Obsessive Compulsive Disorder

February 7, 2017

Obsessive-compulsive disorder is a mental illness. It’s made up of two parts: obsessions and compulsions. People may experience obsessions, compulsions, or both, and they cause a lot of distress –

Obsessions – Obsessions are unwelcome thoughts, images, urges or doubts that repeatedly appear in your mind; for example, thinking that you have been contaminated by dirt and germs, or experiencing a sudden urge to hurt someone. These obsessions are often frightening or seem so horrible that you can’t share them with others. The obsession interrupts your other thoughts and makes you feel very anxious.
Compulsions – Compulsions are repetitive activities that you feel you have to do. This could be something like repeatedly checking a door to make sure it is locked or repeating a specific phrase in your head to prevent harm coming to a loved one. The aim of a compulsion is to try and deal with the distress caused by the obsessive thoughts and relieve the anxiety you are feeling. However, the process of repeating these compulsions is often distressing and any relief you feel is often short-lived.

People who experience OCD usually know that obsessions and compulsions don’t make sense, but they still feel like they can’t control them. Obsessions and compulsions can also change over time.

Obsessive-compulsive disorder (OCD) is an anxiety disorder characterized by uncontrollable, unwanted thoughts and repetitive, ritualized behaviors you feel compelled to perform. If you have OCD, you probably recognize that your obsessive thoughts and compulsive behaviors are irrational—but even so, you feel unable to resist them and break free.

OCD presents itself in many guises, and certainly goes far beyond the common perception that OCD is merely hand washing or checking light switches. In general, OCD sufferers experience obsessions which take the form of persistent and uncontrollable thoughts, images, impulses, worries, fears or doubts. They are often intrusive, unwanted, disturbing, significantly interfere with the ability to function on a day-to-day basis as they are incredibly difficult to ignore. People with OCD often realise that their obsessional thoughts are irrational, but they believe the only way to relieve the anxiety caused by them is to perform compulsive behaviours, often to prevent perceived harm happening to themselves or, more often than not, to a loved one.

Most people with obsessive-compulsive disorder (OCD) fall into one of the following categories:

Washers are afraid of contamination. They usually have cleaning or hand-washing compulsions.
Checkers repeatedly check things (oven turned off, door locked, etc.) that they associate with harm or danger.
Doubters and sinners are afraid that if everything isn’t perfect or done just right something terrible will happen, or they will be punished.
Counters and arrangers are obsessed with order and symmetry. They may have superstitions about certain numbers, colors, or arrangements.
Hoarders fear that something bad will happen if they throw anything away. They compulsively hoard things that they don’t need or use.

PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal infections) is a type of OCD that occurs in childhood following the body’s reaction to infection. PANDAS looks very different from other forms of childhood OCD, the most obvious difference being that it happens very suddenly, with the child starting to have symptoms seemingly overnight, and has a very severe impact on the child’s life.

Causes

The brain is a very complex structure. It contains billions of nerve cells — called neurons — that must communicate and work together for the body to function normally. Neurons communicate via chemicals called neurotransmitters that stimulate the flow of information from one nerve cell to the next. At one time, it was thought that low levels of the neurotransmitter serotonin was responsible for the development of OCD. Now, however, scientists think that OCD arises from problems in the pathways of the brain that link areas dealing with judgment and planning with another area that filters messages involving body movements.

Who is at risk?

OCD can start at any time from preschool to adulthood. Although OCD can occur at any age, there are generally two age ranges when OCD tends to first appears –

Between the ages 8 and 12.
Between the late teen years and early adulthood.

Adults

Our best estimates are that about 1 in 100 adults — or between 2 to 3 million adults in the United States — currently have OCD.

Children

There are also at least 1 in 200 – or 500,000 – kids and teens that have OCD. This is about the same number of kids who have diabetes.
That means four or five kids with OCD are likely to be enrolled in any average size elementary school. In a medium to large high school, there could be 20 students struggling with the challenges caused by OCD.

