Life with OCD is a daily struggle. This brain disorder is associated with pervasive thoughts known as obsessions, and behaviors to quell these obsessions known as compulsions. It’s an endless cycle, much like a hamster wheel. Sadly, if you’re suffering from OCD you get no pleasure because it’s a negative spiral that drains your energy and leaves you depleted. OCD takes on many forms, with all manner of invasive thoughts.
Sometimes, these thoughts are malicious, even criminal, despite the fact that the individual has no desire to follow through on these reprehensible notions. A noncriminal-minded person with OCD may start thinking about robbing a bank, hurting a child, committing lewd acts in public, et cetera. The problem with these thoughts is that they become so overwhelming that it becomes impossible to think clearly.
We’ve all heard of OCD sufferers obsessing about cleanliness and hygiene. This is one of the most common OCD ailments. Others include safety and security, performing actions according to set patterns, or simply replaying conversations and experiences over and over again. These repetitive urges could be due to an inability to understand and identify what researchers call ‘safe stimuli’. At least that’s the thinking behind a new study by neuroscientist AA Schoute [https://m.pnas.org/content/114/12/3216.abstract] from the University of Cambridge in the UK. Her team conducted an intensive experiment with OCD and non-OCD brain activity and anxiety-related responses.
78 people were recruited in the study, including 43 volunteers with OCD and 35 without. A magnetic resonance imaging device was used with visual stimuli. Shocks were administered for a green face, but no shock for a red face. Surprisingly, patients with OCD did not quite understand that the red face was safe and the green face would yield a shock. With OCD, patients find it difficult to unlearn negative associations even in the face of efforts to correct the thought processes. It is this same track that might explain the sometimes limited efficacy with ERP (Exposure and Response Prevention) when treating OCD.
What Treatment Options Are Available for OCD?
Studies reflect that between 32% – 72% of OCD sufferers will undergo remission of symptoms over time [https://bit.ly/3yu3qAY], provided the right approach is adopted. The first line of defense against OCD is medication. The FDA has approved a class of drugs known as
SSRIs (selective serotonin reuptake inhibitors), SNRIs (selective norepinephrine reuptake inhibitors), and TCAs (tricyclic antidepressants).
The terminology is not to be confused: antidepressants are highly effective for treating anxiety disorders. OCD is an anxiety disorder. Serotonin-related issues are a known contributor to OCD. More and more patients and their medical professionals are tackling the medication route with augmented solutions. This combination of antianxiety medications has proven successful in treating this disorder.
Psychotherapy is one of several recommended forms of OCD therapy. When administered by an expert, according to a structured plan, psychological therapy can mitigate the intensity of OCD symptoms through two specific therapies. These include ERP and CBT. Cognitive Behavioral Therapy is the preferred option, but it comes at a premium. The costs of this form of therapy can be prohibitive. Often, people with OCD attend group-style therapy sessions where CBT is administered. A new-age therapy that is being promoted is known as ACT (acceptance & commitment therapy) which seeks to redefine our reactions to stressors.
Beyond the basic therapies are sophisticated technologies that are reshaping the way that medical professionals deal with OCD. One of the most promising treatments is Deep TMS™, cleared by the FDA in 2018. Deep Transcranial Magnetic Stimulation is entirely unique in terms of the magnetic fields that are employed to target problematic brain structures associated with this mental health disorder. The neural activity in specific sections of the brain does not work as it is supposed to. Deep TMS attempts to safely, non-surgically alter the brain structures by way of electromagnetic waves in a specialized helmet. It is particularly effective for patients who do not respond well, if at all, to medication and therapy.
Surgical Options for Treating OCD
When patients are suffering from severe OCD, surgical solutions can be considered. Provided the OCD meets the criteria, several surgical options are available. Brain surgery for mental health disorders is known as psychosurgery. Various options such as DBS (Deep Brain Stimulation) are available, albeit with higher risks involved. No brain tissue is destroyed with this particular surgery.
This procedure requires an electrical device to be implanted. It sends shocks to the brain. This is a reversible form of surgery and doesn’t permanently damage the brain tissue. It was approved by the FDA in 2009 [https://www.livescience.com/37120-psychosurgery-ocd.html]. The implant may falter over time, necessitating urgent surgery to remove and replace it. The device itself is similar to a pacemaker for the heart. Potential side-effects include infection, surgical errors, and complications from anesthesia.
An anterior capsulotomy is another surgical procedure that is routinely conducted. Similar in style to anterior cingulotomy surgery, this treatment option targets the ‘anterior limb of the internal capsule’. When patients are suffering from treatment-resistant obsessive-compulsive disorder, this surgical procedure tends to bring about relief 50% – 60% of the time. [https://www.psychguides.com/ocd/treatment/]. Gamma knife radiation is yet another form of psychosurgery that has proven to be effective 60% of the time with treatment-resistant OCD. It involves targeting brain tissue with multiple sources of gamma rays to destroy problematic areas.
There are many different surgical and nonsurgical options available for treating OCD. There is no single best approach to adopt since each patient must be assessed accordingly. For many patients suffering from OCD, medication and therapy tend to suffice. For treatment-resistant OCD, alternative options must be considered. These include surgical and nonsurgical treatments. The best course of action is the one that patients respond to favorably. For that, several treatment regimens may need to be considered.
