Obsessive Compulsive Disorder (OCD)

About OCD, What Causes OCD, Its Symptoms & Cure

What is Obsessive Compulsive Disorder?

Obsessive Compulsive Disorder is one of the Anxiety Disorders that affects as many as three in a hundred people, irrespective of gender and social and cultural background. You may go undiagnosed for many years, partly due to a lack of knowledge about the condition, and partly due to feelings of shame and guilt associated with this illness.

We all experience symptoms akin to OCD at one time or another, especially when undergoing immense stress. But if you are suffering from OCD it can have a devastating effect on all aspects of your life, be it work, social life or relationships.

The World Health Organization (WHO) ranks OCD as the tenth most disabling illness of any kind, in terms of lost earnings and diminished quality of life.

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OCD traps you in an endless cycle of repetitive thoughts and behaviors. You are plagued with recurring and distressing thoughts, fears or images (Obsessions) and it’s beyond your control to stop them.

The nervousness that is produced due to these thoughts leads to a compulsive need to perform certain actions or rituals (Compulsions). The compulsive rituals are performed in an attempt to prevent the obsessive thoughts or make them go away.

Most people who have OCD are aware that their obsessions and compulsions are irrational, yet they feel powerless to stop them. Some spend hours at a time performing complicated rituals involving hand-washing, counting, or checking to ward off persistent, unwelcome thoughts, feelings, or images. Others live in the fear that their thougths will cause harm to someone or throw something out by mistake.

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Causes of OCD

A condition similar to OCD has been recognized for almost 300 years. Each stage in the history of OCD has been influenced by the intellectual and scientific climate of the period.

Psychoanalytical Theory

Most part of the 20th century was dominated by psychoanalytic theories of OCD.

According to Psychoanalytic Theory, Obsessions and Compulsions reflect maladaptive responses to unresolved conflicts from early stages of psychological development. The symptoms of OCD represent the patient’s unconscious conflict for control over impulses that are undesirable at a conscious level.

However, this theory soon lost favor, as it was not grounded on evidence based on the studies of brain.

Although the theory does shed light on the content of the patient’s obsessions, it has not contributed enough towards the understanding of the underlying processes and therefore has not led to any effective remedies for the condition.

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Learning Theory

The Learning Theory models of OCD have received better acceptance owing to the success of Behavior Therapy.

The Behavior Therapy does not concern itself with the psychological origins or meaning of obsessive-compulsive symptoms. The theory is based on the premise that Obsessions and Compulsions are the result of abnormal learned responses and actions.

Obsessions are produced when a generally neutral object ( e.g , staircase) is associated with a trigger that produces fear (e.g, seeing your sibling falling off the staircase and getting badly injured). Staircase thus becomes connected with fear of injury even though it played no causative role.

Compulsions ( e.g not using the staircase at all or using it only if someone holds your hand) are formed as you try to reduce the anxiety produced by the learned fearful stimulus ( in this case, staircase).

Avoidance of the object reinforces the fear and perpetuates a vicious cycle of OCD.

It became quite apparent that the learning theory does not account for all aspects of OCD. It does not tell us why some compulsions persist when they produce, rather than reduce, anxiety.

Moreover, this theory cannot satisfactorily explain the obsessive-compulsive symptoms that develop as a result of a brain injury. These limitations notwithstanding, the effectiveness of a Behavior Therapy technique referred to as exposure and response prevention has been confirmed in numerous studies.

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Chemical and Brain Dysfunction

One cause that is gaining ground concerns the probability that there is a level of brain dysfunction in many OCD sufferers. But that is not to suggest that people with this problem have damaged brains or their ability to reason is in any way inferior to those who do not have OCD.

Research suggests that chemical messenger, Serotonin, may have a significant role to play in the development of OCD. An imbalance in the Neurotransmitter, or brain chemical, Serotonin could also be to blame.