Symptoms

Obsessions –

Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress
The thoughts, impulses, or images are not simply excessive worries about real-life problems
The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action
The person recognizes that the obsessional thoughts, impulses, or images are a product of his or her own mind (not imposed from without as in thought insertion)

Compulsions

Repetitive behaviors (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly
The behaviors or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize or prevent or are clearly excessive
At some point during the course of the disorder, the adult has recognized that the obsessions or compulsions are excessive or unreasonable (not applicable to children).
The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person’s normal routine, occupational (or academic) functioning, or usual social activities or relationships.
If another disorder is present, the content of the obsessions or compulsions is not restricted to it. The disturbance is not due to the direct physiological effects of a substance (e.g., a drug of abuse, a medication) or a general medical condition.

Treatment

Psychotherapy – A type of psychotherapy called cognitive behavior therapy is especially useful for treating OCD. It teaches a person different ways of thinking, behaving, and reacting to situations that help him or her feel less anxious or fearful without having obsessive thoughts or acting compulsively. One type of therapy called exposure and response prevention is especially helpful in reducing compulsive behaviors in OCD.

Medication – Doctors also may prescribe medication to help treat OCD. The most commonly prescribed medications for OCD are anti-anxiety medications and antidepressants. Anti-anxiety medications are powerful and there are different types. Many types begin working right away, but they generally should not be taken for long periods.

Antidepressants are used to treat depression, but they are also particularly helpful for OCD, probably more so than anti-anxiety medications. They may take several weeks—10 to 12 weeks for some—to start working. Some of these medications may cause side effects such as headache, nausea, or difficulty sleeping. These side effects are usually not a problem for most people, especially if the dose starts off low and is increased slowly over time.

Alternative Treatment

Folate and folic acid, vitamin B12 – Studies suggest that folate deficiency, increased homocysteine, impaired metylation have been identified in depressive disorder. Recently, growing research has resulted in the biological association between obsessive-compulsive disorder and affective disorders. Therefore, in the present study it was evaluated whether or not folate and homocysteine levels changed. The B12 deficiency could be the consequence rather than the cause of OCD. Deficiencies of magnesium and the B vitamin folate have been linked to depression.

5HTP or 5-hydroxy-tryptophan – L-tryptophan was found to be effective in reducing the symptoms of OCD.29 The first study investigating the possible anti-anxiety effects of 5-HTP is proved to be helpful.

St. John’s wort – Daily supplement. St. John’s wort contains the active ingredient hypericin, which reduces anxiety and depression symptoms.

Fish oil supplements – Rich in omega-3 fatty acids, have been shown to be effective in a wide range of psychological conditions. Fish oil supplements contain eicosapentaenoic acid, or EPA, an essential fatty acid important for your nervous system to improve thoughts associated with OCD and regulate the brain chemical serotonin.

Stress and Relaxation Techniques – Relaxation techniques may produce modest, short-term reduction of anxiety in people with ongoing health problems such as heart disease or inflammatory bowel disease, and in those who are having breast biopsies, dental treatment, or other medical procedures. These techniques have also been shown to be useful for older adults with anxiety. In people with generalized anxiety disorder, studies indicate that cognitive-behavioral therapy is more effective over the long term than relaxation techniques. For symptoms of depression they may have modest benefit, but they are not as effective as cognitive-behavioral therapy (CBT) or other psychological treatment. Find out more.

Meditation – Moderate evidence suggests that meditation is useful for symptoms of anxiety and depression in adults. Learn more.

Yoga – Yoga, which combines physical postures, breathing exercises, meditation, and a distinct philosophy, is one of the top ten CAM practices. Studies suggest that practicing yoga (as well as other forms of regular exercise) might confer health benefits such as reducing heart rate and blood pressure, and it may also help alleviate anxiety and depression.

Acupuncture – Evidence for the use of acupuncture – the Chinese practice of inserting needles into the body at specific points to manipulates the body’s flow of energy – to treat anxiety disorders is becoming stronger.

Kava – A plant found in the South Pacific, kava has been shown to be safe and effective in treating anxiety and improving mood.

Reference –

http://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/index.shtml#part_145346

http://ocd.stanford.edu/about/symptoms.html

http://psychcentral.com/lib/treatments-for-obsessive-compulsive-disorder/

http://www.health.com/health/gallery/0,,20707257,00.html

http://www.helpguide.org/articles/anxiety/obssessive-compulsive-disorder-ocd.htm

Posted in SOCIAL-MENTAL HEALTH