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Obsessive compulsive disorder (OCD) is a debilitating brain and behavior disorder characterized by the person developing obsessions or undesirable, recurrent, disturbing thoughts and compulsions that cause anxiety, worry, fright and apprehension. These lead to repetitive or ritualized behaviors as an attempt to lessen the anxiety. People with OCD understand that their behavior is unreasonable or abnormal, but find themselves out of control or powerless. The resultant symptoms usually cause severe impairment and dysfunction from an early age.
The imbalance of the chemical serotonin in the brain increases the likelihood of a person developing OCD. Serotonin imbalance makes it difficult for the brain to ignore obsessive and compulsive impulses. For instance, the brain cannot turn off thought of contamination when leaving the restroom, triggering the urge to wash hands repeatedly. OCD patients respond to medications affecting serotonin, establishing the neurobiological basis of the disorder.
Image Credit: flickr.com/Cristina Chirtes
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The traditional notion was that life experience in childhood such as inordinate emphasis on cleanliness and mind conditioning cause OCD. Research has challenged these assumptions. Increasing evidence now points to neurobiological factors, behaviors and environmental factors as the major triggers.
A great deal of research on OCD now focuses on:
- the interaction of neurobiological factors and environmental influences with cognitive processes to develop OCD
- the question of whether neurobiological factors such as genetics, gender and family history of OCD, or environmental influences such as stress, occupation, and relationships are the major causes.
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Research on the relationship between environmental factors and OCD is still ongoing.
A major environmental factor that can worsen the symptoms of OCD is stressful life events, especially traumatic events such as death of a loved one, major accidents, and physical or sexual abuse during childhood. Traumatic events can also take place in school, such as unpleasant experiences of bullying or the teacher caning the student.
Apart from traumatic life events, substance abuse ranks among the major OCD triggers. Whether substance abuse is a consequence of traumatic life events in childhood or the OCD is not always clear.
Research has uncovered a link between socioeconomic conditions and OCD, with people of a lower socioeconomic status more at risk of developing the disorder. Changes in living conditions, from good to bad or bad to good also influence OCD. What is unclear however is whether lower socioeconomic conditions causes OCD, or OCD leads to a lower socioeconomic condition owing to inability to lead a normal life.
Just like the link between socioeconomic conditions and OCD, research has also established a link between marriage and OCD and employment and OCD. Unmarried people are more at risk of OCD, and so are unemployed people. Research is still ongoing, and whether unemployment and/or single life contributes to OCD or whether OCD gets in the way of a person’s employment or marriage is not yet established
Illness can also trigger OCD. For instance, a streptococcal infection of the throat may cause the body to confuse healthy cells with the infection, leading to cellular damage. Such cellular damage occurring in the brain triggers OCD symptoms. This is however a rare and temporary condition.
Another theory is that children who tend to feel guilty about their natural needs owing to cultural factors and societal norms develop OCD.
The relationship between environmental factors and OCD is based on the fact that all OCD risk factors related to environmental issues cause stress, and sometimes depression, which in turn causes more stress. Stress triggers intrusive thoughts, rituals, and emotional distress which are characteristic of OCD.
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OCD was once thought of as a rare condition, but it is actually amongst the most common of all mental diseases, with the National Institute of Mental Health estimating that about 2.2 million Americans are sufferers. A good understanding of the causative factors will help researchers to find the most effective treatments.
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- MayoClinic. “Obsessive Compulsive Disorder (OCD)." http://www.mayoclinic.com/health/obsessive-compulsive-disorder/DS00189/DSECTION=risk-factors. Retrieved 07 December 2010.
- Washington State University. “Obsessive Compulsive Disorder." http://www.vetmed.wsu.edu/academic/counseling/ocd.aspx.%20Retrieved%2007%20December%202010.
- Obsessive Compulsive Disorders. http://www.medicinenet.com/obsessive_compulsive_disorder_ocd/page2.htm.%20Retrieved%2007%20December%202010.
- Grisham, J., Anderson, T., & Sachdev, P. (2008, April). Genetic and environmental influences on obsessive-compulsive disorder. European Archives of Psychiatry & Clinical Neuroscience, 258(3), 107-116.