Friday, July 5, 2013

Obsessive Compulsive Disorder (OCD) with LBD

This is different from impulsiveness, which is doing something without considering the results. This is the need to do a certain behavior like gambling, shopping, eating or sexual activity repeatedly without consideration of the results and dwelling on that behavior excessively in response to hidden anxiety. Women are more likely to overeat and shop; men are more likely to gamble and be obsessed with sex.

While not specifically a Lewy body symptom, OCD is a common response to the anxiety that can accompany any degenerative disorder. It may also be a side effect of certain medications.

Parkinson’s drugs, particularly Requip and Miripex, but also Sinemet on a lesser scale, can sometimes cause ODC-like behavior. When the drugs are stopped or decreased, the behaviors may disappear. Times vary. The compulsive behavior may not show up for as long as a year after the start of a drug. Once the drugs have been adjusted, it can take from days to months for the behaviors to subside. If changing the drugs don’ work:

Don’t use logic. It won’t work. Even with a person who can still be logical in other situations, OCD does not respond to logic. The compulsions overcome awareness and the person cannot see the problem. Your interfering is the problem they see!

Try distractions. This may work because LBD shortens attention spans. Try to get them interested in something else. Suggest something your loved one likes, such as going for a walk or a favorite food, activity, TV show or video.

Build in limits. With each targeted behavior, the limits would be different. If eating is the behavior, monitor the food in your home and limit what is available. Offer healthy choices. With gambling or shopping, limit the funds available, up to canceling or changing your credit cards. Monitor your computer; it is a great source for shopping and gambling.

Evaluate stress levels. OCD is a response to anxiety—stress. Incorporate stress management tools and use them with your loved one regularly. This is a partnership activity. Since your loved one mirrors your stress, his won’t go down unless yours does.

When all else fails, ask the doctor about medication to decrease the behavior. Some caregivers report that Seroquel helped.

Next week will be about sexual acting out, which can be a compulsion with some LBDers.

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