Alternative names: OCD.
Obsessive-Compulsive Disorder is characterized by obsessive thoughts and/or compulsive behaviors that significantly interfere with normal life. Obsessions are unwanted, recurrent, and disturbing thoughts which the person cannot suppress and which can cause overwhelming anxiety. Compulsions are repetitive, ritualized behaviors that the person feels driven to perform to alleviate the anxiety of the obsessions. The obsessive and compulsive rituals can occupy many hours of each day. It affects men, women, and children, as well as people of all races, religions, and socioeconomic backgrounds.
OCD is a medical illness recognized by experts throughout the world. People with OCD are not "crazy", although they may sometimes feel that way because they are troubled by thoughts and actions that they know are inappropriate. People with OCD are often anxious and depressed; they often believe they are the only ones who have irrational, obsessive thoughts, and are therefore often ashamed and afraid to tell anyone or to seek help. Having OCD is not a sign of weakness or a lack of willpower in stopping the thoughts and behaviors. At least 80% of patients with OCD have both obsessions and compulsions. Probably under 20% have only obsessions or compulsions.
The most common obsessions are:
The most common compulsions are:
OCD is the fourth most common mental illness and affects approximately 5 million people in the United States.
Although the exact cause is not known, OCD appears to be caused by increased activity in the orbital frontal cortex and caudate nucleus of the brain. OCD may also involve abnormal functioning (low levels) of the neurotransmitter serotonin in the brain.
Stress does not cause OCD; however, a stressful event like the death of a loved one, birth of a child, or divorce can trigger the onset of the disorder.
Diagnosis is delayed until the symptoms are "unmasked".
OCD is a treatable disease, and effective medications and therapy techniques are available: Sufferers can get better if they seek help and get the appropriate treatment.
The two most effective treatments for OCD are conventional drug therapy and behavioral therapy. It is generally most effective if the two can be used together.
Obsessions can cause anxiety, causing the sufferer to engage in compulsions in an attempt to alleviate the distress caused by the obsessions. Carrying out these compulsions, or rituals, does not result in any permanent change, and in fact, the OCD symptoms worsen.
It is now recognized that obsessive-compulsive symptoms occur in about half of patients with Tourette Syndrome. One informal survey of TS patients found that 72% (18 out of 25) had obsessive compulsive traits.
OCD may be related to a central disturbance in serotonin metabolism, a hypothesis which appears to explain the efficacy of serotonin reuptake-blocking drugs. L- tryptophan and 5-HTP are serotonin precursors.
Side effects were mainly drowsiness and headaches in those whose daily doses of L- tryptophan exceeded 6,000mg. [Clinical Psychiatry News, September, 1981] Supplementation may be contraindicated in OCD patients with a history of aggressive behavior since it may increase
The most effective medications for OCD are the SSRIs (Selective Serotonin Reuptake Inhibitors) Prozac, Paxil, Luvox, and Zoloft as well as the tricyclic Anafranil. Other medications may be added to improve the effect.
Behavioral therapy teaches people with OCD to confront their fears and reduce the anxiety without performing the rituals.
One study showed that 18gm of inositol daily (2 tsp in juice 3 times daily) for 6 weeks significantly reduced OCD symptoms compared with placebo. At 3 weeks there were no significant effects of inositol. The mechanism may be that the desensitization of serotonin receptors is reversed by addition of dietary inositol. [Brain Res 631: pp.349- 51, 1993; American Journal of Psychiatry, September, 1996;153(9): pp.1219-1221]
A study found plasma pyridoxal-5-phosphate (active vitamin B6) levels were about 48% lower in depressed patients than in controls, a statistically significant finding. 57% of depressed patients, but none of the controls, were B6-deficient. When B6 nutriture was evaluated by enzyme stimulation testing (a more sensitive method), all the depressed patients and none of the controls were deficient. [Russ CS et al. Vitamin B6 status of depressed and obsessive-compulsive patients. Nutr Rep Int 27( 4): pp.867-73, 1983]
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