Serotonin and other Neurotransmitters travel from nerve cell to nerve cell across fluid-filled gaps called synapses. Serotonin is thought to be involved in regulating everything from anxiety to memory to sleep.

When Serotonin is released by one cell, it enters another cell through a special area of the cell membrane called a Receptor.

But in OCD, some receptors are thought to block Serotonin from entering the cell. This leads to a deficiency of the Neurotransmitter in key areas of the brain.

Brain scans have revealed that people with OCD have some anomaly within the brain, especially in the Orbital Cortex (the part of the brain above the eyes) and in deeper structures such as Basal Ganglia and Thalmus.

Research suggests some irregularity in the communication between these parts of the brain. It is believed that a rise in the anxiety level of an OCD patient results in a circuit of inappropriate response in these areas of the brain.

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Symptoms of OCD

OCD has three important stages:

1. Unwanted, intrusive and distressing thoughts that plague you all the time (obsessions)
2. The anxiety, fear, and helplessness you feel as a result of these thoughts
3. The repetitive actions or things you do to ease or reduce your anxiety

Common Obsessions

• Thoughts – distasteful, appalling and even blasphemous words or phrases plague you constantly. Try as you much not to think of them, they just leave you. For instance, you may worry that germs, dirt or cancer has infected you.

Common Compulsions

• Controlling Obsessional Thoughts – you try to counter or neutralize your obsessive thoughts with actions like counting, praying or repeating a special word over and over again. You feel that this would prevent any unfortunate incidents from happening.

• Rituals – repeatedly washing hands, bathing, or cleaning household items, often for hours at a time.

These obsessions make you susceptible to a gamut of emotions including: anxiety, fear, guilt, disgust, and depression.

In order to ease your anxiety and cope with these emotions you perform certain actions or rituals repeatedly. These rituals or actions are aimed at preventing or reducing distress or preventing some dreaded event or situation.

But the problem lies in the fact that these actions are either not connected in a realistic way with what they are designed to neutralize or prevent; or are clearly excessive.

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Treating Obsessive Compulsive Disorder

Obsessive-compulsive disorder treatment can sometimes be difficult, and it may not offer a cure. However, onClick="javascript:urchinTracker('/goolefile/rootc.html');" target="_blank"> OCD Treatment can help you bring symptoms under control so that they don't rule your daily life.

Generally speaking, OCD treatment has two main components:

• Psychotherapy
• Medications.

Psychotherapy

OCD is treated with the Cognitive-Behavior Therapy (sometimes referred to as Behavior Therapy) recommended in the Expert Consensus Guidelines for OCD.

The name of the treatment is Exposure and Response Prevention (ERP). It aims to give the person contact with the object, situation, or obsession that raises anxiety or discomfort (exposure), while the person refrains from performing the compulsive behavior or mental ritual (response prevention).

As a result, anxiety decreases, or habituates. ERP weakens, and eventually can eliminate the urge to do compulsions. ERP also weakens the ability of the object, situation, or thought to trigger anxiety or discomfort

Medications

Medications that inhibit Serotonin reuptake have been found to be effective in the treatment of Obsessive-Compulsive Disorder. The advent of selective Serotonin reuptake inhibitors (SSRIs) has changed the treatment of obsessive-compulsive disorder dramatically. These medications have fewer side effects.

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Famous people with OCD

Famous sufferers may have included the biologist Charles Darwin, the pioneer nurse, Florence Nightingale, and John Bunyan, author of Pilgrim's Progress. More currently, Academy Award-winning writer, actor and director Billy Bob Thornton, actress Jessica Alba and football stars Paul Gascoigne and David Beckham have candidly discussed their battle with the disorder.

Perhaps most famous of all was the twentieth century billionaire aviator and entrepreneur Howard Hughes (“The Aviator”) who, in spite of his immeasurable financial wealth, spent his final days both mentally and physically incarcerated by his own contamination terrors and elaborate cleaning rituals.

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