Obsessive compulsive disorder
Mental health
Hey all,
Welcome to Human Nature, the illustrated psychology newsletter.
This week, we’re continuing on the theme of mental disorders. Today’s topic is obsessive compulsive disorder.
Obsessive compulsive disorder
What it is: Obsessive compulsive disorder (OCD) is a mental health condition characterised by a cycle of obsessions and compulsions. Obsessions are unwanted, intrusive thoughts, images and urges that occur outside a person’s control. Common obsessions include fears of contamination, fears of causing physical or sexual harm or violence, perfectionism, and excessive concern over questions of morality, religion or identity. Compulsions are behaviours or thoughts that a person uses to temporarily stop or quieten down their obsessions. These activities are time consuming and get in the way of the person’s day-to-day life. Common compulsions include washing and cleaning, compulsive checking, repetitive behaviours (e.g. tapping), and engaging in thoughts that the person believes will prevent harm.
How it works: The causes of OCD still remain unclear and are thought to be complex. Although there are differences between the brains of those with OCD and those without, it isn’t possible to say whether these are at the root of the disorder or caused by it. Still, the parts of the brain in charge of behavioural control, error prediction and detection, movement and physical sensation, and thoughts, memories and emotions are overactive in people with OCD. Certain neurotransmitters such as serotonin, dopamine, GABA and glutamate also play a role (Pittenger, 2017).
OCD seems to be inheritable, with 10-20% of children who have parents with OCD also developing it themselves (Browne, Gair, Scharf, & Grice, 2014). However, we don’t know if this has a purely genetic basis, or is rather learned. Twin studies show that genetic factors are more important than environmental ones, with shared environments having little relation to the development of OCD (Krebs, Waszczuk, Zavos, Bolton & Eley, 2015). However, non-shared environments play a larger role, and the content of a person’s obsessions and compulsions are affected by their culture and environment. For example, during the Covid-19 pandemic, there was a shift in people’s obsessions towards contamination (Dennis, McGlinchey & Wheaton, 2023).
Treatment: The most effective treatments for OCD are cognitive behavioural therapy (CBT) and/or medication. Just like in depression and anxiety, SSRI’s (serotonin reuptake inhibitors) are effective in the treatment OCD.
A specific type of CBT called Exposure and Response Prevention (ERP) is commonly used for treating patients with OCD. It consists in gradually exposing the patient to their obsessions without trying to alleviate them by engaging in their compulsions.
Thank you for reading, see you next time.
If you are struggling with your mental health, please seek the advice or support of your GP. You can call the Samaritans 24/7 for free emotional support: 116 123. If you are having thoughts of suicide, call 999.
Sources:
International OCD Foundation, iocdf.org
Obsessive-compulsive disorder: phenomenology, pathophysiology, and treatment. (Pittenger, 2017).