I’m pissed off about an article in Psychology Today that suggests smarter people consume more alcohol. As someone who’s sober, the article is kind of insulting. After all, I consider myself a reasonably intelligent person.
Mood music:
Here’s a snippet from the article by Satoshi Kanazawa:
Drinking alcohol is evolutionarily novel, so the Hypothesis would predict that more intelligent people drink more alcohol than less intelligent people.
Human consumption of alcohol, however, was unintentional, accidental, and haphazard until about 10,000 years ago. The intentional fermentation of fruits and grain to yield ethanol arose only recently in human history. The production of beer, which relies on a large amount of grain, and that of wine, which similarly requires a large amount of grapes, could not have taken place before the advent of agriculture around 8,000 BC and the consequent agricultural surplus. Archeological evidence dates the production of beer and wine to Mesopotamia at about 6,000 BC. The origin of distilled spirits is far more recent, and is traced to Middle East or China at about 700 AD. The word alcohol – al kohl – is Arabic in origin, like many other words that begin with “al,” like algebra, algorithm, alchemy, and Al Gore.
His hypothesis pisses me off because there are days when I hate being sober. I’d give anything for a few drops of wine, for that mellow feeling I get after a couple glasses.
It’s also been drilled into my head that addiction isn’t about being smart or stupid. The perfect description comes from this “West Wing” episode where Leo, the chief of staff, tries to explain what alcohol does to him:
As Leo says, his brain works differently. It has nothing to do with being smart or stupid.
Nevertheless, there are days where my addictions make me feel supremely stupid. It has certainly compelled me to do stupid things in the past.
To be fair, the article doesn’t really say that only smart people drink a lot. Reading it just pisses me off because I can’t drink anymore.
I can’t eat flour or sugar anymore. Lots of smart people love those two ingredients.
I can’t smoke anymore. Lots of smart people smoke.
I won’t lie: I used to think I looked very smart and sophisticated with a cigar hanging from my lips.
Some would call that stupid. Whatever.
The bottom line is that I can’t drink or do the other things anymore. It’s not because I lack intelligence. It’s because that intelligence is powerless against the mental impulse that screams out for a good feeling; for a break.
Mine is a particularly strange tale of addiction. My biggest problem was compulsive binge eating. My drinking accelerated after I put the flour and sugar down because I needed a crutch. Then I realized I needed the wine a little too much, so I put that down and started on the cigars for a crutch.
Now I don’t smoke anymore, and there are days where I struggle to find a good release. Yoga doesn’t do it for me. As Erin points out, yoga could do it for me, but I’m prejudiced against it. Fair enough.
Moderation doesn’t exist in my world. It’s all or nothing.
That doesn’t make me dumb. But it might mean I’m a victim of dumb luck.
Guest column: An OCD sufferer finds that managing his demon is a lot like managing the dark side of The Force.
Mood music:
A few months ago I told you about my friend and former co-worker Steve Repsys and how, as two undiagnosed OCD sufferers, our working relationship was often the stuff of comedy. What follows is Steve in his own words, explaining how helpful it can be to open up about the disorder and “give in to the dark side.”
***
“You don’t know the power of the dark side.” Darth Vader to Luke Skywalker
For those of us suffering from OCD, this mental condition is our “dark side.” Often times we ignore or minimize this “dark side” because we are so embarrassed by it. When I don’t acknowledge this part of me, I find myself running into problems, like Luke Skywalker in the cantina. But when you “embrace the dark side,” there is a subtle but noticeable change.
I learned this the other day when I shared with my co-worker Kate that I suffer from OCD. Kate is one of the nicest people I work with and is extremely approachable. Somehow in one of our recent conversations, I felt confident enough in our friendship to divulge this “bombshell.”
When I described what I’ve experienced over the last few months – anger, frustration and humiliation – that large part of me that I’ve often kept hidden from others grew a bit smaller. I was surprised how easy it was for me to talk about it. I was like C-3PO – you couldn’t get me to stop talking about it.
Conversing with Kate, she was attentive and asked questions so she could better comprehend what it is like to live with OCD.
It amazed me – like when Luke found out that Han wasn’t in it for the money – that she was so touched and flattered that I shared this important piece of personal information with her.
I don’t have to worry about her thinking of me any different. Instead, I gained her admiration because I had the courage to admit there is this “demon” inside of me that I can control.
