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Obsessive-compulsive disorder (OCD) is generally defined as having tendencies of unreasonable thoughts and fears that lead to compulsive and/or obsessive behaviors or unwanted urges. Not all forms of OCD include both obsessions and compulsions, but instead show a propensity towards either behavior. A person dealing with OCD may exhibit symptoms such as orderliness, counting, checking, following strict routines, washing and cleaning, ritualistic behavior and other signs.
OCD can be caused by a number of factors such as an imbalance of neurotransmitters. Understanding what causes OCD can help to provide better, more accurate treatment methods for those dealing with the disorder.
Low serotonin levels
Serotonin is a highly useful neurotransmitter that is responsible for influencing mood levels, aggression, impulse control, body temperature, pain levels, learning and processing new information, focusing abilities, memory, appetite and sleep patterns. Serotonin regulatory disorder is the most essential part of the pathophysiology of OCD. Research on the link between lower serotonin levels and OCD symptoms is limited; however, studies show that treating OCD with selective serotonin reuptake inhibitors (SSRIs) can help curb OCD symptoms (NIMH 2014).
Low dopamine levels
Dopamine is the neurotransmitter linked to experiencing rewards, as dopamine elevation in the brain mediates the sensation of pleasure, it acts as a hormone in the hypothalamus. When a person is exposed to things like sugar, new clothes or something that one would usually get excited about, the dopamine hormone is sent to the nucleus accumbens.
Certain theories suggest that the function of dopamine may be involved in the awareness of perceived objects and events, and that dopamine’s role is to assist in decision making by influencing the priority of the situation. Studies show lower levels of dopamine could cause a person with OCD to feel compelled to fix or perfect something in the effort to please one’s senses. Overtime the importance of these thoughts can become obsessive and the resulting behavior can become compulsive (Buckholtz 2010).
The cingulate gyrus in the brain plays a big role in generating OCD by:
- Being the area of the brain that is believed to contribute to the emotional responses to obsessive thoughts
- Being interconnected to the prefrontal orbital cortex and functioning as a delegator of social behavior, telling the rest of the brain to act on certain obsessions, which in turn relieves anxiety
- Lowered activity or damage to this region of the brain being linked to making bad judgments, feeling uninhibited, as well as lacking remorse or regard for one’s actions
- Higher activity that may result in being more meticulous, neat, preoccupied with cleanliness and overly concerned with acting appropriately
Established treatments for OCD consist of cognitive behavioral psychotherapy and pharmacotherapy with medications that target serotonergic and dopaminergic neurotransmission. Studies show that people with OCD suffer from an imbalance of serotonin, dopamine and norepinephrine and are therefore prescribed medications that increase serotonin and dopamine output to reduce symptoms of OCD (NIMH 2014).
Cognitive behavioral therapy is based on a cognitive theory of psychopathology, focusing on how people with OCD misinterpret their thoughts and why. Thoughts for people with OCD are intrusive and uninvited. When people with OCD start to fear their thoughts, they attempt to neutralize the feelings that come from their thoughts by acting out their compulsion. Thoughts, feelings and fears can be of a distorted reality and based on misconceptions of current situations based on past trauma or negative experiences. Cognitive behavioral therapy teaches a patient how to identify distorted beliefs that result in negative thoughts and eventually trigger unwanted behavior.
If you or a loved one would like more information on how to obtain treatment for OCD, you can call the Mental Health Helpline at 855-653-8178.