People with obsessive-compulsive disorder, or OCD, have recurrent thoughts and behaviors that can be crippling. What follows is a discussion of the biology of the disorder and several aspects of treatment.
Obsessive compulsive disorder is not a single disorder; rather, it’s of a cluster of conditions. In OCD, sufferers might obsess and be anxious and compulsive about hoarding, cleaning, ordering and checking. Patients can also exhibit body dysmorphic disorder (BDD), where they imagine possessing a defect in physical appearance. Other diseases that overlap with OCD include Tourette’s syndrome and hypochondria. OCD also has a genetic component and runs in families; relatives of someone with OCD are 8 times more likely to present symptoms.
The areas of the brain that appears involved with OCD are the orbito-frontal cortex (OFC), a center for decision-making, and the thalamus, which filters and relays information. In these brain regions, the neurotransmitter glutamate is responsible for neuronal signaling. It’s thought that the deficit of glutamate production and function might contribute to the condition of OCD and other counter-productive behavior, including making decisions based on inappropriately perceived danger.
Obsessive Compulsive Disorder Treatment
The neurotransmitter serotonin may play an important role in whether someone gets obsessive compulsive disorder. Researchers have found a defect in the gene that makes a protein that “mops up” serotonin from between neurons. When there’s too much of this protein there is not enough serotonin, and that’s what is found in some with OCD. This is why Serotonin Re-uptake Inhibitors (SRIs) such as Prozac, which makes serotonin more available to the brain, are perhaps the most popular OCD treatment.
Another commonly used OCD treatment is exposure and response prevention (ERP), where the patient is exposed to stimuli that trigger the repetitive behavior but do not allow the patient to actually perform the compulsive behavior. Eventually the patient can learn that nothing bad happens when they don’t act out their compulsion.
Unfortunately, ERP is a stressful treatment for patients to endure. And significant numbers of patients drop out of treatment. Various drugs, such as the SRIs, are now being used in conjunction with ERP.
Anxiety usually is significant part of obsessive compulsive disorder. While anxiety does not appear to be the actual cause of OCD, anxiety can drive persistent thoughts and behaviors. A reduction in anxiety can be important in the treatment of OCD. Various modalities for treating anxiety include medication, neurofeedback (both traditional and LENS Neurofeedback), and/or behavioral approaches.
When anxiety is successfully brought under control, there are not only fewer obsessive thoughts, but those obsessive thoughts that do persist become less prominent. Instead being the dominant focus, compulsive become background music as opposed to a loud concert. These thoughts demand less attention and this makes it easier to control compulsive behavior.