Now I can add a new weapon – talking about it openly and freely to people I trust – to my arsenal of weapons to keep my OCD at bay (not Docking Bay 93).
As Ben told Luke when introducing him to the force, “You’ve taken your first step into a larger world.”
As I mentioned earlier, I’m taking Wellbutrin to combat a tougher-than-usual bout of winter depression. Here’s where I stand eight days in.
Mood music:
I think I’m starting to feel it, though it’s hard to know for sure this soon. The nurse told me it could take several weeks before I’d feel the full effect, since Wellbutrin slowly accumulates. I have noticed a few things, though:
–I’m a little more focused than I’ve been in several weeks.
–I’m not feeling like I’m in a fog as much as I had been.
–I haven’t been feeling down like I was a week ago.
Whether it’s the Wellbutrin kicking in or not, I’m just glad to be feeling better.
Note: Four hours after writing the part you just read, I came down with vicious mood swings. As I write this, my skin doesn’t fit right, I’m itchy all over (yes, I showered today) and I’m agitated as hell. The good news is that I have gone through the same exact thing whenever my Prozac dose has been adjusted. It lasts a few hours, and then everything evens out. It’s usually the point I reach when the medication is about to kick in.
For those wondering what this experiment is all about, let’s review:
I started taking Wellbutrin because it’s supposed to shore up depleted brain chemistry that the Prozac isn’t designed to fix.
The Prozac increases the amount of serotonin, a natural substance in the brain that helps maintain mental balance. Serotonin is a neurotransmitter, a substance that helps transmit messages from one nerve cell to another. In other words, it keeps traffic in the brain moving normally.
It has served me well, but this winter the blue moods have been tougher to shake. Enter the Wellbutrin, a drug used to treat major depression and seasonal affective disorder. It’s also used to help people quit smoking because it squashes cravings.
While the Prozac raises Serotonin levels, Wellbutrin shores up another neurotransmitter called Dopamine.
If this all sounds confusing, think of the brain as a car engine. To run properly, the engine needs the right amount of fluids, including brake fluid, transmission fluid and oil. Run low on any one of these and you got problems.
It’s amusing for me considering my efforts to kick some addictions in recent years. Despite my sobriety and abstinence, here I am, finding that there’s better living through chemistry after all.
I was saddened to see tweets today from a guy who says he was fired over his depression.
Mood music:
He tweeted:
“We’re a small company, there’s no room for passengers.” – My boss after I told her about my depression and how I’m getting help with it.
Then, another tweet:
I just had a phone call from my boss. I’ve been fired. Wow.
He also shared the termination letter he received:
“Dear (name removed):
It is with regret that we must terminate your contract with COMPANY NAME, due to non-performance. As discussed with your line manager, ***** ******, on several occasions, there has been a lack of activity resulting in lack of business and an unacceptable future business pipeline.
We do not take these decisions lightly but as you admitted yourself, you have been unable to pick up the phone and make calls lately and, as a small business, we cannot continue to pay a salesman a salary when no sales are forecast.
You are due one month’s notice as per your Contract of Employment and so will be paid up until 14th February 2012. This will be paid into your bank account on the 26th January (for January) and the balance on the 14th.
As of today you will be on garden leave and not expected to attend the office nor contact clients or candidates.”
A few thoughts:
If he did his job well and the boss couldn’t handle the fact that he has a mental illness, that’s an outrage he should fight tooth and nail. I wrote about such a case a few months ago in a post called “The Mental Illness Stigma That Won’t Die, Part 2.”
My tirade was inspired by this comment posted on the LinkedIn NAMI group discussion board:
I LOST MY JOB AS DIRECTOR – COMMUNICATIONS FROM A REGIONAL CHAMBER OF COMMERCE AFTER DISCLOSING MY 30 YEARS OF LIVING AND WORKING WITH BIPOLAR IN DEC. 2009.
Now after trying to find another job, I applied for SSDI. I just got rejected with a letter saying,”The medical evidence in your file shows that your condition does cause restriction in your ability to function, however, while your condition prevents you from doing previous jobs, you still have the ability to do unskilled work.”
I was diagnosed with bipolar in 1980, have bouts of depression, social anxiety, migraines, gerd and visable essential tremors in my hands and legs. I cannot stand unsupported for more than a few minutes and the tremors make me not want to leave my home and when I do anxiety worsens them. I can take medication to calm the tremors but those meds also negatively effect my memory, errors, and cognitive abilities.
