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Obsessive Compulsive disorder (OCD)

Obsessive-compulsive disorder (OCD) is a disorder whereby a person has repeated, unwanted thoughts, ideas (obsessions) that drive them to do something repetitively (compulsions). Some of these behaviors include repeatedly washing your hands, checking stuffs like the door, gas, etc even when they are either locked or turned off. All these activities get in the way of a person’s daily activities and social interactions.

A lot of us have thoughts that we are unable to control leading to the repetitive behaviors but these actions do not interfere with our daily life. For people with OCD, these thoughts are consistent, and behaviors are rigid. When these actions are not carried out, it interferes with the person’s daily life and cause a lot of distress.  Most people with OCD are aware that their thoughts ( i.e. the things they are obsessing about) are not real but they cannot stop. This happens because they are unable to control these feelings. When ever they decide to stop, they feel so uncomfortable that they may go back to the habit again.

A study done by Dr. Van Den Heuvel and colleagues using brain scans of study participant showed a detailed image of each participant’s cortex. When they compared these images, they observed that the surface area and thickness of certain regions of the cortex were smaller in people with OCD.

They noticed that the parietal lobe (part of the brain thought to be involved in attention, planning, and response inhibition) was thinner in people with this disorder. This contributes to the reoccurring thoughts and repetitive behaviors.

OCD Causes and Risk Factors

The main cause of OCD is not know yet but here are some of the risk factors:Age (most common between teens and young adults).

  1. Gender: It is more common in females than males.
  2. Other mental health conditions such as Anxiety disorders, Depression, Attention-deficit hyperactivity disorder (ADHD), Eating disorders, etc.
  3. Traumatic experiences.
  4. Stress
  5. Pregnancy hormones can trigger OCD. This can affect the mother mostly after birth leading to intense worry over baby’s safety
  6. PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders associated with Streptococcal Infections).
  7. Genetic factors might also play a role in developing OCD. If a family member has OCD, it increases the risk.

SIGNS AND SYMPTOMS

Obsessions

Obsessions are reoccuring thoughts, impulses, or mental images that cause anxiety.

  • Constantly worrying about you or other people getting hurt.
  • Fear of being contaminated by germs/ dirt.
  • Severe concerns about particular order and symmetry
  • Fear of losing stuff that you might need
  • Unwanted sexual or violent thoughts.

Compulsion

Compulsions are behaviors that a person feels driven to carry out over and over again. These activities are usually carried out in order to make the obsessions go away.

  • Ritualistic/ repeated hand washing, showering, etc.
  • Organizing things in a particular order.
  • Constantly double-checking things like door locks, appliances, sockets, etc.
  • Repeatedly cleaning things in your house.
  • Always checking up on loved ones to ensure they are safe
  • Praying excessively or engaging in rituals as a result of fear that something bad might happen.

Yes, we all have some of these habits. We tend to double check the door sometimes, we might even wash our hands a little too often especially in this COVID-19 season, lolz. But in a person with OCD,

  • It’s very hard for them to control their thoughts or behaviors, even when they are aware that it is excessive.
  • They spend more than 1 hour a day on these thoughts or compulsive behavior (time consuming)
  • It can cause severe distress, interfering in the person’s work or social life
  • These persons does not derive pleasure when carrying out these behaviors, but may feel brief relief from the anxiety the thoughts cause

If you are experiencing these symptoms and they are beginning to interfere with your daily life, please see your Doctor.

Treatment for OCD

Some of the recommended treatments/therapies include:

  • Cognitive Behavioral Therapy/ Psychotherapy: This is the most effective treatment for obsessive-compulsive disorder and the general idea is to help you change your thoughts. This is achieved via 2 means:
    • Exposure and response prevention: In this case, your doctor will put you in a situation where you are repeatedly being exposed to your obsession. 
    • Cognitive therapy teaches you healthy ways to respond to this obsession without carrying out the compulsive behavior
  • Medication: The class of medication commonly used are Selective Serotonin Reuptake Inhibitor(SSRIs). Some example of drugs under this category include citalopram (Celexa), escitalopram (Lexapro), fluoxetine (Prozac), fluvoxamine, paroxetine (Paxil), sertraline (Zoloft). These medications might take 4 to 6 weeks to start working. If after this period, you are still experiencing symptoms, your doctor might prescribe you an antipsychotic medication such as aripiprazole (Abilify) or risperidone (Risperdal) which have been proven to be helpful.
  • TMS (Transcranial Magnetic Stimulation).  This is a non-invasive device that uses magnetic fields to stimulate nerve cells in the brain. It usually targets a specific part of the brain that causes the symptoms of OCD. It was approved by FDA in 2018 as an addition in treating  OCD in adults.
  • Relaxation: Relaxation therapies such as meditation, yoga, and massage can help reduce stress related symptoms of OCD .