Dr. Khalid is a health researcher and science writer with a Ph.D. in clinical research.
How Do You Perceive OCD?
OCD (obsessive-compulsive disorder) is a mental health complication that intrudes on thoughts and perceptions while triggering painful compulsions and obsessions. The repeated imaginations of OCD patients with unwanted thoughts increase the level of their distress and anxiety to many folds. The repetitive behaviors of OCD patients reflect their impatience and irritations that unavoidably prompt them to overcome their disturbed state of mind. The stigma of the OCD disorder forces the affected patients to hide their symptomatology (Seibell & Hollander, 2014). Their introverted attitudes become the cause of their social isolation. The agony of the ethnically underprivileged OCD people reflects their extreme stress and anxiety. The hyperfunction of the striatum, thalamus, anterior cingulate, and orbitofrontal cortex of OCD patients impacts their cognition and day-to-day activities. Psychotherapists utilize antipsychotic medication for the medical management of OCD. The neurosurgical and neurological techniques, including deep brain stimulation and gamma knife radiation, also help to control OCD complications to a limited extent.
How Does OCD Impact your Life?
You may experience one or more of the following symptoms under the influence of obsessions (Reddy et al., 2017).
- Increased distress
- Recurrent thoughts
- Fear of developing AIDS/HIV
- Extreme irritation from bodily secretions
- Irrelevant sexual apprehension regarding family friends or strangers
- Visualization of images
- Visualization of maltreatment with children
- Sexual abuse perception
- Fear of creating harm to close friends or relatives
- Suicidal or homicidal ideations
- Visualization of mutilated bodies
- Fear of committing blasphemy
- Fear of engaging in salacious activities
- Uncertainty regarding locking of doors and other day-to-day activities
- Urge for adjusting symmetry in objects
- Magical thought process (for example, the fear of an untoward accident in the absence of a scenario)
- Attempts to memorize advertisements
- Extreme superstitions
- Believe in specific color combinations
- Moral confusions
- Perceptions of violent accidents
- Fear for infection
Your mind and body will force you to overcome the obsessions through compulsions. Accordingly, you could develop any of the following symptoms (Reddy et al., 2017).
- Repetitive behaviors or acts to subdue the obsessions
- Unrealistic and illogical measures to overcome the anxiety
- Excessive washing of objects or hands
- Excessive bathing
- Excessive cleaning of the room
- Repeated checking of locks
- Repeated self-checks due to the fear of causing harm to self or others
- Repeated counting of objects or currency
- Urge for confession
- Excessive engagement in religious activities
The admixture of obsessions and compulsions drastically deteriorates the occupational and social outcomes of OCD patients. Some of the commonly reported intrusions include religious apprehensions and fears related to physical abuse and aggression (Brock & Hany, 2020). The compulsive behaviors rely on compensatory mechanisms that the OCD patients adapt to fight their unbearable obsessions. Eventually, the OCD patients seek reassurance or repeatedly rearrange their tasks to divert their attention from the reported presumptions.
What are the Causes of OCD?
Research studies so far have not gathered conclusive evidence regarding the causes of OCD. However, a few researchers believe in the impact of environmental and genetic factors on the development of OCD manifestations. Stressful circumstances and traumatic experiences that create a socioeconomic crisis also increase the risk of OCD (IQWiG, 2006). The evidence-based scientific literature does not substantiate any causal relationship between OCD and posttraumatic stress disorder. Conscientious attitudes and fearful habits in many situations could increase the risk of OCD. Adults, adolescents, and children of various age groups prevalently experience OCD at different stages of their lives.
What are the Diagnostic Methods to Confirm OCD?
OCD assessment relies on the below-mentioned diagnostic methods (Reddy et al., 2017).
- A thorough physical assessment helps to investigate the clinical complications that could have caused OCD symptoms in the affected patient.
- A comprehensive psychological examination helps to investigate the behavioral pattern and feelings of OCD patients.
- The psychotherapists usually deploy the Y-BOCS (Yale-Brown Obsessive-Compulsive Scale) to evaluate the severity of OCD in children and adults.
What is the Pathophysiology of OCD?