I know most people get rejected but I am almost 60 and have worked in public marketing communications at managerial levels since 1984. What should I do?
I felt I needed to disclose as the work was socially demanding and my tremors showed.
I felt in disclosing that especially a Chamber of Commerce would be somewhat more understanding. Instead they became hostile and took away my startegic job duties and bumped me down to a typist.
The question I have is this: If someone loses their ability to do their job because of heart disease, a terrible injury or cancer, do they get dropped cold by their employer? Do they get treated in a hostile manner? Not from my experience.
I’ve known many people who developed a disease or got in an accident, and none lost their jobs. Their seat simply stayed empty and, in some cases, temps were brought in to do their work until they either recovered or resigned. They were treated with support.
If this woman did her job admirably for many years and just recently hit a period of intensified mental illness, she should be treated like the cancer or heart patient. To fire her because she’s “gone crazy” is, in my opinion, unacceptable.
These stories ratchet up the fear level for those suffering from depression, OCD, bipolar disorder and the like. It proves to the sufferer that mental illness is still viewed as a less-than-legitimate illness, something that’s more a figment of the sufferer’s imagination.
Many good people have died because of mental illness. They were ashamed and afraid to get help because of the stupid notion that they are somehow crazy and either need their ass kicked or be institutionalized. So they try to go it alone and either end up committing suicide because their brains are knocked so far off their axis or they die from other diseases that develop when the depression forces the sufferer into excessive eating, drinking, starvation, drug taking or a combination of these things.
There’s also the ridiculous idea that a person’s workmanship becomes valueless when they’re in a depression. If someone misses work because they have cancer, they are off fighting a brave battle. They are fighting a brave battle, of course. No doubt about it.
But depression? That person is slacking off and no longer performing.
Now that I’ve said all that, let’s look at the other side.
In the case of this just-fired fellow, the boss claimed he was not doing his job and that revenue was being lost. If his illness prevented him from doing his job, that does put the employer in a bind. I get that. If his condition has suddenly nosedived and it prevents him from doing what he used to do, that’s a tragedy.
I do believe that people like us have a responsibility to prove we’re up to the challenges we seek.
Beth Horne, president and CEO of The Horne Agency, a marketing and advertising firm, has lived this from both sides, as the mental illness sufferer and as an employer. She wrote the following via the United States Mental Health Professionals group on LinkedIn:
I was diagnosed with Bipolar 2 twenty years ago. I received treatment and have been stable for years, thanks to excellent therapy, medication and education. Before returning to school for my PhD in Psychology, I worked in Marketing/Advertising for several large media companies before opening my own advertising agency. I was open about my diagnosis with my employers during my interview process, and it never hindered me from being hired. In fact, I never interviewed for a job I did not get, due to my work record, resume and references.
I think that my work performance more than made up for any issues I may have had regarding my disorder, such as sometimes having periods of depression or getting a bit manic when life changes occurred. I worked very hard NOT to let them affect my work performance or reduce my ability to generate revenue for my company.
However, I have been in management with these companies and had employees with mental issues who did not take care of themselves and they became liabilities to the company and had to be let go. Some would refuse to take their medication and attend therapy, some would miss work continually or be so over-medicated they were in a constant stupor, unable to perform their duties. I had one woman who came into the office in such a manic state I had to ask her to stay in her office until she could have her husband take her to her doctor, and to please refrain from taking any sales calls, for fear of her ruining client relations.
If someone knows they have a mental issue/disorder, it is a personal choice whether or not to accept their diagnosis and get help and follow their treatment. Is this always easy? NO! But if they are to function in the work environment, it is their responsibility to do anything and everything in their power to stay as healthy as possible. If this is not possible for them, then it is time to look into disability.
Employers need to understand that not everyone with a diagnosis of a mental illness is like another…there are people with bipolar disorder who have little problem going on with their daily routine with just therapy and medication, while others find it impossible to blend into the work environment. I use bipolar disorder as just one example, but there are many others, as we all are aware. I have a mother who has a mild form of OCD and is a supervisor at a hospital. What better profession could there be for someone who will always be strict about following rules, cleanliness and excellent patient care than an RN? Or like my brother, who also has the same issue, works in IT?
