well as the first clinical trials demonstrated the efficacy of
the medications that are now standard treatments for the
disorder – SSRIs and neuroleptics.
• The Obsessive Compulsive Foundation, a leading education
and advocacy organization for patients with OCD, was
founded in large part by participants in these early research
• UCLA School of Medicine has performed brain imaging
studies to view the metabolic differences between brains
with normal control and the OCD brain.
CEREBRAL GLUCOSE METABOLIC RATE
IS HIGHER IN THE OCD BRAIN
Cognitive Behavior Therapy (CBT)
CBT is effective treatment for OCD. About 7 out of 10 people will benefit
from either CBT or medication. For CBT to work, a patient must actively
participate in the treatment. Unfortunately, about 1 in 4 OCD patients
refuse to do CBT.
There are different kinds of CBT, but the one that works the best for OCD is a kind
called Exposure and Response Prevention, or ERP. The “Exposure” in ERP refers
to confronting thoughts, images, objects and situations that make a person
with OCD anxious. With ERP, a person has to make the commitment to not
give in and do the compulsive behavior until they notice a drop in their
anxiety. In fact, it is best if the person stays committed to not doing the
compulsive behavior at all. The natural drop in anxiety that happens when
you stay “exposed” and “prevent” the “response” is called habituation.
• Medication is also an effective treatment for OCD. About 7 out of 10 people with
OCD will benefit from either medication or CBT. For the people who benefit from
medication, they usually see their OCD symptoms reduced by 40 – 60%.
• The treatment for most OCD patients should involve the combination of CBT/ERP
• Most drugs that help OCD are known as antidepressants or Selective Serotonin
Reuptake Inhibitors (SSRIs). SSRIs work by blocking a receptor in the brain that
absorbs the chemical serotonin. Serotonin is known to influence mood, but the
exact way SSRIs improve mood isn’t clear. Depression often results from OCD.
• Doctors can treat both OCD and depression with the same medication. Eight of
these antidepressants (SSRIs) worked well in studies:
Fluvoxamine (Luvox) Fluoxetine (Prozac)
Sertraline (Zoloft) Paroxetine (Paxil)
Citalopram (Celexa) Clomipramine (Anafranil)
Escitalopram (Lexapro) Venlafaxine (Effexor)
• Neuroleptics are antipsychotic medications. Antipsychotic medications are
used to augment current treatments. In general, scientific evidence
strongly supports the use of antipsychotic medications as useful
augmentation drugs for adults whose OCD symptoms have not responded
to standard treatments.
• Although antidepressants/SSRIs are the standard medical treatment for
OCD, it has been suggested that adding antipsychotics for the people who
do not adequately respond to these drugs is helpful in improving OCD
symptoms. Antipsychotic medications such as Risperdal (Respiridone),
Zyprexa (Olanzapine) or Seroquel (Quetiapine) affect levels of the
neurotransmitter dopamine. Problems with the dopamine system have
been implicated in OCD.
• OCD is a debilitating disorder that disrupts the life of the person
with OCD. It effects their relationships, both personal and
• OCD is a serious disorder and should not be taken lightly.
• People with OCD suffer and it is important to take the steps
necessary to relieve OCD symptoms.
• More and more strides are being made to help those suffering from
• Those who have OCD are not alone. Don’t wait years and suffer in
silence. Many people have the disorder and with help are very
productive members of society.
• Images of Monk and OCD
• Pearlman, E. (n.d.). Actor Tony Shalhoub Takes on Obsessive Compulsive Disorder. Retrieved from WebMD:
• Images of Famous People with OCD. (n.d.). Retrieved from
• Psychiatry, M. (2009, February). Rapid Effects of Brief Intensive Cognitive-Behavioral Therapy on Brain Glucose
Metabolism in Obsessive-Compulsive Disorder. Retrieved from US National Library of Medicine National
Institutes of Health: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2893580/
• Understanding the Facts/Obsessive Compulsive Disorder. (n.d.). Retrieved from Anxiety and Depression
Association of America: http://www.adaa.org/understanding-anxiety/obsessive-compulsive-disorder-ocd
• Perles, K. (2010, November 11). Types of Obsessive Compulsive Disorder Characteristics. Retrieved from
• Bell, J. (n.d.). Cognitive Behavior Therapy (CBT) and Medications for OCD. Retrieved from International OCD
• Owen Kelly, P. (2010, August 24). Augmentation is an Effective OCD Medication Strategy. Retrieved from
About.com Obsessive Compulsive Disorder: http://ocd.about.com/od/treatment/a/augmentation.htm