Meg Eubanks '01

"The other night my wife and I went to the movies. It was torture even though the movie was great. For about an hour before going, I couldn’t stop thinking about this need I have to check the doorknob in order to make sure it was locked. I had to get out of the car four times to check the doorknob. When inside the theater, I kept wondering whether the door was locked. I would bet I had similar thoughts while at the theater."
(Serason, Serason, 1999)

    The case above, is a perfect illustration of the driven thoughts and rituals people suffering from obsessive-compulsive disorder often encounter. While each case varies, there seems to be a common trend in recurring thoughts and obsessions that seem to cause significant distress in an individuals daily activities. The DSM-IV criteria for obsessive-compulsive disorder include having recurrent and persistent thoughts, impulses, or images that are not general worries (Sarason, Sarason, 1999). Individuals recognize that the unwanted thoughts and rituals is a product of their mind however distress continues especially if one chooses not to seek help (Sarason, Sarason, 1999).

    There are clear distinctions between obsessions and compulsions. Obsessions are unwanted ideas or thoughts that excessively invade the mind of a person with OCD. Common fears or persistent thoughts include one’s concern of becoming contaminated or the excessive need to perform a task perfectly. Over and over, a person suffering from OCD will experience these intrusive thoughts that produce extreme anxiety (www.nimh.nih.gov/publicat/ocd).

    Due to these obsessions, most people respond in repetitive behavior or compulsions. The most common of these compulsions are hand washing, checking, and counting. Mental rituals such as repeating phrases and list making are also very common. These types of behaviors are performed to ward off preconceived harm to the individual suffering from OCD. These types of rituals may give the person suffering from OCD temporary relief (www.nimh.nih.gov/publicat/ocd).

    A recent survey conducted by the National institute of Mental Health in 1980, revealed that OCD effects more that 2% of the population meaning that it is more common than mental illnesses such as schizophrenia, bipolar disorder, and panic disorders (www.nimh.nih.gov/publicat/ocd). It is hard to determine the exact number of cases because many people tend to be secretive about their preoccupations and perform daily tasks quite well. OCD does strike all ethnic groups and it does not appear that there is an effect on gender. Both males and females are equally affected by this disorder.  Further, OCD can strike at any age ranging from preschool age to adulthood (www.ocfoundation.org/ocf1010a.htm).

    The present research on OCD indicates that there is not a specific cause of the disorder. However, research provides evidence that OCD implements problems in communication between the orbital cortex, the front part of the brain, and the basal ganglia, the deep structures of the brain (www.ocfoundation.org/ocf1010a.htm). These brain structures work together and use the neurotransmitter serotonin. It is assumed that insufficient levels of serotonin may affect individuals suffering from OCD because OCD patients have responded well in medications that induce serotonin (www.ocfoundation.org/ocf1010a.htm).

    In an effort to try and identify specific biological factors that may be important to the onset of this disorder, the NIMH has used a PET (positron emission tomogrphy) scanner to examine the brains of OCD patients (www.ocfoundation.org/ocf1010a.htm). Brain studies showing abnormal neurochemical activity that play a pivotal role in certain neurological disorders suggests that these areas of the brain maybe crucial in determining the cause and origins of OCD (www.ocfoundation.org/ocf1010a.htm).

    No specific genes for OCD have yet been identified, but current research suggests that genes do play a role in the development of this disorder in some cases. OCD tends to run in families and when a parent has OCD there is a greater risk that the child will develop OCD. When OCD occurs in families, it is the general nature of the disorder that tends to be inherited as opposed to the actual symptoms being inherited (www.ocfoundation.org/ocf1010a.htm).

    As mentioned earlier, certain drugs that enhance levels of serotonin have proven to be effective methods of treatment for those suffering from OCD. In addition, cognitive-behavioral therapy has proven to be very effective accompanied by medication. Types of psychological therapies are effective when the individual is exposed to stimuli that usually evoke compulsive rituals and the patient actively inhibits the rituals (Sarason, Sarason, 1999). Further, this type of behavior therapy involves the individual to be highly motivated to resist obsessive thoughts and rituals (Sarason, Sarason, 1999). Additional components of treatment involve education. Education is crucial in helping families and patients learning how best to manage the disorder and seek the best available treatment.

    There are many disorders that often get confused with OCD. Trichotillmonia, a compulsive hair pulling disorder, in addition to body dysmorphic disorder is often associated to OCD. Patients suffering from both of these disorders have responded very well in the treatment imposed by those suffering from OCD (www.ocfoundation.org/ocf1010a.htm).

    The most common conditions that resemble obsessive-compulsive disorder are Tourette’s disorder and other motor and vocal tic disorders. These involuntary motor and vocal behaviors occur when an individual is feeling uncomfortable. More complex tics, such as touching or tapping, may closely resemble compulsions as well. The relationship between OCD and tics occurs most often when OCD or tics begin in early childhood (www.ocfoundation.org/ocf1010a.htm). Depression and OCD occurs more often in adults than in youth. OCD is often confused with posttraumatic stress syndrome and the distinction is easy because OCD is not caused by a terrible event. Further, in children and adolescents, OCD may cause disruptive behaviors, enhance a pre-existing learning disability, and cause problems with attention and concentration. All of which increase low performance in school. In most cases, these disruptive behaviors are related to the OCD and will go away when OCD is treated (www.ocfoundation.org/ocf1010a.htm).

    As you can see, obsessive-compulsive disorder can disrupt an individuals daily life if left untreated. Individuals suffer from unwanted intrusive thoughts that are often carried through by some kind of ritual or compulsion. Obsessive behavior is the inability to stop thinking about a particular idea or topic. In comparison, compulsive behavior is the need to perform certain tasks over and over again. Common compulsions include counting, ordering, checking, touching, and washing. The disorder may strike anyone of anyone, race, and gender. Individuals who seek treatment will benefit from serotonin-related drugs accompanied by some kind of therapy. These treatments have proven to be most effective when they are implemented together.

References:

Sarason, B.R., and SarasonI.G. (1999). Abnormal Psychology: The problem of Maladaptive Behavior. Prentice-Hall Inc: Upper Saddle River, NJ.

www.nimh.nih.gov/publicat/ocd)

(www.ocfoundation.org/ocf1010a.htm)