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Obsessive-Compulsive Disorder

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Obsessive-Compulsive Disorder (OCD) is a nervousness-associated disorder that is characterized by repeated compulsions and/ or obsessions that obstruct the victim’s ability to effectively function at work, school or socially (Lowe, 2007, p. 1). An obsession can be defined as an impulse, a thought or an image that keeps repeating and as a result causes anxiety while a compulsion is a behavior that a person suffering from OCD frequently engages him/ herself in because of the obsessions (Foa & Kozak, 2005, p. 15). OCD victims usually take long before they are diagnosed. This is due to the fact that most of them do not understand the symptoms of the condition while others feel embarrassed and guilty.  In one way or the other, OCD related symptoms are experienced by most individuals particularly when stressed. Nonetheless, this disorder can have severe effects on social life, work and personal relationships among others. OCD is rated the tenth most immobilizing illness in terms of retreating life quality and loss of property.

OCD can be experienced in many ways but the most common ones include disturbing, unfriendly and recurring feelings, impulses, misgivings, and images which in most cases are impossible to ignore (Abramowitz, 2009). It is these thoughts that cause the individual to experience the obsessive-part of the illness and cause the individual to have recurring coercions in an unsuccessful effort to alleviate the obsession and counteract the fear. Some victims may experience obsession but do not show physical compulsion a type of OCD commonly referred to as Pure O. Commonly experienced obsessions include; causing mischief to other people or to oneself, germs and contagion, aggressive or offensive sexual thoughts, ordering objects or throwing them away.

Several researches and studies have been carried out in the past few years concerning the causes of ODC. Following this, several causes of OCD have been suggested and some of these include; brain and chemical dysfunction, infection, genetics, psychodynamics, depression and life. It has also been hypothesized that there might be numerous types of OCD and that which develops in childhood is different of the one that develops in adulthood.

Brain and chemical dysfunction is one of the causes of OCD that is gaining popularity. The probability is that the level of brain dysfunction in OCD victims is higher than in people who do not have it. This involves the Seretonin, which is a chemical courier or neurotransmitter that facilitates communication between nerve cells as well as connecting these cells to the brain (Penzel, 2000, p. 318). Research has revealed that this neurotransmitter is involved with most of the biological processes taking place in the body such as sleep, antagonism, mood, pain and appetite. Since the different parts of the brain have unlike levels of urgency and priority, it is their coordination with the nerves that may cause severe perplexity to the reasoning part of the brain, commonly referred to as Cortex. For instance, as the Thalamus processes all the images coming from the other parts of the body to the brain, the Caudate Nucleus controls and filters all the thoughts and information.

Now when these thoughts are misinterpreted, the reasoning part of the brain, Cortex, becomes confused and responds chemically to a danger perceived by the non-reasoning part of the brain and the urgent need to respond as if this danger is a reality. Actually, the Caudate Nucleus is sending unnecessary impulses and thoughts to the Cortex where emotions and thoughts combine; the over active Cingulate Nucleus at the center of the brain shifts attention from one behavior and/ or thought to another. With time, it becomes over active and seizes up on certain thoughts, behaviors or ideas (Penzel, 2000). It is therefore this Cingulate that alerts the OCD victim that something horrible will take place if the impulses are not accomplished. Thus when the Thalamus is sending information that makes the individual aware of everything happening around them, the Caudate Nucleus causes invasive thoughts while the Cortex perceives major danger that needs immediate response and finally the Cingulate Gyrus requires that compulsions be carried out so as to alleviate the terrible unease feelings.

A streptococcal illness of the throat has been believed to result in the body mistaking healthy cells for the infection thus resulting to cellular damage. Once this happens with the brain, the disease fighting system of the body attacks the exterior of the nerve cells in the Basal Ganglia of the brain consequently resulting to symptoms of OCD (Lowe, 2007). However, these symptoms may just take a short time and the occurrence of OCD caused by such an infection is still very rare.

Several researches and studies have shown the likelihood that victims of OCD are likely to have one or more of their family members having OCD (Meng, 2001, p. 14). However, the chances that it is genetically inherited are questionable. For instance, it does not automatic follow that both identical twins will have OCD even if there is a member of the family suffering from it. 

This theory states that disruptions in development or early sexual and unconscious desires are likely to result into OCD. Concerning development, the theory suggests that the child deals with the conflicts between the reasoning and thinking part of the brain and that part which wants to work in its own way in an unstable way thus resulting to mental problems in future. As for the unconscious desires, the theory suggests that for instance, a person may fear to run over people because he actually wants to do it; thus to keep the consciousness out of mind, he uses a lot of energy which consequently gives the thought an obsessive quality (Meng, 2001, p. 14).

