Obsessive-Compulsive Disorders
- uyyarvu
- 4 days ago
- 3 min read
When most people think of Obsessive-Compulsive Disorder (OCD), they imagine someone who’s constantly cleaning or afraid of germs. However, that’s only one small piece of the bigger picture, OCD is a much more complex disorder.
Let’s break it down.
According to CAMH, obsessions are intrusive thoughts, urges, or images that replay in the mind over and over again. So much that it becomes hard to control or ignore (CAMH, 2016). While everyone experiences unwanted thoughts from time to time, OCD is different because these thoughts are persistent, distressing, and disruptive to daily life (Singh et al, 2023).
On the other hand, compulsions are repetitive actions or rituals that people take on to suppress or neutralize the unintended obsessions (CAMH, 2016). Unfortunately, the relief is only temporary and individuals are likely to become dependent on these rituals. OCD affects individuals at all stages of life. The symptoms disrupt one’s education, work and relationships (Singh et al, 2023).
The causes of OCD are complex, lacking a clear understanding from the mass population. Researchers believe it arises from a mix of genetics, neurological, cognitive, and environmental factors (Brock et al, 2024). Twin studies estimated a heritability rate of approximately 35-48%. However, the exact gene is unknown. Current neurological research shows the possibility of disruptions in brain circuits or activity. (Brock et al, 2024)
However, biology is not the sole cause behind this disorder. The interpretation of one’s thoughts is crucial as it can be influenced by social constructs and the environment. For example, individuals with OCD may:
- Overestimate danger
- Feel the need to control and overanalyze every thought
- Fear of thinking about something blasphemous (CAMH, 2016)
These fears and obsessions fuel one’s anxiety, while compulsive behaviours temporarily reduce it causing a cycle of repeated patterns.
In children, infections such as PANDAS, (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections), can affect certain regions of the brain, triggering the onset of OCD symptoms. Stress and trauma during pregnancy can also increase the risk of OCD.
Depending on how severe the symptoms are and how much they interfere with daily life, a combination of medication and therapy is suggested as the best treatment practice (Krzyszkowiak et al, 2024).
Let’s review the treatment options in-depth:
The first go-to and effective method is psychotherapy, more specifically exposure response prevention (ERP). ERP helps people gradually face their fears while resisting the urge to perform compulsions. It helps individuals reframe how they interpret intrusive thoughts. Studies show that ERP works better than medication alone, and the positive effects can last for years. (Krzyszkowiak et al, 2024)
When therapy isn’t enough, doctors prescribe serotonin reuptake inhibitors or SRIs. SRIs are a type of antidepressant that helps balance brain chemistry. For OCD, it may often require higher doses and longer treatment periods. Hence therapy is found to be a better starting point and it is more effective in the long run (Krzyszkowiak et al, 2024).
However, there can be cases of severe treatment resistant OCD. These cases would require more intensive treatment options may be (Krzyszkowiak et al, 2024):
1. Deep brain stimulation (DBS): DBS involves implanting small electrodes in specific areas of the brain to help manage certain medical conditions (Mayo Clinic, 2023). These electrodes deliver controlled electrical impulses that can help reduce symptoms. (Mayo Clinic, 2023)
2. Ablative Surgeries: This treatment method is only used in extreme cases. It is used to disconnect overstimulated brain circuits. (Krzyszkowiak et al, 2024)
3. For children who contracted PANDAS, antibiotics may be given as early treatment towards OCD symptoms.
With the right combination of therapy, medication, and support, many individuals regain control and lead full, balanced lives.
References
Brock, H., Rizvi, A., & Hany, M. (2024, February 24). Obsessive-compulsive disorder.
StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK553162/
Krzyszkowiak, W., Kuleta-Krzyszkowiak, M., & Krzanowska, E. (2019). Treatment of
obsessive-compulsive disorders (OCD) and obsessive-compulsive-related disorders (OCRD). Psychiatria Polska, 53(4), 825–843. https://doi.org/10.12740/pp/105130
Mayo Foundation for Medical Education and Research. (2023, September 19). Deep Brain
stimulation. Mayo Clinic. https://www.mayoclinic.org/tests-procedures/deep-brain-stimulation/about/pac-20384562
Centre for Addiction and Mental Health (CAMH). Obsessive-Compulsive Disorder. CAMH. (2016).
Singh, A., Anjankar, V. P., & Sapkale, B. (2023, November 17). Obsessive-Compulsive Disorder
(OCD): A Comprehensive Review of Diagnosis, Comorbidities, and Treatment Approaches. Cureus. https://assets.cureus.com/uploads/review_article/pdf/200641/20240724-319105-pa8khf.pdf
