Obsessive Compulsive Disorder (OCD) and Your Brain

By at December 11, 2010 | 3:20 pm | Print

Obsessive Compulsive Disorder (OCD) and Your Brain

Obsessive Compulsive Disorder (OCD) written by Telisa Yandell

The Physiology of an Imprisoned Mind: An Investigation into OCD

Imagine being helpless against incessant, irrational thoughts and behaviors that seem completely outside the realm of one’s control. Whether the lack of control centers around someone washing their hands fifty or more times per day to avoid contamination, or someone who cannot sleep no matter how hard they try because they have to keep re-checking the locks to make sure that they are locked. It could also be a person who is basically imprisons themselves in their own room because they are unable to leave if everything is not in the exact order or place that it is “supposed to be” (Abramowitz 3). These are just some of the many examples of the adversities faced by someone who has obsessive-compulsive disorder, or more commonly known as OCD. The manifestations of this disorder are easily discernable as out of place and quite bizarre however, no one really knows why a person is acting out in this way. If society had a fuller understanding it could help people who are close to people with OCD to cope, and it additionally would help take away the shame that a person afflicted with this disorder feels because of their unconventional thoughts, urges, and behaviors.

To address obsessive-compulsive disorder biologically, it all has to begin with the brain. The brain itself is an organ of overwhelming complexity. It is made up of many neural networks that aim to transmit chemical messages from different parts of the body to specific areas of the brain to be processed, and then off with another nerve impulse sent via the postsynaptic neuron to produce thoughts, feelings, and behaviors (McGrath 51). This process is not as simple as it sounds as each neuron, or brain cell, is not connected to one another; there is a junction known as the synapse between each of the neuron cells. Therefore, the neurons have to send messages utilizing neurotransmitters which leave the presynaptic neuron and accumulate on the postsynaptic neuron by attaching to their nerve processes called the dendrites. Once there are enough of these neurotransmitters the electrical charge along the cell is great enough that it sets off an action potential, or sends a large charge to the cell body. The action potential then goes through the cell body and to the axon, which is the nerve process that carries the impulse to the terminal side of the neuron, and the whole process starts anew with each neuron till it reaches its final destination (Krumme). It is very comparable to the way a light switch works. The nerve impulses, or the electrical currents of lights, are propelled toward different areas of the body while the light switch disperses its light energy among different light bulbs within the vacinity.

This all becomes vitally important when discussing the Cortico-Striato-Thalamo-Cortical Circuits or CSTC. The parts of this system indicated in OCD research are the orbit frontal cortex, striatum, and thalamus. Although there are two separate branches, OCD is mainly concerned with the second branch called the cortico-striato-thalamic branch (Rauch 194). Like a fast-paced roadway, the striatum can either propagate nerve impulses with a green light keeping traffic flowing, thereby causing the thalamus to fire an action potential, or it can inhibit the production of an action potential when the traffic signal turns red to stop traffic. The tasks of this system include “[filtering] out extraneous input, [ensuring] refined output, and [mediating] stereotyped, rule-based processes without necessitating the allocation of conscious resources” (Rauch 194).

Putting this all into context in a person with OCD, the cortico-striato-thalamo-cortical circuit over-functions. In some cases troubled thoughts, worries, or doubts, which originate in the orbital frontal cortex, in normal brain functioning travel to the striatum; once there, these extraneous thoughts are able to be halted through the action of the caudate nucleus. However, in the case of an obsessive-compulsive disorder brain this part of the striatum is hypothesized to be deficient. Thus, these unnecessary thoughts turn into obsessions as the line of thought continues on and overworks the system like a traffic signal always stuck on green (“Obsessive” 3). In an attempt to quell the anxiety and fear that are elicited, the person acts out on urges by performing the action that they perceive as an avoidance of a particular trigger. There are as many avoidance behaviors out there as there are people and they are all unique to the person and subject to change due to life circumstances at any time.

Another theory in the making effects children who have certain genetic markers, such as elevated levels of D8/17 antibodies, and at some point have come down with a case of streptococcal infection. When their bodies try to combat the illness in an autoimmune response, a case of “molecular mimicry” occurs. In this phenomenon, “antistreptococcal antibodies cross-react with basal ganglia proteins, triggering an inflammatory response [to] [produce] the symptoms of Sydenham’s chorea” (Arnold 1353-54). The antibodies are basically unable to differentiate between the brain cells and the streptococcal ones. This course of illness ultimately may lead some children to become obsessive-compulsive based on the location of inflammation and damage to brain cells. The U.S. National Institute of Mental Health has termed this as “pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections” respectively (PANDAS) (Arnold 1354).