Both are successful and well-adjusted, and their coworkers probably have no idea they have any mental problems whatsoever. So before they judge and dismiss a potential employee because of ignorance, they should look at the person as a whole and not just their diagnosis.
Like Beth, I’ve been judged by my workmanship and not by mental health issues I’ve disclosed. That has been the case for me in every job I’ve ever had. I do my current job well, and that’s all my bosses care about. I’m very fortunate.
There have also been times in past jobs where my workmanship suffered because I wasn’t taking care of myself. I was refusing to even consider therapy or medication, and I sank lower and lower.
I was reinforcing the stigma instead of breaking it.
Today I succeed because I refuse to let the struggles render me useless. I fight harder and longer, and I never give up.
But if you’re in the grip of deep depression, that’s not always possible. I feel for people in that situation, and pray that they’ll come through this better than before.
It’s been an interesting month in mental disorder awareness. In taking steps to nip wintertime depression in the bud, I’ve learned that OCD isn’t my only mental defect.
Mood music:
It appears that as OCD messes with one side of my brain, Attention Deficit Disorder is toying with the other side. This little epiphany happened when I visited the nurse who helps me manage my regimen of medication.
She asked a lot of questions she usually doesn’t ask about my focus of late. I noted that while I still have frequent OCD moments — particularly if I’m knee-deep in a work project or tackling a list of chores at home — I also seem to be having trouble concentrating a lot. One recent day in work, for example, it took all the strength I had to focus on the work at hand.
That almost never happens. But this time, doing the work was painful. It gave me a migraine. If I hated what I do that would be normal. But I love what I do. Meanwhile, at home, I’d stand in the kitchen, oblivious to the fact that I was standing right where Erin was working on dinner. I would try to give her a hug or shoulder rub while she was in the middle of a task — almost as if I had one foot in this dimension and another foot in some other world.
There’s more to it, but those are a couple good examples.
Looking back on my life, it all makes sense. The OCD-ADD push and pull has always been there to some degree. As a kid I would go into OCD mode, organizing my Hot Wheels and Star Wars action figures just so. Then I’d go the other way and have a hell of a time trying to focus on simple homework assignments or chores around the house.
The Prozac nurse tells me it’s actually typical for someone to go back and forth with these disorders. OCD and ADD operate on the same mental plain. Both spark anxiety (I used to be crippled by anxiety, but that’s not an issue today) and mood swings. Both are effected by the time of year, amount of daylight vs. darkness, etc.
The image that comes to mind is two-face, that villain in Batman with the split personality.
As the reader knows, I’ve had a persistent bout of winter depression. Not the “I’m sad and want to hurt myself” type, but the ho-hum, grumpy old man variety.
Mood music:
http://youtu.be/c-QnnLudkQA
This afternoon I visited the nurse who manages my Prozac intake and walked out with a new drug: Wellbutrin.
I’ll be taking it in addition to the 60 MG of Prozac I’ve been taking for a few years now. The Prozac increases the amount of serotonin, a natural substance in the brain that helps maintain mental balance. Serotonin is a neurotransmitter, a substance that helps transmit messages from one nerve cell to another. In other words, it keeps traffic in the brain moving normally.
It has served me well, but this winter the blue moods have been tougher to shake. Enter the Wellbutrin, a drug used to treat major depression and seasonal affective disorder. It’s also used to help people quit smoking because it squashes cravings.
While the Prozac raises Serotonin levels, Wellbutrin shores up another neurotransmitter called Dopamine.
If this all sounds confusing, think of the brain as a car engine. To run properly, the engine needs the right amount of fluids, including brake fluid, transmission fluid and oil. Run low on any one of these and you got problems.
I just started taking the Wellbutrin this afternoon. I’ll let you know how it goes.
Erin is playing me an NPR broadcast about OCD. I went looking for the link to include here and tripped over another good NPR segment. This one is an interview with Traci Foust, author of “Nowhere Near Normal: A Memoir of OCD.”
I recently connected with Traci on Facebook and she’s a great resource for understanding the disorder.
While we’re on the topic, it’s also worth checking out “A Life Lived Ridiculously” by Annabelle R. Charbit, about a girl with obsessive compulsive disorder who makes the mistake of falling in love with a sociopath.
Both writings work so well because of how the authors use humor. Of course, my humor falls on the dark side, so take that comment with a grain of salt.
