Obsessive Compulsive Disorder (OCD) is a mental disorder that prompts a person to repeat certain actions or think certain thoughts on a loop. While the person may be well aware of the behavior, they can’t stop themselves from repeating the action – much like Shakespeare’s Lady Macbeth who is obsessed with washing the blood off her hands! Daily life takes a severe hit as the OCD behavior engulfs their time and energy.
Symptoms Of OCD
OCDs manifest as obsessions with a certain thought, image, or impulse, or compulsions to perform a certain action. People with OCD may be found washing hands continuously, arranging and rearranging things “perfectly,” or repeatedly thinking thoughts that are otherwise considered taboo. Cleaning up continuously because of a fear of germs, counting obsessively, or checking and rechecking things (say, whether a light has been switched off or a window is shut) are also common OCD behaviors. People wth OCDs may also have tic disorders, causing them to blink, jerk, shrug, grunt, or clear their throats repeatedly.
Contrary to what internet memes would have us believe, straightening something askew,
The symptoms tend to ebb and flow, often reducing over time; disappearing for a while before making a reappearance; or even worsening.
What Causes OCD?
Like many other mental disorders, the causes of OCD are still understood clearly. Some damage in the brain circuitry is suspected to be a cause, but this is still a gray area. Some other factors that precipitate
Interestingly, even in people not related to each other in any way, mutation of a certain gene that regulates serotonin levels is shown to cause OCDs.3 Serotonin is a hormone that serves many functions such as mood, behavior and appetite regulation in the body. More specifically, it plays a role in suppressing obsessive behavior in healthy adults.4
In one study of pediatric and adolescent subjects, OCDs were found to develop very rapidly after a severe streptococcal infection.
Children who have suffered some form of childhood trauma and abuse seem to be at greater risk of developing OCD later in life. Even in people who have been successfully treated for OCD, an extremely stressful situation can cause a relapse.6
Treatment For OCDs
Psychotherapy, medication, or a mix of both is usually recommended for treating OCDs. But in most cases of OCDs, therapy, especially Cognitive Behavioral Therapy (CBT), is the first line of treatment. One specific type of CBT called Exposure Response Prevention has been proven to be effective in both children and adults.
Drugs that work on the brain, particularly on the serotonin receptors, have been used effectively to treat OCD. These medicines work by suppressing the serotonin pathway that prompts patients to practice their ritual-like behavior.8
About a third of people with OCDs also have some form of clinical depression. In such cases, therapy for OCDs alone may be insufficient.12 Deep brain stimulation (DBS), involving electrical stimulation of specific parts of the brain, is emerging as a potential procedure here as well as in OCD which is treatment resistant. In one study, DBS was found to resolve symptoms of both depression and OCD within six months’ time.13 Further clinical trials will help to firm up the role of this technique.
|↑1||Obsessive-Compulsive Disorder, National Institute of Mental Health.|
|↑2||Abramowitz, Jonathan S., Steven Taylor, and Dean McKay. “Obsessive-compulsive disorder.” The Lancet 374, no. 9688 (2009): 491-499.|
|↑3||Menzies, Lara, Sophie Achard, Samuel R. Chamberlain, Naomi Fineberg, Chi-Hua Chen, Natalia Del Campo, Barbara J. Sahakian, Trevor W. Robbins, and Ed Bullmore. “Neurocognitive endophenotypes of obsessive-compulsive disorder.” Brain 130, no. 12 (2007): 3223-3236.|
|↑4||Baumgarten, H. G., and Z. Grozdanovic. “Role of serotonin in obsessive-compulsive disorder.” The British journal of psychiatry. Supplement 35 (1997): 13-20.|
|↑5||Moretti, Germana, Massimo Pasquini, Gabriele Mandarelli, Lorenzo Tarsitani, and Massimo Biondi. “What every psychiatrist should know about PANDAS: a review.” Clinical Practice and Epidemiology in Mental Health 4, no. 1 (2008): 1.|
|↑6||de Silva, Padmal, and Melanie Marks. “The role of traumatic experiences in the genesis of obsessive–compulsive disorder.” Behaviour Research and Therapy 37, no. 10 (1999): 941-951.|
|↑7||Huppert, Jonathan D., and Deborah A. Roth. “Treating obsessive-compulsive disorder with exposure and response prevention.” The Behavior Analyst Today 4, no. 1 (2003): 66.|
|↑8||Jenike, M. A. “Clinical practice. Obsessive-compulsive disorder.” The New England journal of medicine 350, no. 3 (2004): 259.|
|↑9||Fux, Mendel, Joseph Levine, Alex Aviv, and R. H. Belmaker. “Inositol treatment of obsessive-compulsive disorder.” American Journal of Psychiatry 153, no. 9 (1996): 1219-1221.|
|↑10||Sayyah, Mehdi, Hatam Boostani, Siroos Pakseresht, and Alireza Malayeri. “Comparison of Silybum marianum (L.) Gaertn. with fluoxetine in the treatment of Obsessive− Compulsive Disorder.” Progress in Neuro-Psychopharmacology and Biological Psychiatry 34, no. 2 (2010): 362-365.|
|↑11||Hanstede, Marijke, Yori Gidron, and Ivan Nyklícek. “The effects of a mindfulness intervention on obsessive-compulsive symptoms in a non-clinical student population.” The Journal of nervous and mental disease 196, no. 10 (2008): 776-779.|
|↑12||Overbeek, Thea, Koen Schruers, and Eric Griez. “Comorbidity of obsessive-compulsive disorder and depression: prevalence, symptom severity, and treatment effect.” The Journal of clinical psychiatry 63, no. 12 (2002): 1106-1112.|
|↑13||Aouizerate, Bruno, Emmanuel Cuny, Corinne Martin-Guehl, Dominique Guehl, Helene Amieva, Abdelhamid Benazzouz, Colette Fabrigoule et al. “Deep brain stimulation of the ventral caudate nucleus in the treatment of obsessive-compulsive disorder and major depression: case report.” Journal of neurosurgery 101, no. 4 (2004): 682-686.|