Birds of Prey #87: A Medical Review

November 9th, 2005

Filed under: Comics, Medicine

cover, Birds of Prey #87Birds of Prey #87 “Perfect Pitch, part one”
Gail Simone, writer
Joe Bennett and Eddy Barrows, pencilers

Calculator: …Somehow, Lex suspects. Unless it’s just coincidence that three of the doctors supplying me with my Selective Serotonin Reuptake Inhibitors committed suicide on the same night…That this genius of mine — and it is genius, make no mistake — stems from more than a touch of Obsessive-Compulsive Personality Disorder. I don’t wash my hands fifty times a day. I don’t count sidewalk cracks. My weakness is ignorance. When I have a riddle, I can’t rest, can’t eat, can’t even think straight, until I solve it.

Calculator makes a common mistake here: he confuses Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder — two different conditions.

Obsessive-Compulsive Disorder (also known as OCD) is what most people think of when they hear the words “obsessive-compulsive.” These are the people with behavioral “quirks” such as repetitively washing their hands, locking the door, or flipping light switches. It’s not an easy diagnosis to understand. Most people with OCD have an intrusive thought or impulse that distresses them. They develop these bizarre behaviors in order to alleviate the unwanted thought or impulse. In other cases, people with OCD perform repetitive actions and behaviors in an illogical manner to ward off some dreaded event. In both cases, individuals with OCD know that their behavior is not normal but they are powerless to stop it. (The diagnostic criteria for OCD).

Traditionally, OCD has been treated with varying success with therapy. In the last decade, the SSRI (Serotonin Specific Reuptake Inhibitor) class of drugs has been used as well. This is the class that contains fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), fluvoxamine (Luvox), citalopram (Celexa) and escitalopram (Lexapro). Normally used for depression and anxiety disorder, high doses of these medications can help people who suffer from OCD. Complete remission is rare, but therapy combined with medication can often give an 80-85% relief of symptoms.

Obsessive-Compulsive Personality Disorder describes people who are overly preoccupied with details, lists and schedules, or are such perfectionists that it actually interferes with their life. They are the people who are anal retentive* to the nth degree. For instance, they spend all day organizing their desk — lining up their pens, making sure each pencil is identical in length — but it takes so much time that they don’t actually accomplish any work. Unlike OCD, people with Obsessive-Compulsive Personality Disorder generally do not realize that there is anything wrong with their behavior or actions. (The diagnostic criteria for Obsessive-Compulsive Personality Disorder).

Obsessive-Compulsive Personality Disorder, like all personality disorders, is extremely difficult to treat. Personality disorders are so deeply ingrained in a person’s very psyche that they do not recognize they have it, or are unwilling to admit that that there is any problem. Therapy is the best treatment for personality disorders, and even that rarely works well.

So what diagnosis does the Calculator have? As I see it, there are 3 possibilities:

  1. He has OCD. His high doses of SSRIs support this, though his symptoms don’t seem to match. Of course, he could be taking the SSRIs because of another diagnosis (anxiety or depression) or because of a misdiagnosis.
  2. He has Obsessive-Compulsive Personality Disorder. This one is close, but I don’t think that he quite meets the full criteria. I’ll admit that he certainly has some strong Obsessive-Compulsive Personality traits though.
  3. He has been misdiagnosed. I suspect that this is the case. There are a too many self-help books, psycho-babble web sites and quacks that diagnose people with personality disorders incorrectly and there are simply too many people who are willing to believe it. Many of these “resources” confuse OCD with Obsessive-Compulsive Personality Disorder, just like Calculator. Given his touch of ego, I suspect he (mis-) diagnosed himself** and arranged medication without every seeing a specialist. Of course, I wouldn’t be surprised if Dr. Psycho had a hand in it as well — that guy is nuts!
I want to touch briefly again on Personality Disorders. If you look at the list of traits associated with the various personality disorders, you’ll recognize many of the behaviors in yourself, your family, your co-workers, and your friends. Everyone has some of these personality traits and quirks — it’s human nature. It becomes a personality disorder when these traits become so pronounced that they interfere with daily life. Remember that these personality traits are deeply ingrained in the very being of the person so they are nearly impossible to treat. Be wary of being diagnosed with a personality disorder by anyone other than a trained psychiatrist or psychologist, especially if they offer a “cure.”

Gail Simone does get bonus points for including Dr. Mid-Nite and having him act as a doctor. A real doctor who’s actually following up with patients.

