The cause of OCD is not clear but, like many mental health disorders, it is thought to develop due to a combination of genetic and environmental factors.
OCD can be effectively treated with psychological treatments and medications.
The most common medication prescribed for this condition are typically selective-serotonin reuptake inhibitors (SSRI’s). An example of an SSRI prescribed for this condition is fluoxetine (also known as Prozac), and it works to reduce intrusive thoughts and compulsions, and any associated depression.
Exposure and response prevention therapy (ERP therapy): This is the most effective psychological treatment for OCD and occurs with a psychologist or psychiatrist there to support the patient. The first step of ERP is to make a list of things or activities which makes the patient anxious and order them on a scale from easiest to hardest. Starting at the easiest activity, they then go ahead and perform it with the help of a therapist. During the activity they will be encouraged to experience the anxiety and then refrain from performing the compulsion, while waiting for their anxiety levels to drop. The patient then repeats the activity until they become used to it and then progress onto the next situation.
Cognitive behaviour therapy (CBT): This therapy is a treatment based on the idea that how you think and act affects the way you feel. With this therapy, the patient works with a therapist to recognise the patterns of thinking and behaviours that are causing them problems and actively challenge them. The aim of this treatment is to assess the negative thought’s the individual is having, and to replace them with more positive and constructive thoughts and behaviours. A person undertaking CBT will learn coping skills and techniques both tailored to their OCD health issue, and more general ones which will help with everyday life.
Surgery may be used as a last resort in people who do not improve with other treatments. In this procedure, a surgical lesion is made in the area of the brain known as the cingulate cortex. Studies show that approximately 30% of participants benefitted from this procedure.
Electroconvulsive therapy, deep brain stimulation and Vagus nerve stimulation are other surgical options which do not include the destruction of brain tissue. Electroconvulsive therapy has been found to have some effect in severe and refractory cases of OCD. This treatment involves passing a carefully controlled electric current through the brain to induce a seizure, which acts to affect the brain’s activity. Doctors are not sure exactly how ECT works, but it is thought that the electric current stimulates the production of certain chemicals in the brain, such as serotonin and dopamine, which are generally lacking in people who suffer from mental disorders. It seems to actively increase the metabolism and effectiveness of these chemicals, while also improving blood flow through the brain and changing the metabolism of areas in the brain which may be affected by depression. Recent research also suggests that this therapy can help the growth of new cells and nerve pathways in certain areas of the brain.
Deep brain stimulation is a neurosurgical procedure which involves the implantation of a medical device called a neurostimulator into the desired area of the brain, which then sends electrical impulses to specific targets in the brain for the treatment of neuropsychic and movement-related disorders. It has been shown to beneficial in the treatment of otherwise treatment resistant disorders with the added benefit of being completely reversible, unlike the lesioning techniques mentioned above. DBS is not a treatment for OCD but can effectively treat the symptoms by disrupting the abnormal patterns of brain activity that become prominent in this condition. it does this by emitting constant pulses of electrical charge delivered at settings which are thought to restore normal brain rhythms. The implantation (electrodes) implanted in the brain are connected to a device known as a neurostimulator which is imbedded in the chest and connected via an insulated wire which is also implanted. It is similar to a pacemaker, and people who have this device are given an external remote control which allows them to turn it on and off whenever they wish, although in some cases the device stays on at all times.
Vagus nerve stimulation therapy is a medical treatment that involves delivering electrical pulses to the vagus nerve via a generator implanted under the clavicle and through a wire which travel up the neck and wrap around the left vagus nerve at the carotid sheath. It is used as an adjunctive treatment for certain types of intractable-epilepsy, and treatment-resistant depression and mental disorders including OCD. The vagus nerve sends information to brain regions essential in anxiety regulation (locus coeruleus, orbitofrontal cortex, insula, hippocampus, and amygdala), therefore this pathway may be involved in manifesting various cognitive symptoms that characterize anxiety disorders. More study is needed on the effectiveness of this method for the treatment of OCD.
Repetitive Transcranial Magnetic Stimulation is a non-invasive therapy which is administered via a helmet filled with magnetic coils. The coils carry electricity and produce a magnetic field similar in strength to an MRI scan. The flow of electricity which pulses through the device targets areas of the brain and causes the neurons in the brain in certain areas to become either more or less active. Specific area of the brain can be stimulated repeatedly to cause long-lasting changes in the activity of the neurons. The activity level of these neurons has been linked to symptoms of mental illnesses, including OCD. During the treatment, the patients are awake and do not experience any pain. The system even has a cooling system installed so the wearer does not overheat.
Community support can be a helpful asset to those suffering from OCD as it can be an extremely isolating condition. Studies show that people with OCD and their families can benefit greatly from support groups, especially those which include sharing coping strategies and actively develop support networks.
Obsessive compulsive disorder is one of the most common psychiatric conditions affecting children and adolescents. OCD commonly has peaks of onset at two different life phases: pre-adolescence, and early adulthood. The first peak of OCD usually occurs around the age of 10 – 12 years and directly corresponds to the increased load in school, increased performance pressures, and the biologic changes of the brain and body due to puberty. The second peak usually occurs in early adulthood, which is generally also a time of stress and developmental transition and when educational and occupational stresses tend to be high. Children and adolescents have similar OCD symptoms as those of adults with the symptoms distinguishable from other healthy childhood development stages by the definition of “symptoms which impair function and distract the child from learning and developmental tasks”.
A way that childhood and adolescent OCD differs from adult OCD is that the affected individual may not notice or realize that their obsessive thoughts and compulsions are not normal or obsessive, as opposed to adults.
Religious and somatic symptoms appear to be more prevalent in children versus adolescent and adult OCD, and hoarding symptoms appear to be more common in both children and adolescents opposed to adult OCD. Another distinction between childhood OCD and OCD in adults is that their symptoms often include ‘just right’ obsessions, compulsions involving other family members such as parents or siblings, superstitious rituals, and an intense fear or avoidance of an ill or ‘contaminated’ sibling. Biological triggers in children may include an immune response to illnesses such as strep throat. Genetic causes are thought to attribute to 45 – 65% increased risk of a child developing OCD, although studies suggest that a child may have differing OCD symptoms to their parents, which also opposes the belief that OCD runs in the family due to learned traits and the child imitating the parent’s actions.
Diagnosing OCD in children is much the same as diagnosing the condition in adults. A psychologist, paediatrician, or child psychiatrist will make the diagnosis based on the child’s symptoms, and discussions with the parents, affected child, and sometimes school teachers as well.
Therapeutic treatment can be effective in reducing the compulsive ritual behaviours caused by OCD in children and adolescents. Cognitive Behavioural Therapy and Exposure and Response Prevention therapy are considered the best form of treatment for children, with family involvement proving to be highly beneficial. Parental interventions can also provide positive reinforcements when the child shows appropriate behaviours as an alternative to compulsive responses.
You can help a friend or a loved one through dealing with this condition by:
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