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How Neurosurgery and Psychiatry Transform OCD Treatment

Jorun Christanson standing in a group of trees and foliage

Since he was 14 years old, Jorun Christianson's life has been heavily impacted by severe obsessive-compulsive disorder (OCD). His experience with OCD goes beyond the common misconceptions and stereotypes involving intrusive thoughts and repetitive, ritualistic behaviors that cause significant distress. Instead, Jorun's OCD manifests as scrupulosity, germaphobia, and cleanliness rituals. These compulsions have taken over Jorun’s daily life, creating chaos that extends beyond his mind and into his surroundings.

“OCD took control of my life—I spent countless hours every day on obsessions and rituals”
Jorun Christianson, patient

Jorun said. The constant rumination and intrusive thoughts left him feeling guilty and paranoid most of the day, with little relief. His disorder made it difficult to hold a job or maintain healthy connections with others, leaving Jorun feeling lost and disconnected from the world around him.

Despite trying numerous medications, cognitive-behavioral therapy (CBT), exposure and response prevention (ERP), and other treatments, Jorun's OCD did not improve and was considered resistant to conventional methods. OCD robbed Jorun of his passions and success along with the basic pleasures of adolescence and the joys of life. Eventually, Jorun considered himself debilitated: he lived at home, struggled with suicidal ideation, and at one point even moved his bed into his parents' room out of concern for his life.

Deep Brain Stimulation: A New Hope

In July 2023, after years of worry, despair, and heartbreak, Jorun found hope in the Psychiatric Neurosurgery Program at University of Utah Health. This unique collaboration between the Department of Neurosurgery and the Department of Psychiatry works in concert with the Treatment-Resistant Mood Disorders (TRMD) Clinic at Huntsman Mental Health Institute, offering innovative treatments for patients with treatment-resistant mental health disorders.

A neurosurgeon with a mask stands in an operating room
Functional neurosurgeon Ben Shofty, MD, PhD, performing DBS surgery on a patient in an operating room

Here, Jorun was introduced to a multidisciplinary team dedicated to his care. He met Ben Shofty, MD, PhD, a functional neurosurgeon specializing in deep brain stimulation and other methods of neuromodulation for treatment-resistant disorders. Additionally, Jorun continued his psychiatric care with Brent M. Kious, MD, PhD, an associate professor of psychiatry whose research focuses on ethical issues in psychiatry, new treatments for major depressive disorder, and suicide prevention programs. 

Dr. Kious had been involved in Jorun's care from the very beginning, providing comprehensive support and expertise throughout his journey. Together, Dr. Shofty and Dr. Kious offered Jorun a renewed sense of hope.

As the only hospital in the Mountain West offering surgical procedures for treatment-resistant mental health disorders, the Psychiatric Neurosurgery Program gave Jorun a glimmer of hope. After so many conventional treatments failed to bring relief, Jorun saw deep brain stimulation (DBS) as his last resort. DBS is a surgical procedure that involves implanting electrodes in specific areas of the brain. These electrodes deliver electrical pulses that can help regulate abnormal brain activity and provide relief for patients with debilitating OCD.

“DBS has been a game-changer for patients with treatment-resistant OCD,” Dr. Shofty said. “It offers a new avenue of hope for those who have not found relief through traditional methods.”
Ben Shofty, MD, PhD

DBS does more than treat the symptoms of OCD; it also helps patients respond better to treatment approaches that didn’t work in the past. It’s also adjustable and reversible.

Dr. Shofty and Dr. Kious collaborate closely to ensure that patients like Jorun receive comprehensive, multidisciplinary care. This integrated approach combines the expertise of neurosurgery and psychiatry to provide the best possible outcomes for patients with complex, treatment-resistant conditions.

Patients undergoing DBS have many follow-ups to ensure optimal results. The team stays in touch, adjusting the device as needed and providing continuity of care. It's not just a one-and-done procedure; the commitment to ongoing support is crucial for long-term success.

On the Road to Recovery

Since the surgery, Jorun's life has improved remarkably. He no longer struggles with suicidality and has found joy in his work as a barber. Activities that were once overwhelming, like talking with clients, are now enjoyable. He's also been able to exercise more consistently and eat healthier, and he’s found that therapy is more effective. 

"I've started sleeping in my own room and even think about moving out eventually," he said.

Jorun Christanson giving a haircut to a client
Jorun back at work as a barber

“The more we research OCD, the more we understand that it is a brain circuit disorder,” Dr. Shofty said. “Much like in epilepsy and Parkinson’s disease, a specific brain network is hyperactive. We hope that as we continue our research, the stigma that is often associated with psychiatric disorders will subside and more patients will feel comfortable knowing that OCD is just like any other disorder.” Jorun's journey has transformed his perception of mental health. He understands that mental illness can be serious and life-threatening. He advocates for greater awareness and understanding of OCD and the importance of seeking appropriate treatment. “I want people to know that if typical treatments aren’t working, it may require getting something like DBS to manage their illness,” he emphasized.

The care and understanding of friends, family, and health care professionals have made a significant difference in Jorun’s recovery, even when people didn’t know exactly how to help. “My family stood by me through every difficult moment, and their support kept me going,” Jorun said. Now, he can enjoy activities and hobbies that help him connect with others: playing sports, spending time with loved ones, and helping coach the high school tennis team. He’s finally looking forward to a future filled with hope and possibilities.

“Do whatever it takes to get the treatment you need,” he said. “It was a battle, but my family refused to give up, and I hope others will do the same because it is worth it.”
Jorun Christanson

Jorun's story is a testament to the importance of perseverance in seeking treatment for mental health conditions, highlighting the critical need for comprehensive care and the profound impact it can have on an individual’s life.

 

What Is a Treatment-Resistant Mood Disorder?

Many patients diagnosed with major depressive disorder or bipolar disorder experience episodes of depression that do not respond to first-line treatments such as psychotherapy and medications.

You may have a treatment-resistant mood disorder if you meet one or more of the following criteria:

  • You have tried two or more antidepressant medications with little to no long-term symptom improvement.
  • Psychotherapy and medications aren’t enough to significantly reduce your symptoms.
  • You experience periods of treatment success, but your symptoms return with severity.

Your health care provider will rule out other health conditions and mental health disorders to diagnose a treatment-resistant mood disorder. At the Treatment-Resistant Mood Disorders (TRMD) Clinic at Huntsman Mental Health Institute, our specialists will identify the condition associated with your symptoms and find treatments that can help bring you relief.