What is Obsessive Compulsive Disorder?
Definition: Obsessive Compulsive Disorder (OCD), is an anxiety disorder with traits of prolonged, excessive worries about life circumstances. These worries are described as absurd, unusual, intense and frightening. Patients try to avoid or ignore these thoughts using ritualized actions, or compulsions, to direct their focus away from these thoughts.
Explanation of Obsessive Compulsive Disorder: This psychiatricdisorder affects children, adolescents and adults. Persons affected with this type of anxiety disorder have repeated, unwanted thoughts or ideas. When trying to void these intrusive thoughts, they’re anxiety becomes unbearable, driving them to develop repetitive behaviors to control sensations or obsessions. Eventually, the avoidance behaviors become compulsive, often because they keep the patient’s mind focused off the obsessive thinking. Patients believe they can control bad things from happening with the repetitive behaviors.
OCD sufferers are unable to tell when their thoughts and feelings are imaginary or real, or whether they are appropriately acting on them.Approximately 40 of the population experiences ODC behaviors in stressful periods of their lives. This mental disorder is more prevalent than manic depression (Bi-Polar disorder), or Schizophrenia. People from every ethnic group, age or financial status suffer from OCD.
What is the Cause of OCD?
The complete picture of the causes of obsessive compulsive disorder are not fully understood and still under active study. There are two areas of scientific study that have significant theories at present. Scientists are studying the effects of fear, anxiety and environmental situations on the brain, and their relationship to the onset of OCD.
Physiological or Biological Theory: Natural changes in the chemistry of the body and brain functions are thought to cause OCD under a set of specific circumstances. Scientists have not yet identified the specific genes that effect these brain dysfunctions but the genetic component remains a possible problem.
Environmental Factors that May Cause OCD: Researchers have found evidence that is currently being studied that links certain infections to a trigger in the body’s defense systems. It is suggested that these triggers to defensive antibodies of our immune systems can be a factor in the development of brain conditions that result in OCD when the infection is repeated during childhood.
Risk Factors for OCD: Having a parent or family member with a diagnosis of ODC increases the likely-hood that a person will have OCD. This family component points to a genetic factor in the disease.
Effects of Stress Relating to OCD: Stressful life events, traumatic events and a tendency to react strongly to stress will increase risk of OCD. Overly worrying during times of stress can trigger emotional distress, rituals and intrusive thoughts, which result in OCD symptoms.
Obsessive Compulsive Disorder Symptoms
Experts in the field of studying brain function believe OCD is caused by a chemical imbalance in the brain that blocks effective communication processes between the frontal lobe and deeper areas of the brain. These deeper areas function with behavior triggers. Overactivity of these areas of the brain, like excessive worrying, triggers the feeling of alarm. With overuse, brain cells get stuck in “alarm mode”.
Research shows the relationship between an overactive orbital cortex, located under the frontal lobe, always occurs in OCD patients. They devop rigid thinkging and repetitive actions when this orbital cortex is overactive.
Common phobias connected with this disorder are fear of germs and the fear of intruders. Two observable symptoms are repetitive hand-washing and opening-shutting, or locking-unlocking doors. Even though these behaviors are overpowering and OCD sufferers must carry them out, they are ashamed of their compulsions and try to keep them hidden. They will not seek treatment and continue to hide their problems from family and friends until the compulsions are so ingrained, they cannot reverse the process. It can often take up to ten years for a person with OCD to get dysfunctional enough for family or friends to take notice and help get professional treatment.
Some people with OCD have a condition called Tourette Syndrome, their behaviors include uncontrolled swearing and facial or movement tics. If left untreated for a long-period of time, the symptoms will worsen and lessen with stress, but increase with age. Another coping mechanism of OCD is having everything orderly and symmetrical. This focus interrupts the involuntary, harmful thoughts that torment a person with OCD.
Obsessive Compulsive Disorder in Children
During recent scientific studies, a link between OCD and patients who had strep throat as children has brought some hope for very young OCD sufferers. Added to genetic causes, a child may be susceptible to an attack of strep antibodies in specific parts of their brains. These attacks are actually from antibodies made within their own bodies to protect them from an invading disease, such as strep. Children are seen to demonstrate symptoms like phobias or irrational fears during this infection. Often these fears disappear over time, but repeated infections will cause a full blown OCD disorder.
Some children treated early with antibiotics during strep infections have lessening OCD symptoms. Treatment at a young age may avoid increased symptoms later in life. These conditions are also linked with levels of seratonin in the brain. Seratonin is a chemical that acts as a brain messenger linked to emotion. This link helped to find medications that control anxiety and provide a feeling of well-being to reduce OCD thinking and related behaviors. Using therapy with the drug treatment is an effective way to help kids and adults with OCD.
Treatments Used for Obsessive Compulsive Disorder
Some drugs have been approved to treat Obsessive Compulsive Disorder when used in combination with a therapy called cognitive behavioral therapy. This combination has proven to be more effective than either treatment by itself.
Cognitive Behavioral Therapy
This treatment focuses on changing an individual’s thoughts or cognitive patterns. Based on the psychosocial therapeutic assumption that maladaptive thinking patterns cause negative emotions and maladaptive behaviors, changing wrong thinking can change the emotional state and correct negative behaviors.
Methods Used in Cognitive Behavioral Therapy: This is an action-oriented therapy requiring an element of trust relationship between patient and therapist. The patient must be motivated to seek truth and expose the inaccuracy of some beliefs that may trigger worry and wrong behaviors.
Cognitive Rehearsal: The patient works with a trained thrapist in a step-by-step process to imagine a difficult situation, rehearses what to do in dealing with it. As the patient continues to rehearse appropriate responses, when real-life situations present themselves, the new steps the patient takes replace old habits and compulsive behaviors.
Behavioral Homework: Patients try out new coping mechanisms to stresses they encounter and return to therapy sessions to discuss the outcome of using new solutions to stressful events.
Validity Testing: Therapist works with the patient to self-test if their thoughts or “schemas” are real or valid. They are encouraged to defend or produce evidence of their thoughts. The faulty nature of these thoughts are recognized when the patient sees the rationale cannot be proven.
These are just a few of the techniques that therapists use during their cognitive behavioral therapy sessions with OCD patients. Combined with medications to relieve stress that can help the patient work through therapy, the effects and symptom of OCD ca be manageable.
Medication – Drug Therapy for OCD
Anti-depressants are often the first choice in treatment as they work better than anti-anxiety medications for most OCD patients. Effects only begin working after 10-12 weeks. If the dose starts off low and is continually increased over time, the side effects are avoided for most people. Some people are at risk with these medications, including children, teens and some adults. It is important to set up monitoring scenarios during the first few months.
Prozac, Luvox, Paxil and Zoloft are common names for some medications that are serotonin reuptake inhibitors. They affect the levels of serotonin in the brain. They must be taken for at least 12-weeks before it can be evaluated as being effective in treatment.
If the OCD is severe and maybe life-threatening, a last phase of treatment may involve brain surgery. Only one in three severely impaired OCD patients can be helped with this form of surgery. The surgeon will remove the cingulate cortex to reduce severe symptoms. Side-effects from the surgery include seizures, personality changes and some loss of organizational skills.
Only approximately 20 percent of OCD patients are not able to be helped with the combination of therapy and medication. Most patients that continue with treatment will go into complete remission. Those in the twenty percent that have no success may have to be hospitalized. The National Institute of Mental Health is sponsoring other treatment modality research such as deep brain stimulation and others to heal those OCD patients who do not respond to present treatments. There are also managed care clinical settings that help more chronic cases of OCD that cannot be managed in a community setting.