Duke University researchers using mice might have unleashed another piece of the overall puzzle as well. Using genetically engineered mice they eliminated a specific gene known as SAPAP3 which encodes for a particular protein. Without this protein the mice began exhibiting OCD –like behaviors. They were grooming and scratching themselves to the point that they were bald in some areas and had rubbed their skin raw. Furthermore, the researchers noticed a certain type of energy they claimed to be the symptom of anxiety just as can even be seen in individuals with OCD. As done with humans with OCD, they gave the mice SSRI’s and saw improvement in their behaviors. To a great degree researchers have been baffled by this disease because they have been unable to replicate it in any animal model. For that reason this has made many within the medical community excited about the possibilities of solving the psychological phenomenon that plagues people from all across the world similarly (“Mice” 7).    

After discussing the possible theories being attributed to the disorder, it is likewise important to talk about the science behind treating the disorder. The most prevalent treatment from a biological standpoint is prescribing a selective serotonin reuptake inhibitor (SSRI). As the name implies, this line of medications keep the serotonin within the synaptic gap rather than being absorbed back into the neuron it released from. Thus, the serotonin molecules have a greater probability of attaching to the dendrite of another neuron and starting an action potential. This is important because “serotonin is known to be one of the chemical messengers in the pathway between the basal ganglia and the frontal cortex” (Harvard 19). The increase in nerve impulses throughout this part of the brain has been clinically shown to damper the effect of OCD on an individual. Common SSRI’s that the FDA indorses for the treatment of OCD are Prozac, Luvox, Zoloft, Paxil, and Anafranil (McGrath 168-69).

All and all, Obsessive-Compulsive Disorder is a very intricate and troublesome disorder to deal with. When most people would not give something a second thought, people with OCD may spend hours on end ruminating about it. OCD ranges all across a variety of subject matters. Thought patterns may be around washing and cleanliness, hoarding, checking, order and symmetry, scrupulosity, and aggression (McGrath 6-7). Behaviors exhibited by individuals with OCD are not only hard for society to understand, but the disorder has dumbfounded professionals as well. Medical researchers have begun to try to unlock the secrets of this disorder pieces at a time. Then it follows that major discoveries are on the horizon because as of now, there are only medications and cognitive behavioral therapies that do progress to a certain point, but even then there is always the risk of relapse. Furthermore, the searching OCD patients have to go through just to find a medication or therapy concept that alleviates a mere fraction of the pain and suffering imposed on them along with the destruction it can bring to their lives, makes breakthroughs in research a daunting task to undertake. However, as the old saying goes “knowledge is power;” meaning that the more people who open the doors to discussing OCD without judgment and spend time researching it, the more likely society can continue to build on the knowledge it has ascertained to bring a hopeful outlook for the future of people everywhere who have to struggle with this nasty cruel disorder.  

Works Cited

Abramowitz, Jonathon S. Obsessive-Compulsive Disorder: Advances in Psychotherapy. St. Louis: Hogrefe & Huber, 2006. Print.

Arnold, Paul D., and Margaret A. Richter. “Is Obsessive-Compulsive Disorder an Autoimmune Disease.” Canadian Medical Association Journal 165.10 (2001): 1353-57. EBSCOhost. Web. 18 Nov. 2010.

Krumme, Gregg M. “Structure of the Central Nervous System .” Missouri State University. Springfield, MO. 10 Feb. 2009. Lecture.

McGrath, Patrick B. The OCD Answer Book. Naperville, IL: Sourcebooks, 2007.. Print.

“Mice Provide New Clues About Obsessive-Compulsive Disorder.” Harvard Mental Health Letter 24.6 (2007): 7. Academic Search Elite.  Web. 18 Nov. 2010.

“Obsessive-Compulsive Disorder–Part II.” Harvard Mental Health Letter 15.5 (1998): 19 pars. EBSCOhost. Web. 18 Nov. 2010.

Rauch, Scott L., Gabriela Corá-Locatelli, and Benjamin D. Greenberg. “Pathogenesis of Obsessive-Compulsive Disorder.” Textbook of Anxiety Disorders. Eds. Dan J. Stein, and Eric Hollander.  Washington D.C.: American Psychiatric Publishing, 2002. 191-202. Print.

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