OCD obsessive compulsive disorderCauses, Symptoms and Treatment for OCD
Obsessions are intrusive, irrational thoughts - unwanted ideas or impulses that repeatedly well up in a person's mind. Again and again, the person experiences disturbing thoughts, such as "My hands must be contaminated; I must wash them"; "I may have left the gas stove on"; "I am going to injure my child", "Did I leave the garage door open", "checking to see if the doors are locked multiple times", "Twitches". On one level, the sufferer knows these obsessive thoughts are irrational. But on another level, he or she fears these thoughts might be true but cannot let go of them. Trying to avoid such thoughts creates great anxiety.
Compulsions are repetitive rituals such as hand washing, counting, checking, hoarding, or arranging. An individual repeats these actions, perhaps feeling momentary relief, but without feeling satisfaction or a sense of completion. People with OCD feel they must perform these compulsive rituals or something bad will happen. Or they are simply feel a bondage to these thoughts much in the same way as an addiction.
Most people at one time or another experience obsessive thoughts or compulsive behaviors. Obsessive-compulsive disorder occurs when an individual experiences obsessions and compulsions for more than an hour each day, in a way that interferes with his or her life. When the thoughts and behaviors get to a point of disabling a normal functioning life; it is time to seek help.
Causes of OCD:
A large body of scientific evidence suggests that OCD results from a chemical imbalance in the brain. For years, mental health professionals incorrectly assumed OCD resulted from bad parenting or personality defects.This theory has been disproved over the last 20 years. OCD symptoms are not relieved by psychoanalysis or other forms of "talk therapy," but there is evidence that behavior therapy can be effective, alone or in combination with medication. People with OCD can often say "why" they have obsessive thoughts or why they behave compulsively. But the thoughts and the behavior continue.
People whose brains are injured sometimes develop OCD, which suggests it is a physical condition. If a placebo is given to people who are depressed or who experience panic attacks, 40 percent will say they feel better. If a placebo is given to people who experience obsessive-compulsive disorder, only about two percent say they feel better. This also suggests a physical condition.
Clinical researchers have implicated certain brain regions in OCD. They have discovered a strong link between OCD and a brain chemical called serotonin. Serotonin is a neurotransmitter that helps nerve cells communicate.
OCD also "seems" to have a genetic component to it or at least a familial aspect whereby the obsessive behavior of a parent is likely to show up in some of the children. Again these theories of the causes of OCD are tenuous at best.
Scientists have also observed that people with OCD have increased metabolism in the basal ganglia and the frontal lobes of the brain. This, scientists believe, causes repetitive movements, rigid thinking, and lack of spontaneity. Successful treatment with medication or behavior therapy produces a decrease in the over activity of this brain circuitry. People with OCD often have high levels of the hormone vasopressin. In layperson's terms, something in the brain is stuck, like a broken record.
People with OCD typically react to their disorder:
People with OCD generally attempt to hide their problem rather than seek help. Often they are remarkably successful in concealing their obsessive-compulsive symptoms from friends and co-workers. An unfortunate consequence of this secrecy is that people with OCD generally do not receive professional help until years after the onset of their disease. By that time, the obsessive-compulsive rituals may be deeply ingrained and very difficult to change. Often they have to get to the point of being sick and tired of the ritual. Often people can also hold their families "hostage" to their compulsive behavior; especially if the family is not educated about the illness and doesn't mandate treatment.
How long does OCD last:
OCD will not go away by itself, so it is important to seek treatment. Although symptoms may become less severe from time to time, OCD is a chronic disease. Fortunately, effective treatments are available that make life with OCD much easier to manage. Often these symptoms come and go depending on the level of anxiety in one's life. Some have even reported long periods of remission or have out grown many of the rituals. Sometimes families must go through counseling to learn how to make the best of the behavior of the member suffering from this disease - assuming the case is moderate.
Age as a factor in OCD:
OCD usually starts at an early age, often before adolescence. It may be mistaken at first for autism, pervasive developmental disorder, or Tourette's syndrome, a disorder that may include obsessive doubting and compulsive touching as symptoms. Sometimes it shows up as habits and twitches that are written off as benign behaviors that will be out grown such as facial twitches, blinking, fastidious demands of order and cleanliness; hoarding or sloppiness - all of these "can" be signs of OCD. Like depression, OCD tends to worsen as the person grows older, if left untreated. Scientists hope, however, that when the OCD is treated while the person is still young, the symptoms will not get worse with time.