*The modern understanding of the phrase; not in the original Fruedian meaning.
**My diagnosis? I think the Calculator has many traits of Obsessive-Compulsive Personality Disorder and Narcissistic Pewrsonality Disorder (that ego of his!). There’s some Anti-Social Personality traits mixed in as well, but I’m not sure you could diagnose him with any one particular disorder.

9 Responses to “ Birds of Prey #87: A Medical Review ”

  1. argott
    November 10th, 2005 at 1:43 am

    Jeesus, I feel like I’m learning more about medicine here than listening to Dr.Dean Edell.

    He arranged medication without seeing a specialist? You’re quite witty.

  2. A. H.
    November 10th, 2005 at 2:28 am

    I may be misreading the quote since it’s out of context, but it sounds like his attitude toward riddles is actually a compulsion (if you want to call solving riddles a behavior, which I think is fair), which would speak to him having some OCD symptamatology. That aside, though, why would he want to be medicated for the thing he makes his living on? I almost wonder if he’s got crippling depression/anxiety that he needs the SSRIs for, and Luthor is preventing him from getting his meds so he’s less effective. (Why would he need at least three separate doctors to write scripts for them, anyway? That’s weird.) If he’s getting treated for solving riddles, then taking away his medicine will only make him more likely to poke his nose in Luthor’s business.

    But someone really should tell him it’s not that hard to get SSRIs. It’s not like they’re Oxycontin. :)

  3. Scott
    November 10th, 2005 at 7:32 am
    Official Comment

    I think his riddle solving may meet the first criteria for a compulsion, but I don’t think it meets the second one. He certainly has some characteristics of both conditions, but I’m sure he has either one.

    I think he has different doctors writing SSRI scripts either because 1)he wants an ungodly high dose and doesn’t want any of them to know about it, or 2)he has some docs set up as “back-up suppliers” in case something happens to his original doc…like “suicide.”

    Maybe he should just respond those spam e-mails and order his Proz@c or P@x!l…

  4. David Oakes
    November 10th, 2005 at 2:26 pm

    Lexapro? Lexapro Luvox? And the Calculator didn’t realize that a Superman villain was going to mess with his drug supply?

    I agree that Calc’s symptoms don’t seem to match the diagnosis. But I also have a hard time believing that – even in the tradition of Super-villain ego – the second greatest brain on the planet wouldn’t have made sure to solve such an immediate conundrum. My pre-Med/Evolutionary Geneticist’s two cents, might he have both? (You know these comic book villains, always the over achievers.) His personality is so dedicated to problem-solving that without a chemical “brake”, he focuses to much on some minor detail rather than taking in the big picture? His OCPD makes him the traditional anilytical super-villain, always coming up with plans for everything. But without his meds, his OCD compels him to, oh, put on a garrish purple suit and summon cranes out of dust to implement them.

    (What a boring place the DCU could be if they ever discover Ritilin…)

  5. mike
    November 11th, 2005 at 10:36 am

    He’s not obsessional, he’s manic. Obsessive-combulsive personality and OCD don’t have so much grandiosity. D/C the SSRI’s and get some Lithium on board. Some Risperdal. while we’re at it.

  6. Chris Arndt
    November 11th, 2005 at 4:17 pm

    I miss the dust-made cranes.

  7. badrock
    November 11th, 2005 at 4:21 pm

    First spell personality. Second i think that a better light should be shown on mental illness , for instance Wolverine , Psylock ,sabertooth ,rogue ,and etc. These are all patience of the 0ne DR. with the ability to help them Professor X. Woth his compation and super mental powers he has helped through years of toment and torture if were to guess we ( or the people with mental illnesses) would prefer that traetment over medication. In reality please remember to help and understand friends or family with mental disorders.

  8. Andrew Burton
    November 12th, 2005 at 6:47 pm

    I think you forgot a diagnosis: there’s nothing wrong with him. As House might say, “People lie, supervillains doubly so.”

    Calculator says that he can’t let go of a riddle until it’s solved, yet if memory serves he’s been playing with those sixty-four piece Rubik’s Cube puzzles since Identity Crisis. Given the number of solver programs out there, and that he’s supposed to be one of the DCU’s greatest brains, if those kinds of puzzles bugged him so badly, he’d have an algorithm etched in his brain to solve them.

    There’s nothing wrong with him. He’s just trying to throw Luthor off.

  9. Maxx
    April 21st, 2007 at 11:36 am

    hi

Leave a Reply

« House – Episode 5 (Season 2): “Daddy’s Boy” In Defense of the Calculator »