Individual with severe depression tend to develop OCD symptoms just in the same way those with OCD suffer depression. Shame and guilt in life is also considered as a cause of OCD especially in children (Lowe, 2007). They tend to experience guilt over their needs at an early age a condition that is prevalent to fanatical people.

According to Abramowitz (2009), the symptoms of OCD range from mild to brutal; they include compulsions, the need to act in order to cancel out an obsession, and obsessions, the feelings and thoughts which make the patient anxious or distressed. Even though most victims experienced both compulsions and obsessions, it is possible for a patient to exhibit only one. Compulsions are characterized by recurring behaviors such as checking to ensure that everything is well, washing and cleaning surfaces, hands etc, hoarding and collecting objects that are unnecessary and arranging things  among others. Mental compulsion involves repeating of prayers or certain scriptures and/or phrases in the mind. Obsessions on the other hand are characterized by thoughts and feelings that the objects around are contaminated or dirty, worry about hygiene and health, urge to keep unnecessary things, disrupting thoughts about sex and/ or aggression, worry about safety; for instance worrying about a door that has been left unlocked and general thoughts (Abramowitz, 2009, p. 9). Avoidance of dreaded situations is also familiar though it often leads to further preoccupation with the obsessive thoughts.  

OCD is diagnosed by administering screening inquiries to an individual who is suspected to be suffering from it, assessment of the family OCD history, and the existing symptoms. Apart from checking for symptoms of compulsion and obsession through mental-status examination, practitioners also investigate the possibility that the symptoms may be a result of another emotional infirmity and not OCD (Foa & Kozak, 2005, p. 14). 

Most of the individuals suffering from OCD have experienced the symptoms indefinitely with periods of improvement alternating with those of difficulties. Nevertheless, the prognosis is preferential for victims with milder symptoms and those who had no other illnesses before developing OCD. According to Lowe (2007), OCD treatments include; medication and behavioral therapies.

The most common medications that are prescribed to OCD patients are the Selective Serotonin Reuptake Inhibitors (SSRIs). Lowe asserts that the purpose of these medications is to increase the levels of neurochemical serotonin in the brain since they are usually low in OCD victims. As suggested by the name of the medications, SSRIs work by carefully and selectively holding back serotonin reuptake in the brain. This holding back specifically occurs at the junction where the nerve cells are interconnected, a place known as the synapse, so as to ensure that message transfer from one nerve cell to another is limited. SSRIs also keep the serotonin in the synapses. This is possible because they prevent serotonin reuptake back to the nerve cell that specializes in conveying the impulses. Serotonin reuptake is believed to be responsible for lessening the generation of new serotonin. As a result messages from serotonin keep on coming through. Consequently, this helps in activating the cells which were initially deactivated by the OCD, thus relieving the patient of the symptoms of the disorder. Examples of SSRIs include sertraline, paroxetine, citalopram, fluoxetine, escitalopram and fluvoxamine (Lowe, 2007, p. 58). SSRIs can in general be tolerated since their side effects are generally gentle. Common side effects include agitation, nausea, headache, diarrhea, and insomnia however; these effects diminish in the first month of use. Other medications that can be used in place of the SSRIs are the clomipramine and atypical though their side effects have been reported to be severe than those of the SSRIs (Lowe, 2007, p. 58).

Behavioral therapies that are commonly administered to OCD victims include; ritual avoidance and exposure. The avoidance of rituals engages a mental-health expert in helping the patient to oppose the push to engage in obsessive behaviors. Exposure therapy, on the other hand, is a process through which the OCD victim is exposed to situations that are likely to increase his urge to be involved in obsessive behaviors, thereby helping him him/her to resist the urge (Foa & Kozak, 2005, p. 21). In other words, the behavioral experts help the OCD patients to transform their negative way of thinking that is linked with the anxiety involved with the OCD.

In conclusion, OCD can be described as a type of disorder that results from recurring obsessions and compulsions whose effects are severe to an extent that they interfere with the victim’s way of relating to the surrounding and the people around him. Several factors have been brought forward to explain the causes of the disorder. Some of these include; brain and chemical dysfunction, infection, genetics, psychodynamics, depression and life, though the universally accepted cause is brain and chemical dysfunction. A person is said to have OCD if he show signs such as hoarding, repeated cleaning, concerns of security, hygiene etc. such signs are diagnosed by examining the patient’s family history as well as asking questions that screen his mental health.  There are two ways through with OCD can be treated. One is by administering medications, SSRIs are the most recommended, and the second is behavioral therapy where the patients are helped to overcome their urge to get involved in compulsive thoughts.

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