Obsessions and Compulsions

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Definition:

Behavioral disorder, anxious thoughts and rituals you feel you can't control. When doing a ritual you feel temporary relief, this is a problem with the way the brain deals with regular worries or doubts.

Symptoms:

In one common form of obsessive-compulsive disorder, an exaggerated fear of contamination (the obsession) leads to washing one's hands so much that they become raw (the compulsion). Other common manifestations of OCD involve sorting, checking, and counting compulsions. Checking compulsions seem to be more common among men, whereas washing is more common among women. Another type of OCD is trichotillomania, the compulsion to pull hair. The compulsive behavior is usually not related in any logical way to the obsessive fear, or else it is clearly excessive

Causes:

Sigmund Freud attributed obsessive-compulsive disorder to traumatic toilet training and, although not supported by any empirical evidence, this theory was widely accepted for many years. Current research, however, indicates that OCD is neurobiological in origin, and researchers have found physical differences between the brains of OCD sufferers and those without the disorder. Specifically, neurons in the brains of OCD patients appear to be overly sensitive to serotonin, the chemical which transmits signals in the brain. A recent study at the National Institute of Mental Health suggests a link between childhood streptococcal infections and the onset of OCD. Other research indicates that a predisposition for OCD is probably inherited. It is possible that physical or mental stresses can precipitate the onset of OCD in people with a predisposition towards it. Puberty also appears to trigger the disorder in some people.

Treatment:

Fewer than one in five OCD sufferers receive professional help; the typical OCD patient suffers for seven years before seeking treatment. Many times, OCD is diagnosed when a patient sees a professional for another problem, often depression. Major depression affects close to one-third of patients with obsessive-compulsive disorder.
In recent years, a new family of antidepressant medications called selective serotonin reuptake inhibitors (SSRIs) has revolutionized the treatment of obsessive-compulsive disorder. These drugs include clomipramine (Anafranil), fluoxetine (Prozac), fluvoxamine (Luvox), and sertraline (Zoloft). They work by altering the level of serotonin available to transmit signals in the brain. Thanks to these medications, the over-whelming majority of OCD sufferers (75-90%) can be successfully treated.
In addition to medication, an extreme type of behavior therapy is sometimes used in patients with OCD. In exposure-response prevention therapy, a patient slowly gives up his or her compulsive behaviors with the help of a therapist. Someone with a hand-washing compulsion, for example, would have to touch something perceived as unclean and then refrain from washing his/her hands. The resulting extreme anxiety eventually diminishes when the patient realizes that nothing terrible is going to happen. Neuro_biol_OCD.JPG

Anecdote:

I don't know if this helps, but my Grandmother used to come over to our house and demand that we rearrange the livingroom furniture. Rather than argue, my parents would do it, then move it back when she was gone. She also would alphabetize our spice rack, unasked, and go through our private stuff to the point that my mom made an arrangement with our neighbors to keep private things (journals, prescriptions, etc) in a bag at the neighbor's house for the extended stay.

Many year ago, when my parents were living together "in sin" before they married, my grandmother bribed the superintendant of their apartment building to let her in while my parents were out. She rearranged the furniture herself. Then she went through my mom's underwear drawer, found the birth control pills, and set them out in the middle of the dining room table. THen she sat in the dark, waiting for them to come home. She said it was to conserve electricity, but I think she did it for the effect.

Sources:

"Obsessive-Compulsive Disorder." Gale Encyclopedia of Psychology. Ed. Bonnie Strickland. 2nd ed. Detroit: Gale, 2001. 462-463. Gale Virtual Reference Library. Web. 30 Mar. 2011.
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