Understanding OCD
By Satya Vasan
Highlights:
Obsessive-compulsive disorder (OCD) is an anxiety disorder that is signaled by continuous thoughts that lead to distinctive behaviors. For example, a person who fears getting sick may be compelled to wash their hands a certain way. Additionally, a person who fears losing things may count them a specific number of times.
Overview of OCD
OCD affects children and adults. It is 1.8% likely to be found in women, and 0.5% likely to be found in men. Furthermore, OCD is known to affect 1.2% of the population of the United States and 2% of the world’s population (“Obsessive-Compulsive Disorder (OCD), n.d.). There are many varieties of OCD and symptoms vary within each individual as each person responds differently to its triggers:
Contamination OCD is when a person is anxious about being infected with germs. They can be found cleaning and handwashing excessively, changing their clothes and showering frequently, and discarding objects that they believe to be contaminated.
Perfection OCD is the desire to get things “just right." This is characterized by an extreme need to keep things organized and an urge for symmetrical activities. An example of a symmetrical activity is if somebody itches their right leg they will itch their left leg.
Doubt and Harm OCD is where someone checks and rechecks behaviors and actions because they have the fear of harming the people around them because of their own carelessness. Some behaviors that characterize doubt and harm OCD are checking and rechecking of stoves, lights, windows and retracing their every move. (MedCircle, 2020)
Forbidden Thoughts OCD is demonstrated through uncomfortable and unwanted thoughts of violent, religious, or sexual nature. People with Forbidden Thoughts OCD constantly worry about being a bad person and have recurring inappropriate thoughts.
Overall, there are a variety of treatment options to choose from to help combat the struggles of OCD. Medications are known to be 40%-70% effective in reducing OCD compulsions (MedCircle, 2020). Selective serotonin reuptake inhibitors, which are antidepressants that help reduce OCD symptoms, are a top choice among patients and physicians. A type of cognitive behavior therapy called exposure and response prevention focuses on bringing about the obsessions and learning how to let them sit there without acting upon them. Transcranial Magnetic Stimulation uses electrical impulses to target and stimulate areas of the brain, such as the pre-supplementary motor area, which can aid in reducing brain excitability which is seen in people with OCD.
Clearly, there are a lot of options to choose from. However, it is important to discuss the benefits and drawbacks of each option with a trusted team that includes psychiatrists, psychotherapists, and your primary care physician.
The Science Behind OCD
To switch subjects, we will now be discussing how OCD affects the brain. Simply, OCD brains have less function in areas that regulate impulse control. Specifically, OCD disturbs communication between two crucial areas of the brain: the prefrontal cortex and the ventral striatum. The prefrontal cortex helps people focus, plan for the future, and manage emotional reactions. The ventral striatum is involved in decision making and rewarded behavior. The prefrontal cortex and the ventral striatum are the “dynamic duo” of motivating us to make good decisions. However, OCD disrupts theis communication between the dynamic duo: OCD encourages compulsive behavior. This is further accomplished when OCD reduces the amount of grey matter present in the brain since grey matter is necessary to control impulses, manage our five senses, and process information. OCD reduces grey matter in four notable areas: the medial surface on the superior post frontal gyrus, the medial orbitofrontal cortex, the frontal operculum, and the OFC. The lack of grey matter on the medial surface of the superior post frontal gyrus prevents suppression of impulses and logical responses to thoughts; the lack of grey matter on the medial orbitofrontal cortex opens up the door so worries and fear will overwhelm the mind; the lack of grey matter on the frontal operculum urges compulsive behavior and the lack of great matter on the OFC urges unnecessary activities (“How Does Obsessive Compulsive Disorder Affect the Brain?”, n.d.).
Conclusion
Ultimately OCD, formally known as obsessive-compulsive disorder, is the continuation of responding to impulses that come from distressing thoughts. There are many different types of OCD, ranging from contamination OCD to harm and doubt OCD. There are many different types of treatments including medications, cognitive behavioral therapy, and transgenic magnetic stimulation of the brain. OCD can affect many different parts of the brain but ultimately leads to continuous irrational decision making.
References
How Does Obsessive Compulsive Disorder Affect the Brain? StoneRidge: Center for Brains. (2020, October 26). https://pronghornpsych.com/how-ocd-affects-the-brain/.
U.S. Department of Health and Human Services. (n.d.). Obsessive-Compulsive Disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/.
What Are the 4 Types of OCD? MedCircle. (2020, February 26). https://medcircle.com/articles/what-are-the-4-types-of-ocd/.
What Is Obsessive-Compulsive Disorder? (n.d.). https://www.psychiatry.org/patients-families/ocd/what-is-obsessive-compulsive-disorder.
What is OCD? International OCD Foundation. (n.d.). https://iocdf.org/about-ocd/.