OCD develops with functional defects in parietal lobe regions, brainstem, thalamus, amygdala, striatum, dorsolateral prefrontal cortex, basal ganglia, and cingulated cortex (Gaikwad, 2013). The human serotonin transporter gene, in some cases, leads to dysregulation of serotonin that triggers anxiety in the affected patients. Children who experience OCD have hyperactive orbitofrontal-subcortical regions, probably due to their neuroanatomical abnormalities. Head injuries, in a few scenarios, also trigger the development of OCD manifestations. The sustained defects in the dorsolateral prefrontal cortex of OCD patients not only impact their goal-oriented behaviors but also reduce their information processing abilities. The abnormality in the anterior cingulate cortex impacts the decision-making abilities and motivation levels of OCD patients. They face substantial difficulty in action planning and memorizing the facts (Gaikwad, 2013). The activation of closed-loop circuits under the impact of OCD also deteriorates the information processing pathways. The defects in visual and spatial memory of the OCD patients attribute to the dysfunction of their parietooccipital junction and left inferior parietal cortex. The striatum dysfunction deteriorates the procedural learning mechanisms and information segregation capacity of OCD patients. Amygdala dysfunction triggers obsessive thoughts and anxiety in OCD patients. The reduction in executive function and action planning is the direct outcome of thalamic dysfunction. OCD patients encounter sustained defects in their brainstem inputs (Gaikwad, 2013). The inappropriate communication between the thalamus, caudate nucleus, and orbital frontal cortex deteriorates their brain activity that not only triggers anxiety but also disrupts object-oriented behavior. The defects in the dorsolateral prefrontal cortex and fusiform gyrus of the OCD patients substantially elevate their distraction while reducing their attention span and face recognition ability (Liu et al., 2017). OCD patients also experience a marked reduction in their visuospatial skills and nonverbal memory.
What are the Possible Treatment Options for OCD Management?
The following treatment modalities help to reduce the symptoms and complications of obsessive-compulsive disorder (Pittenger et al., 2005).
- The behavioral treatment option relies on ERP (exposure and response prevention) therapy that helps in controlling the stress and anxiety of OCD patients. The psychotherapist exposes the OCD patients to increased levels of anxiety to enhance their strength of overcoming preventable mental compulsions and obsessions. CBT (cognitive behavioral therapy) in many scenarios also helps OCD patients to defeat their symptoms.
- The administration of tricyclic antidepressants or serotonin reuptake inhibitors to OCD patients restricts their serotonin reuptake that helps in controlling their anxiety and hyperactive behaviors.
- Opioid agents initiate serotonergic neurons’ disinhibition that restricts the accumulation of glutamate in the cortex. This type of augmentation therapy is beneficial for OCD patients who do not respond to routine treatment interventions.
- The neurosurgical interventions for OCD management rely on the latest techniques, including gamma knife coagulation for brain lesions, local ablation via radioactive seeds, and standard craniotomy.
- The less invasive techniques for OCD management include vagal nerve stimulation, transcranial magnetic stimulation, and electroconvulsive therapy.
Brock, H. & Hany, M., 2020. Obsessive-Compulsive Disorder (OCD). In: StatPearls. Treasure Island (FL): StatPearls Publishing.
Gaikwad, U., 2013. Pathophysiology of Obsessive-Compulsive Disorder: Affected Brain Regions and Challenge Towards Discovery of Novel Drug Treatment. IntechOpen.
IQWiG, 2006. Obsessive-compulsive disorder: Overview. In: InformedHealth.org. Cologne, Germany: Institute for Quality and Efficiency in Health Care.
Liu, Q. et al., 2017. Pathophysiology of refractory obsessive-compulsive disorder: A study of visual search combined with overactive performance monitoring. Medicine, 96(1).
Pittenger, C. et al., 2005. Clinical Treatment of Obsessive-Compulsive Disorder. Psychiatry, 2(11), pp. 34-43.
Reddy, Y. C. J., Sundar, A. S., Narayanaswamy, J. C. & Math, S. B., 2017. Clinical practice guidelines for obsessive-compulsive disorder. Indian Journal of Psychiatry, 59(1), pp. S74-S90.
Seibell, P. J. & Hollander, E., 2014. Management of Obsessive-Compulsive Disorder. F1000Prime Rep, 6(68).
This content is for informational purposes only and does not substitute for formal and individualized diagnosis, prognosis, treatment, prescription, and/or dietary advice from a licensed medical professional. Do not stop or alter your current course of treatment. If pregnant or nursing, consult with a qualified provider on an individual basis. Seek immediate help if you are experiencing a medical emergency.
© 2022 Dr Khalid Rahman