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Obsessive-compulsive disorder (OCD) is characterized by the presence of unreasonable thoughts and/or fears that manifest as obsessions, compulsions or both. People who have OCD usually don’t recognize the irrationality of their obsessions. There is an apparent challenge in diagnosing OCD due to the symptoms being very similar to other mental health disorders. Diagnosis is also a challenge because of the disorder’s comorbidity with other mental health issues; for example, obsessive and compulsive thoughts and actions could also be a symptom of an anxiety disorder, depression, schizophrenia or another mental illness.
While some of the symptoms of OCD may overlap with those from other disorders, OCD is characterized by a few specific traits.Symptoms of OCD include the following issues:
- Has either obsessions or compulsions or both
- The obsessions or compulsions are time consuming
- The obsessions or compulsions take on an interfering role
- The obsessions or compulsions continue after repeated attempts to ignore the thought
- Normal daily living cannot continue until the compulsive act or thought is completed
OCD’s association with low levels of serotonin, dopamine and norepinephrine
Studies show that people with OCD suffer from an imbalance of serotonin, dopamine and norepinephrine. Serotonin is an inhibitory neurotransmitter needed to regulate moods, social behavior, sleep and appetite. Dopamine is an excitatory neurotransmitter and is considered the brain’s main focus neurotransmitter.
If dopamine levels are too high or low, a person can have issues with focusing. Dopamine is also responsible for motivating the brain to accomplish tasks that one sets out to complete. Norepinephrine is another excitatory neurotransmitter and hormone that is responsible for stimulatory processes in the body and can cause anxiety if levels are too high.
Parts of the brain associated with OCD
The prefrontal orbital cortex is believed to affect appropriate social behavior and is located in the front area of the brain. When synapse activity is lowered or damaged in this area of the brain, it leads to bad judgments, uninhibited feelings, as well as a lack of remorse. Some studies suggest that people with OCD have an elevated level of dopamine in the prefrontal cortex. (Denys; Klompmakers; Westenberg 2004) When activity in this area is higher, it results in preoccupations with cleanliness, neatness, meticulousness, as well as a heightened concern with appropriateness.
The area of the prefrontal orbital cortex of the brain is believed to contribute to emotional responses to obsessive thoughts. This region of the brain interacts with the rest of the mind by telling it to act on certain obsessions in order to relieve anxiety. The repetitive thoughts or actions caused by this can include hand washing, counting, ritualistic thoughts, constant cleanliness, an obsession with symmetry, order or tidiness and more Studies suggest that elevated brain activity in the basal ganglia are potential causes for OCD. Excessive levels of dopamine in this area of the brain can cause many of the compulsive symptoms of OCD.
Dopamine transmission due to completed act
Dopamine is a chemical messenger between nerve cells. It is produced in the substantia nigra, the ventral tegmental and the adrenal medulla, and is released in times of stress. Dopamine, norepinephrine and serotonin levels are increased when a compulsion or obsession is manifested in participating in the thought or action, and anxiety that is brought on by the obsessive thought is alleviated.
According to the Lundbeck Institute, there are three major pathways of dopamine involved in OCD. Dopamine is the neurotransmitter linked to experiencing rewards and its elevation in the brain mediates the sensation of pleasure. When a person fulfills the obsessive or compulsive act, the brain is rewarded by the transmission of the neurotransmitter dopamine from the substantia nigra to the basal ganglia and caudate nucleus-putamen, all of which are parts of the brain concerned with sensory stimuli and movement.
Treatment for OCD focuses on the misinterpretation of the intrusive and uninvited thoughts. When people start to fear their thoughts, they attempt to neutralize the feelings that come from them. According to cognitive theory, people who attach exaggerated danger to their thoughts do this because of false beliefs learned earlier in life. Therefore, utilizing cognitive behavioral therapy can assist established treatments that consist of cognitive-behavioral psychotherapy and pharmacotherapy with medications that increase the transmission of serotonin and dopamine.
If you would like more information on treatment for OCD, you can call the Mental Health Helpline at 855-653-8178 and get the help you need.