As for that other OCD segment on NPR, here it is. It’s about how art can be used to raise a person’s understanding of the disorder.
Me and the happy lamp Erin bought me to combat winter depression aren’t seeing eye to eye. Everyone I talk to who uses one says it works. But here’s my problem…
Mood music:
http://youtu.be/UXFUnnoSphY
As I stare at the florescent glow that’s supposed to simulate sunlight, a nagging thought dogs me: “It’s just not the same as real sunlight,” I keep telling myself.
There’s something about genuine sunlight — how it bounces off trees and houses, how it shoots through windows and lights a room — that you just can’t capture in a box.
When the happy lamp is on, it just seems like I have my face extremely close to one of those florescent ceiling lights.
I’m not blind to the fact that part of the problem is me. Knowing that it’s not the same as real sunlight, I have a hard time giving it a chance. That’s really not fair to those who have to live in the same house with me, I realize.
I bring all this up because I suspect I’m not the only one whose skepticism — or is it cynicism — gets in the way of the scientific benefits of light therapy.
Light therapy is a way to treat seasonal affective disorder (SAD) by exposure to artificial light. Seasonal affective disorder is a type of depression that occurs at a certain time each year, usually in the fall or winter.
During light therapy, you sit or work near a device called a light therapy box. The box gives off bright light that mimics natural outdoor light. Light therapy is thought to affect brain chemicals linked to mood, easing SAD symptoms. Using a light therapy box may also help with other types of depression, sleep disorders and some other conditions. Light therapy is also known as bright light therapy or phototherapy.
Reading further, I can see how I haven’t exactly been doing it right. I turn on the box and don’t keep track of time. I’m inconsistent about the time of day I use it. My mind gets caught on visuals: what I want the light to look like vs. the scientific effect. Here’s how the Mayo Clinic says to do it:
Three key elements for effective light therapy Light therapy is most effective when you have the proper combination of duration, timing and light intensity:
Duration. When you first start light therapy, your doctor may recommend treatment for shorter blocks of time, such as 15 minutes. You gradually work up to longer periods. Eventually, light therapy typically involves daily sessions ranging from 30 minutes to two hours, depending on your light box’s intensity.
Timing. For most people, light therapy is most effective when it’s done early in the morning, after you first wake up. Doing light therapy at night can disrupt your sleep. Because light therapy seems to work best in the early morning, you may need to wake up earlier than you normally would to get the most benefit from treatment. Your doctor can help you find the light therapy schedule that works best.
Intensity. The intensity of the light box is recorded in lux, which is a measure of the amount of light you receive at a specific distance from a light source. Light boxes for light therapy usually produce between 2,500 lux and 10,000 lux. The intensity of your light box affect how far you sit from it and the length of time you need to use it. The 10,000 lux light boxes usually require 30-minute sessions, while the 2,500 lux light boxes may require 2-hour sessions.
Finding time for light therapy Light therapy requires time and consistency. You may be tempted to skip sessions or quit altogether because you don’t want to spend time sitting by a light box. But light therapy doesn’t have to be boring. It can be time well spent.
You can set your light box on a table or desk in your home or in your office. That enables you to read, use a computer, write, watch television, talk on the phone or eat while undergoing light therapy. Some light boxes are even available as visors that you can wear, although their effectiveness isn’t proven.
Getting the most out of light therapy Light therapy isn’t effective for everyone. But you can take steps to get the most out of your light therapy and help make it a success, including:
Be consistent. Sticking to a daily routine of light therapy sessions can help ensure that you maintain improvements over time. If you simply can’t do light therapy every day, take a day or two off, but monitor your mood and other symptoms — you may have to find a way to fit in light therapy every day.
Time it right. If you interrupt light therapy during the winter months or stop too soon in the spring when you think you’re improving, your symptoms could return.
Get the right light box. Do some research and talk to your doctor before purchasing a light therapy box. That way you can be sure your light box is safe, the right brightness and that its style and features make it convenient to use.
Include other treatment. If your symptoms don’t improve enough with light therapy, you may need additional treatment. Talk to your doctor about other treatment options, such as psychotherapy or antidepressants.
I got a call from my mother this morning. She says she’s been reading every post in this blog and that she’s very worried about me.
