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Everything You Must Know About OCD: Treatment, Causes, and History

W. Nate Upshaw, MD

W. Nate Upshaw, MD

Dr. William Nathan Upshaw is the Medical Director of NeuroSpa TMS®. Since receiving training from the inventor of TMS Therapy nearly a decade ago, Dr. Upshaw has been a pioneer, champion and outspoken advocate of TMS Therapy. Dr. Upshaw’s holistic experience in the field has transformed him into Florida’s leading advocate for widespread accessibility to TMS Therapy.

About Dr. Upshaw

Obsessive-Compulsive Disorder (OCD) is a psychological disorder affecting around 2.3 percent of American adults. A member of the anxiety disorder group of disorders, OCD is known for causing intrusive, distressing thoughts (obsessions), which force the sufferer to carry out ritualized behaviors (compulsions) to alleviate the intolerable anxiety that arises from the obsessions.

Signs and Symptoms of OCD

OCD has three primary components: obsessions, compulsions, and anxiety. Intrusive anxiety is the driving force behind OCD. Let’s take a look at obsessions first.

Obsessions may include:

  • Harm. Worry and fear that they may cause serious or lethal harm to others, or even cause a disaster.
  • Sexual thoughts. These thoughts may include inappropriate or taboo sexual behaviors.
  • Religious themes. People may fear they are spiritually lacking, sinning, or otherwise offending God
  • Loss of control. Fear of acting on an impulse to harm oneself or others.
  • Contamination. These are intrusive thoughts of being dirty or “unclean,” and contaminated by germs or other materials that are harmful or offensive.
  • Magical Thinking/Superstition. A fear that a failure to perform certain gestures or other behaviors will lead to harm to oneself or others, or that actions must be performed in a precise, particular sequence in order to prevent harm to oneself or others.

 

Compulsions

For a behavior to be considered compulsive in the context of OCD, it must be performed to reduce the anxiety related to a specific obsessive thought. OCD-type compulsions are time-consuming, repetitious, frequent, and can be ritualistic. The following are some of the more typical compulsions.

  • Handwashing, showering, or bathing. Washers fear contamination or fear that they will contaminate others.
  • Counting. The counting compulsion is exactly what it sounds like. Sufferers feel compelled to count objects in their environment. Usually, a specific type of object or even geometric shapes is the target of counters.
  • Checking. Checkers need to check on locked doors, windows, and items such as stoves, to make sure they’re off, or locked before leaving home or going to bed. The person usually has a precise number of times to check and a certain order or way to perform the checking, as well.
  • Arranging. Arrangers feel compelled to straighten or order items in their environment to fit their standards of symmetry (or asymmetry). This goes far beyond mere tidiness.
  • Hoarding. People who hoard feel an uncontrollable drive to hang on to items, even though they’re useless or even harmful.
  •   Self-monitoring. Self-monitors may check their bodies for signs of illness or disease dozens—or hundreds of times a day.
  •   Repeating, tapping, or touching. For some, completing the same action repeatedly. Either tapping in a particular sequence, repeating certain phrases, or touching things in their surroundings temporarily relieves overwhelming anxiety.

 

History of OCD

Written records of OCD-like behavior date back to the 7th century AD. From the 18th through the late 19th centuries, obsessive-compulsive disorder was considered part of “neurotic melancholia.” Sigmund Freud believed OCD was a result of conflict between the ID and superego, but by the late 20th century, researchers developed a concept of OCD rooted in neurobiology and cognitive learning theory.

 

The Causes of OCD

Researchers believe that OCD may be caused by errors in the way certain areas of the brain respond to serotonin, a chemical brain cells use to communicate with each other. This leads to a person being unable to adequately regulate their behavior in relation to error-checking behavior.  OCD can also be caused by stressful early childhood experiences and often runs in families.

 

Worried About OCD? You Must Know…

  1. There’s no such thing as a person being “a little obsessive-compulsive.” For a diagnosis of obsessive-compulsive disorder to be made, a person’s condition must be severe enough to present a threat to their ability to live life in a pleasing or satisfactory fashion. OCD is a serious impediment to a person having a manageable life.
  2. OCD produces debilitating levels of anxiety. Unmanageable anxiety is the emotional force that creates and sustains OCD.
  3. Obsessive-compulsive disorder isn’t controllable without professional treatment. A person can’t just “snap out of it.”
  4. Both obsessions and compulsions are unpleasant, unwanted, and involuntary. If a person with OCD attempts to resist performing a compulsive behavior, their anxiety will escalate out of control.
  5. Most people with OCD understand that their behavior is irrational, but that doesn’t alleviate the condition.
  6. The cycle of obsession, anxiety, and compulsive behavior is exhausting and a significant impediment to a pleasing, fulfilling life.

 

Treatment for OCD

As with most other psychological disorders, OCD has no cure and will not go away on its own, but there are exceptionally effective treatments out there. Treatment for OCD typically centers on psychotherapy and medication, however newer treatments, like transcranial magnetic stimulation, are also finding success in alleviating OCD.

 

This blog post is meant to be educational in nature and does not replace the advice of a medical professional. See full disclaimer. 

 

Works Cited

Attiullah, N., Eisen, J., & Rasmussen, S. (2005, June 29). Clinical features of obsessive-compulsive disorder. Psychiatric Clinics of North America. https://www.sciencedirect.com/science/article/abs/pii/S0193953X05701751.

Eisen, J., Coles, M. E., Shea, M. T., Pagano, M., Stout, R., & Yen, S. (2006, June 1). Clarifying The Convergence Between Obsessive Compulsive Personality Disorder Criteria And Obsessive-Compulsive Disorder. Journal of Personality Disorders. https://guilfordjournals.com/doi/abs/10.1521/pedi.2006.20.3.294.

Hanna, G., Himle, J., Curtis, G., & Gillespie , B. (2005, April 5). A family study of obsessive-compulsive disorder with pediatric probands. American journal of medical genetics. Part B, Neuropsychiatric genetics : the official publication of the International Society of Psychiatric Genetics. https://pubmed.ncbi.nlm.nih.gov/15635694/.

Murphy, D., Timpano, K., Wheaton, M., Greenberg, B., & Miguel, E. (2010, June 12). Obsessive-compulsive disorder and its related disorders: a reappraisal of obsessive-compulsive spectrum concepts. Dialogues in clinical neuroscience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181955/.

Norman, L., Taylor, S., Liu, Y., Radua, J., & Chye, Y. (2019). Error Processing and Inhibitory Control in Obsessive-Compulsive Disorder: A Meta-analysis Using Statistical Parametric Maps. Biological Psychiatry, 85(9), 713–725. https://doi.org/10.1016/j.biopsych.2018.11.010

Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2008, August 26). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Nature News. https://www.nature.com/articles/mp200894.

Williams, M., Mugno, B., Franklin, M., & Faber, S. (2013, April 20). Symptom Dimensions in Obsessive-Compulsive Disorder: Phenomenology and Treatment Outcomes with Exposure and Ritual Prevention. Psychopathology. https://www.karger.com/Article/FullText/348582.

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