Wednesday, 11 November 2015

The ABC of OCD

One of the first blog posts I wrote was on the subject of behavioural addictions and their neural basis. This week I will be discussing a similar condition, Obsessive Compulsive Disorder (OCD).

This post is based on a radio show I hosted last week with two of my fellow Neuroscience students, Tori and Georgie. If you'd like to hear more on this topic, please click here!

Let’s begin by defining OCD: The 'obsession' is an unwanted (and unpleasant) thought or urge that repeatedly enters a person’s mind, causing anxiety or unease. The 'compulsion' is a repetitive behaviour that someone feels they need to carry out to temporarily relieve the unpleasant feelings. OCD is a distressing and debilitating disease, with patients spending up to 6 hours a day on their obsessions and 4 hours on their compulsions.
12 in every 1000 people in the UK are affected. This works out as 750,000 overall, or 1.2% of the population. The symptoms a person experiences can range from mild to severe; less than a quarter of cases are mild and more than half are severe.

It’s not clear what causes OCD, but a variety of factors have been suggested to contribute to onset. For example, the condition runs in some families and has been linked to certain genes, suggesting that a predisposition to OCD can be inherited. Stressful/traumatic life events have also been linked to a sudden onset of OCD, mostly often seen after a person has developed a syndrome caused by a streptococcal infection. Life changes such as puberty or childbirth can also contribute to the onset of OCD. OCD is a complex condition and unsurprisingly, therefore, there are numerous factors that play a part in its onset.

An irrational fear of dirt and disease is the most commonly seen form of OCD and features in around 1/3 of cases. The next most common is irrational fears of harm (i.e. wondering if the oven was left on etc) and affects around ¼ of cases. Around 10% have a compulsion for patterns and symmetry (i.e. obsession with touching everything on both sides). Can also have obsessions with physical symptoms, blasphemous thoughts or thoughts of carrying out acts of violence. People with OCD may be diagnosed with other conditions – i.e. body dysmorphia/anorexia nervosa, Tourette’s, ADHD etc.

Interestingly, there are also links between suffering from OCD and imbalance in serotonin in the brain. Serotonin is a neurotransmitter that helps to transmit information from one brain cell to another.

Public opinion around OCD varies. OCD is a term that is thrown about casually even though it denotes a distressing and crippling mental health condition. Often when OCD is mentioned, people think of someone manically cleaning (probably because of TV shows such as Channel 4's Obsessive Compulsive Cleaners..!) However, cleaning is not actually an OCD activity, per se. Thoughts and impulses around a topic like cleaning (such as fear of germs on a surface) are of such an irrational degree that it lies far outside the normal range of worries to be classed as OCD.

Repeated and unnecessary washing of hands is often associated with OCD
Depictions of OCD in movies and television often show idealised representations of the disorder. However, despite being idealised, they often raise awareness and can improve understanding of the condition. For example, Leonardo DiCaprio portrayed the American business tycoon Howard Hughes in the film The Aviator, who suffered with incapacitating OCD symptoms, such as contamination fears.Talking about the condition also helps to raise awareness. OCD Awareness Week runs every year from 11-17 October, with aims to raise understanding around OCD and related disorders.

New treatments include Cognitive Behavioural Therapy and Selective Serotonin Reuptake Inhibitors (SSRIs). Both of these treatments target serotonin and dopamine levels in the brain. New research points towards that glutamate may also be of interest for OCD sufferers. Glutamate is the main excitatory neurotransmitter in the brain, and it has been reported that OCD individuals have higher levels of glutamate in cerebrospinal fluid (CSF, the fluid that bathes the brain). The more research that continues in this avenue, the more can be done to create effective treatments for sufferers.

A more controversial potential treatment for OCD is the use of Ketamine. Ketamine has already been implicated for use as an antidepressant, due to it's action at a type of receptor in the brain (called NMDA receptors). Ketamine's use in OCD trials has been seen to improve mood for up to 7 days - showing that the mood improvement is not just a drug 'high'. Depression if often diagnosed alongside OCD, so harnessing the power of Ketamine into a medical treatment could provide a real lifeline for sufferers.

If you'd like to learn more about this condition, some interesting articles from The Guardian that show how debilitating the condition can be are linked here and here.

Let me know what you think in the comments!


  1. Thank you for such an informative post! this will help so many people understand OCD xx

  2. Fascinating! It does annoy me when people misuse the term OCD to describe habit, not the disorder. Hopefully discussing it more will raise more awareness!

    1. I completely agree! It's the same with any mental health issue, such as depression or anxiety. Glad you liked the post! x

  3. Enjoyed your post. Really informative but also clear and engaging to read. Thought the letters in the soup picture was particularly good. Certainly improved my understanding of such a debilitating condition.