Obsessive Compulsive Disorder
Individuals with OCD struggle with unwanted thoughts and urges that won't seem to go away. Some people may have obsessive thoughts like, "I am going to contract an illness" or "Something bad is going to happen." Others have intrusive thoughts related to perfectionism, leaving things incomplete, or things not being "just right." Some people with OCD have described themselves as having strong superstitions. They often recognize the superstition isn't accurate, but they still feel an urge to act as if it were accurate. People often try to ignore or overpower the thoughts. Sometimes the thoughts lead to compulsive behaviors. For example, someone with fears of contamination may wash their hands excessively. Another person might feel they have to perform a certain ritual to prevent a bad outcome from happening.
Signs of Obsessive Compulsive Disorder
There are many different ways that OCD can manifest. For some people, OCD involves intrusive thoughts about germs or disease. These obsessions may result in excessive handwashing, bathing, or cleaning and avoidance of potentially contaminated surfaces. Others may have perfectionist obsessions. They may excessively check or redo school or work assignments or have concerns about things being perfectly even or exact. Others have obsessive thoughts about their relationships, such as "Is my partner attracted to me?" or "Is this the right relationship for me?" These obsessions may lead to excessive reassurance-seeking in the relationship or avoidance of romantic movies or other attractive couples. Obsessive thoughts are perceived as intrusive and unwanted. Compulsions bring temporary relief from the obsessions, but only fuel the flames of OCD over time. As OCD progresses, people often find that they are spending excessive amounts of time experiencing obsessions or engaging in compulsions. They may also find themselves avoiding meaningful life activities due to the OCD.
What Causes OCD?
​OCD, like many other mental health conditions, has a genetic component. Brain imaging studies have found that OCD is related to a specific circuit in the brain that involves the orbital frontal cortex, striatum, and thalamus. The orbital frontal cortex and thalamus send information back and forth to one another about worrisome situations and what to do about them. The striatum regulates the signals sent between these two parts of the brain. Usually, the striatum can act like a stop light that suppresses a worry signal sent by the orbitofrontal cortex to the thalamus when it makes sense to do so. In OCD, this stop signal is not working well. So, the orbitofrontal cortex and thalamus get stuck in a repetitive cycle of worry that becomes overlearned in the brain. The good news is that research indicates medication and/or a specific type of therapy (exposure and response prevention, which is under the umbrella of cognitive behavioral therapy) can help address this problem.
Treatment for Obsessive Compulsive Disorder
Exposure and response prevention (ERP) is a research-based treatment for OCD. ERP involves doing the opposite of what OCD seems to be telling you to do. For example, someone with obsessive thoughts about contamination may be asked to touch something they perceive as contaminated (that's the exposure part) and refrain from immediately washing their hands (that's the response prevention part.) They key is that these exercises are done in a slow and controlled fashion, at a pace that feels manageable to you. Over time, the brain begins to recognize that the feared outcome didn't occur. This reduces anxiety over time.
