Obsessive Compulsive Disorder: Symptoms, Causes, Diagnosis and Treatment

Definition:

Obsessive-Compulsive Disorder (OCD), once considered a type of anxiety disorder, is now considered a unique condition.

It is a potentially disabling disease that traps people in endless cycles of repetitive thoughts and behaviors.

People with OCD are plagued by recurrent and distressing thoughts, fears or images (obsessions) that they can not control.

The anxiety (nervousness) produced by these thoughts leads to an urgent need to perform certain rituals or routines (compulsions). Compulsive rituals are performed in an attempt to prevent obsessive thoughts or make them disappear.

Although the ritual may temporarily relieve anxiety, the person must perform the ritual again when the obsessive thoughts return. This cycle can progress to the point of taking hours of the person and significantly interfere with the normal activities of their day to day.

People with OCD may be aware that their obsessions and compulsions are foolish or unrealistic, but they can not stop them.

What are the symptoms of Obsessive Compulsive Disorder?

The symptoms of Obsessive Compulsive Disorder, which are obsessions and compulsions, can vary. Common obsessions include:

  • Fear of dirt or contamination by germs.
  • Fear of causing harm to another.
  • Fear of making a mistake.
  • Fear of feeling ashamed or behaving in a socially unacceptable way.
  • Fear of thinking bad or sinful thoughts.
  • Necessity of order, symmetry or accuracy.
  • Excessive doubt and the need for constant tranquility.

Common compulsions include:

  • Bathe several times a day, the same with showering or washing your hands
  • Refuses to shake hands or touch doorknobs
  • Check things repeatedly, such as locks or stoves
  • Count constantly, mentally or aloud, while performing routine tasks
  • Constantly fixing things in a certain way
  • Eat food in a specific order
  • Being stuck in words, images or thoughts, usually disturbing, that will not disappear and can interfere with sleep
  • Repeat specific words, phrases or sentences
  • Need to perform tasks a certain number of times
  • Collection or hoarding of articles with no apparent value

Causes

Although the exact cause of Obsessive Compulsive Disorder is not fully understood, studies have shown that a combination of biological and environmental factors may be involved.

Biological factors

The brain is a very complex structure. It contains billions of nerve cells called neurons that must communicate and work together to make the body function normally.

Neurons communicate through chemicals called neurotransmitters that stimulate the flow of information from one nerve cell to the next. At one time, it was thought that the low levels of serotonin neurotransmitters were responsible for the development of OCD.

Now, however, scientists believe that OCD arises from problems in the brain pathways that link the areas that deal with judgment and planning to another area that filters messages that involve bodily movements.

In addition, there is evidence that OCD symptoms can sometimes pass from parent to child. This means that the biological vulnerability to develop OCD can sometimes be inherited.

Studies have also found a link between a certain type of infection caused by Streptococcus bacteria and OCD. This infection, if it is recurrent and untreated, can lead to its development and other disorders in children.

Environmental factors

There are environmental stressors that can trigger OCD in people with a tendency to develop the disease. Certain environmental factors can also cause a worsening of symptoms.

These factors include:

  • Abuse.
  • Changes in the situation of life.
  • Disease.
  • Death of a loved one.
  • Changes or problems related to work or school.
  • Sentimental relationship full of worries.

How common is Obsessive Compulsive Disorder?

Approximately 3.3 million adults and approximately 1 million children and adolescents in the United States have OCD. The disorder usually appears for the first time in childhood, adolescence or early adulthood. It occurs approximately the same in men and women, and affects people of all races and socioeconomic backgrounds.

Diagnosis

There is no laboratory test to diagnose OCD. The doctor bases his diagnosis on an assessment of the patient’s symptoms, including how much time the person spends performing their ritual behaviors.

Treatment for OCD

Obsessive Compulsive Disorder will not disappear by itself, so it is important to seek treatment. The most effective approach to treating OCD combines medications with cognitive-behavioral therapy.

Cognitive-behavioral therapy:

The goal of cognitive-behavioral therapy is to teach people with OCD to face their fears and reduce anxiety without performing ritual behaviors (called exposure therapy or exposure and response prevention therapy).

Therapy also focuses on reducing the exaggerated or catastrophic thinking that often occurs in people with Obsessive Compulsive Disorder.

Drug therapy:

  • Antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), such as Luvox, Prozac, and Zoloft, may be useful for treating Obsessive Compulsive Disease. Old drugs – tricyclic antidepressants like Anafranil – could also be used.
  •  Some atypical antipsychotics, such as Risperdal or Abilify, have also been shown to have value for OCD when used alone or in combination with an SSRI.
  • In severe cases of Obsessive Compulsive Disorder and in people who do not respond to medical and behavioral therapy, electroconvulsive therapy (ECT) or psychosurgery can be used to treat the disorder.

During ECT, a small current is passed through electrodes placed on the scalp while the patient is asleep under general anesthesia. This causes a brief seizure.

It has been found that some repeated ECT treatments have been helpful in helping to improve OCD symptoms in some cases.

  • A new surgical form of brain stimulation called deep brain stimulation (ECP) involves the implantation of small electrodes in the brain areas that are part of the brain circuits associated with the symptoms of OCD.

What is the perspective for people with this disorder?

In most cases, Obsessive Compulsive Disorder can be successfully treated with medication, cognitive-behavioral therapy, or both. With ongoing treatment, most people can achieve long-term relief from symptoms and return to normal or near-normal functioning.