We often come across people who are particular about doing things a certain way such as keeping their books or glasses in a specific pattern or repeating an activity several times until they are content. This can be a sign of a mental health condition called Obsessive-Compulsive Disorder (OCD), which is characterised by a cycle of unreasonable images, urges, and intrusive thoughts that cause distress and anxiety to the person. While obsessions are intrusive and irrational thoughts or fears that happen often, compulsions are the repetitive behaviours that occur due to an obsession. 

What are the signs of OCD?

Obsession can be upsetting and result in severe anxiety. Some of the signs of obsession include:

• Persistent doubts about having done things right. For instance, locking the door, turning off the switches or counting things
• Fear of getting contaminated with dirt or germs
• Thoughts of keeping things in a specific order or symmetry
• Thoughts of hurting or harming someone
• Offensive sexual thoughts

On the other hand, compulsions are the repetitive acts that are carried out to neutralize or counteract the stress caused by an obsession. Some of the signs of compulsion include: 

• Repeatedly checking the door locks, switches or stove
• Washing hands frequently
• Repeated cleaning of the household items
• Arranging things in a specific way and getting upset if the order is disrupted
• Asking for approval or reassurance constantly
• Repeated counting

What causes OCD?

The exact cause of OCD is not known but scientists believe it could be due to overactivity of a part of the brain or low levels of serotonin (a chemical messenger of the brain). Moreover, factors that may increase the risk of developing the condition include:

• Major life changes such as getting married or divorced, starting a new job or moving to a new place
• Emotional trauma such as the death of a loved one
• History of physical or mental abuse at school, work or home
• Suffering from an illness

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How is OCD treated?

There is no exact cure for OCD. However, measures that may help manage the symptoms of OCD include:

• Medications: Doctors may prescribe medications such as serotonin reuptake inhibitors (SRIs), selective SRIs (SSRIs), and tricyclic antidepressants to increase the levels of serotonin (a chemical messenger) in the brain that may help control the OCD symptoms. 
• Psychological therapy: Therapies such as cognitive behavioural therapy are used to make the patient acknowledge and control the obsessive thoughts and fears. 
• Deep brain stimulation (DBS): It is a surgical procedure where electrodes are implanted in certain areas of the brain which are stimulated with mild electric currents. These electrical impulses help in reducing the symptoms of chronic OCD.  

New research for the treatment of OCD

Recent studies have found new treatment modules for treating patients with OCD. Some of these latest research include:

1. Troriluzole 

In April 2021, a US-based pharmaceutical company called Biohaven announced the commencement of a Phase-3 clinical trial to assess the efficacy and safety of troriluzole for the treatment of OCD. Troriluzole is a prodrug (a drug that gets active after administering in the body) that manages the activity of glutamate, one of the most potent chemical messengers of the brain. This prodrug is known to help manage the symptoms of OCD effectively.

2. Deep transcranial magnetic stimulation (dTMS)

In 2020, the Medical University of South Carolina found that OCD obsessions occur due to hyperactivity in a part of the brain called the cortical-striatal-thalamic-cortical (CSTC) circuit. Scientists from the university designed a therapy called dTMS, which helps in regulating the nerve activity of the CSTC circuit using a magnet that produces electromagnetic pulses. This therapy helps in reducing the obsessive thoughts in the brain. The entire session is painless, requires no anaesthesia, and lasts for 30 minutes.

3. Antibody treatment

A study published in the journal Brain, Behavior, and Immunity in July 2020 found that people suffering from OCD have a high level of Immuno-moodulin (Imood). Imood is a protein found in the lymphocytes (a type of immune cell). On treating a group of mice suffering from OCD with an antibody that neutralises Imood, the levels of anxiety reduced significantly. Scientists have been working along with a pharmaceutical company to form a potential medication with this antibody to treat OCD patients.

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Conclusion

Obsessive-compulsive disorder can affect people of any age and gender. The signs include unwanted, inappropriate thoughts or urges that may trigger some compulsive behaviours to reduce anxiety and distress. There is no cure for OCD yet but medications, cognitive behavioural therapy, and new treatment modules can help reduce the symptoms and improve the quality of life.

Consult a Mental Health Expert