“You have a beautiful wife, two healthy kids and a wonderful job, yet I read your blog and see someone who is very unhappy and disturbed,” she told me. Incredibly, she was worried that I might try to hurt myself someday.
Nothing is further from the truth. Which brings me to this post.
She commented on my last post, suggesting I’m still suffering the effects of massive doses of Prednisone during childhood. She wrote:
“When you were really sick in the hospital you were put on one of the highest doses of prednisone they give. Low doses make people have ocd tendencies while on the drug. High doses are 100 times magnified. Thus your many loud memmories. Ask any doctor what this drug can do. Having said that I will note that we are all very happy you came through the physical problems. However I think this drug is still making you sick. Even though you have not taken it for a very long time. I have taken moderate to high doses (not nearly what you took) and came home from the hospital like a crazy just let out of the mental hospital. I cannot even imagine what it did to you. But I am not convinced that this drug ends with the end of the prescibed dosage.”
There’s a lot of truth in there regarding the lingering effects of Prednisone, but that’s a topic best saved for the next post.
For now, I want to tell my mother that the reality of this blog is the complete opposite of what it’s really about. In an effort to set her straight, I’m asking her to read the following posts…
First, some words about how having the occasional bought of depression doesn’t mean a person is unhinged or even unhappy. Depression has it’s emotional components, but a lot of it is about basic science and brain chemistry: things that can be managed with the proper awareness and treatment.
“The Engine” where I compare mental illness and the treatments do the engine of a car.
Next, some words of encouragement I try to send people, especially kids, going through what I’ve experienced, the goal being to give them hope and inspire them to take command of their lives — not sink deeper into despair:
Finally, read these posts because they are all about me making it through the rough stuff and reaching a point where I am a much happier person who loves to experience things I used to fear:
Snowpocalypse and the Fear of Loss. The author remembers a time when fear of loss would cripple his mental capacities, and explains how he got over it — mostly.
Fear Factor. The author describes years of living in a cell built by fear, how he broke free and why there’s no turning back.
Prozac Winter. The author discovers that winter makes his depression worse and that there’s a purely scientific explanation — and solution.
Rest Redefined.The author finds that he gets the most relaxation from the things he once feared the most.
Outing Myself. The author on why he chose to “out” himself despite what other people might think.
Why Being a People Pleaser is Dumb. The author used to try very hard to please everybody and was hurt badly in the process. Here’s how he broke free and kept his soul intact.
Hopefully, you’ll walk away with a new perspective. This thing is really about overcoming obstacles and learning to put ongoing challenges in their proper place.
If you don’t feel that way after more reading, we’ll simply have to agree to disagree.
Someone recently asked if I think about my disease 24-7 and, if so, whether doing so is perilous to those around me. In this case, the disease is OCD and the addictions that go with it.
Mood music:
Let me try to take a stab at addressing that:
I don’t think my disease should define me and keep me in a box. But it’s also a major part of who I am and how I tick. Writing a blog that focuses on that probably amplifies things. But I see some necessity in it all.
Like any person with an addictive personality, I have to have it on my mind around the clock because if I stop thinking about it I forget it’s there. That’s when I get sloppy and sink into the bad behavior.
The OCD part is a little more complicated and maybe even a little contradictory.
Since OCD is largely a disease that triggers destructive over thinking, you would think that the goal is to teach yourself not to think so hard. In some respects, that is the goal. But it’s about not engaging in thinking that snags your brain like the scratch in a CD does to the laser. It’s about never forgetting that the disorder, like addiction, is nearby doing push-ups, ready to kick your ass when you get too comfortable.
I’ll admit that I’m not even close to having this stuff in balance. But to those who think I focus on my disease at the expense of all else, I disagree. The me of today is a deeply flawed animal. But go back and meet the me of five or 10 years ago and you’ll meet a monster. A wounded monster. Everyone is probably better off with me as a flawed animal. I’m less harmful that way.
That doesn’t mean I should tell everyone to fuck off and carry on with no regard for the needs of others.
I need to keep working on being a better husband, a better father, a better friend and colleague. I’m never going to be perfect. But I can be better. If I have to think about my disease 24-7 to keep getting better, so be it.
I also think it’s necessary to remember my disease so I can be be more helpful and supportive of other people dealing with their own diseases — not necessarily cancer and the like, but everything from work stress to a loss of identity.
As for that other OCD segment on NPR, 
