Obsessive compulsive disorder (OCD) is a disorder of both the brain and the behaviors. Obsessions are recurrent thoughts that occur in our brain and compulsions are repetitive acts and are expressed through behaviors. Some of the very common obsessions in OCD are thoughts of contamination, sexual thoughts, religious obsessions, perfectionism, losing control and other similar obsessions. The compulsions may include repeated acts of washing, cleaning, checking and mental compulsions.
Some of the causes identified for OCD include changes in brain or natural chemistry.
Major stressors or traumatic events are also sometimes considered causes of this disorder. In some cases these stressors act as triggers for the predisposed disorder. Depression is sometimes observed as a cause or result of OCD.
Psychodynamic perspective has been made responsible for the fixations and conflicts of early life to be the cause of this disorder.
According to this model, OCD is a result of human body’s biological and evolutionary leaning to suppress primitive actions. A brain circuit in the orbitofrontal cortex fires, and send impulses to direct attention towards actions, and when the actions are completed, the impulse lower downs its intensity.
The Four D’s
DYSFUNCTIONAL: It is often observed that people with OCD find difficulty in completing their daily tasks specially those which do not follow their routine, this also causes hindrance for people living with them as they may be interfering in the routine.
DISTRESS: In OCD if the routines are not followed and if any change is made, it becomes a source of great distress for the person suffering from the disorder.
DEVIANT: The routine lifestyle found in those with OCD is highly different from that found in general social convention.
DANGEROUS: Suicidal thoughts as a result of depression are also commonly observed in OCD. Depression can result in social isolation and causes serious health problems.
Treatment of OCD
There are more than one ways in which the treatment of OCD is addressed. Following is the brief introduction of these methods which we provide to our patients.
The treatments of the disorder include medications which include anti-anxiety and anti depressants which are used to control the symptoms associated with the disorder.
Cognitive Behavior Therapy
This is an amalgam of two evidence based therapies. We look at the cognitive and behavioral part of the disorder for the management. As in OCD thoughts are directly linked to the behavioral consequences so by changing the thinking patterns we can find alternative means to respond to those thoughts.
Exposure and Response Prevention
This approach is a part of behavioral therapy which is actually about letting the person face the fear in a control environment and then refraining the client from performing the ritual. The logic behind this treatment is that the learned fear will disappear as the person realizes that no harm results by actually facing them and hence the anxiety disappears.
Deep breathing is diaphragmatic breathing that sends very strong relaxation signals to brain which turns down the physiological arousal and stress level. This exercise reduces heart rate, lowers down the blood pressure, and promotes a calm state. On the other hand mindfulness meditation is the practice of noticing thoughts without judging or pushing them away.