Other examples of behaviors typical of people who suffer from OCD:
- Repeatedly check things, perhaps dozens of times, before feeling secure enough to go to sleep or leave the house. Is the stove off? Is the door locked? Is the alarm set?
- Fear they will harm others. Example: A man's car hits a pothole on a city street and he fears it was actually a body.
- Feel dirty and contaminated. Example: A woman is fearful of touching her baby because she might contaminate the child.
- Constantly arrange and order things. Example: A child can't go to sleep unless he lines up all his shoes correctly.
- Excessively concerned with body imperfections - insist on numerous plastic surgeries, or spend many, many hours a day body-building.
- Ruled by numbers, believing that certain numbers represent good and others represent evil, excessive counting.
- There are almost infinite behaviors that can be the effects of OCD and the important factors are the impact on one's life and those around them.
Not nearly commonly enough. Again, these behaviors do to a certain extent have some validity and are reasonable and without the patients concern or unless the symptoms are patently evident; OCD is often misdiagnosed, and it is often under diagnosed. Many people have dual disorders of OCD and schizophrenia, or OCD and bipolar disorder, but the OCD component is not diagnosed or treated. In children, parents often are aware of some anxiety or depression but not of the underlying OCD. Researchers believe OCD, anxiety disorders, Tourette's, and eating disorders such as anorexia and bulimia can be triggered by some of the same chemical malfunctioning of the brain.
Heredity as a factor in OCD:
Yes. Heredity appears to be a strong factor. If you have OCD, there's a 25-percent chance that one of your immediate family members will have it. It definitely seems to run in families. This however is tenuous and will depend on your views of genetics versus environmental factors. Often overlooked is the "power" of the environment, parents, and others in the development of a young person conceptual framework. We have all heard the expression "A child's brain is like a sponge"; this is true and environmental factors play a significant role in OCD.
OCD be effectively treated:
Medication and behavior therapy are key in the treatment of OCD. Both affect brain chemistry, which in turn affects behavior. Medication can regulate serotonin, reducing obsessive thoughts and compulsive behaviors. through behavior modification, in mild cases of OCD people can be taught to "ignore the thought" when it is present to the mind or to tell one's self "don't worry if you left the coffee pot on, your insurance will cover the damages..."
Tricyclic antidepressants have been shown to be effective in treating obsessions and compulsions. The most commonly reported side effects of this medication are dry mouth, constipation, nausea, increased appetite, weight gain, sleepiness, fatigue, tremor, dizziness, nervousness, sweating, visual changes, and sexual dysfunction. There is also a risk of seizures, thought to be dose-related. People with a history of seizures should not take this medication. Many of the antidepressant medications known as selective serotonin reuptake inhibitors (SSRIs) have also proven effective in treating the symptoms associated with OCD.
Some physicians make the mistake of prescribing a medication for only three or four weeks. That really isn't long enough. Medication should be tried consistently for 10 to 12 weeks before its effectiveness can be judged.
Behavior therapy and modification:
Behavior therapy is not traditional psychotherapy. It is "exposure and response prevention," and it is effective for many people with OCD. Consumers are deliberately exposed to a feared object or idea, either directly or by imagination, and are then discouraged or prevented from carrying out the usual compulsive response. For example, a compulsive hand-washer may be urged to touch an object he or she believes is contaminated and denied the opportunity to wash for several hours. When the treatment works well, the consumer gradually experiences less anxiety from the obsessive thoughts and becomes able to refrain from the compulsive actions for extended periods of time. As previously mentioned; often the patient has to train him or her to identify and ignore the obsessive thoughts and over time the anxiety will often dissipate with the thoughts.
Several studies suggest that medication and behavior therapy are equally effective in alleviating symptoms of OCD. About half of the consumers or patients with this disorder improve substantially with behavior therapy; the rest improve moderately. Response to treatment varies from person to person. Most people treated with effective medications find their symptoms reduced by about 40 percent to 50 percent. That can often be enough to change their lives, to transform them into functioning individuals. Extreme cases can be the toughest illnesses to treat and the patient is unresponsive to both medication and cognitive therapy.
A few patients find that neither treatment produces significant change, and a small number of people are fortunate to go into total remission when treated with effective medication and/or behavior therapy for OCD.
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This article is for informational purposes only and not to be used in diagnosing or treating any illness
This article is for informational purposes only and not to be used in diagnosing or treating any illness