OCD is Not Just One Thing

Commonly referred to as OCD, obsessive compulsive disorder is a distressing mental health condition that can significantly interfere with day-to-day functioning. It is characterized by obsessions, which are intrusive, frightening, or repulsive thoughts, urges, or images along with repetitious behaviors, called compulsions. OCD can become all-consuming, and if left untreated, it can lead to significant impairments in personal, interpersonal, social, academic, and occupational functioning. Although there is a similar pattern of symptoms, did you know there are multiple types of OCD, and that each type requires a different treatment plan? It’s true! Before describing details about these differences, let’s take a look at some general information about OCD.

Common Symptoms in OCD

While all of us have unwanted or unpleasant thoughts at times, they typically pass quickly and don’t get stuck in a loop inside our heads. However, with OCD, the thoughts become uncontrollable obsessions and tend to revolve around themes related to:

• Germs and contamination
• Symmetry
• Religion
• Sexual ideations
• Aggressive impulses
• Fear of harming or killing others

Depending on what the obsessive thoughts are, people with OCD will usually engage in compulsions to help diminish the anxiety or fear associated with the thoughts by doing things such as:

• Excessive handwashing or cleaning
• Counting, checking or touching
• Arranging things in a specific order
• Certain rituals
• Restrictive or limiting behaviors

Though many who suffer from OCD intellectually recognize the irrationality of their thoughts and behavior, they cannot seem to stop themselves, and without treatment, it is likely their symptoms will persist.

Underlying Causes of OCD

It is estimated that during their lifetime, between 2-3% of people will develop OCD. Research has found there is a genetic component in some, but not all, cases. Published studies on twins have found a heritability range of 45% – 65% in children with obsessive-compulsive symptoms and a range of 27% – 47% for adult-onset OCD. The exact mechanisms of OCD are still not fully known, but there are indications that certain circuits in the brain are—or can become—disrupted and lead to the development of symptoms. This may be caused by events or circumstances in a person’s environment that trigger the symptoms, or it could stem from insults to the brain such as seizure disorders, infections, exposure to toxins, head trauma, or other conditions that adversely impact normal brain function.

Brain SPECT Imaging Patterns in OCD

Since OCD can arise from different underlying causes, one of the challenges with treating it is that without understanding exactly what is going on in a person’s brain, it can be hard to know which strategies will work best to control symptoms. With more than 170,000 brain SPECT (single photon emission computed tomography) scans on patients from all over the world, the doctors at Amen Clinics have found that OCD—like other mental health conditions—is not a single or simple disorder. Rather, there are various sources of dysfunction in the brain that can drive symptoms, and these can be revealed in the SPECT scans. With more than 170,000 brain SPECT scans on patients from all over the world, the doctors at Amen Clinics have found that OCD—like other mental health conditions—is not a single or simple disorder.

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Here are 3 examples:

1. The most common OCD pattern involves increased blood flow in two areas of the brain—the anterior cingulate gyrus and the basal ganglia.

• The anterior cingulate gyrus is involved with attention, and when this part of the brain works normally, it allows us to shift from one thought to the next. However, when it is overactive, people tend to get “stuck” on thoughts or behaviors.
• The basal ganglia help to set the body’s idle or anxiety level. Among other functions, they are involved in forming habits, but overactivity in this area of the brain is associated with increased anxiety.

2. Exposure to toxins, such as mold or acquiring infections like Lyme disease can lead to the development of OCD symptoms. A 2018 study in the journal, General Hospital Psychiatry, found that 84% of those who had been diagnosed with Lyme disease developed symptoms of OCD.

On SPECT scans, toxic or infectious injuries show multiple areas of low blood flow in the brain, which can interfere with how neurons (brain cells) are able to communicate.

3. In seizure disorders like epilepsy, OCD symptoms are much more common than in the general population. A research study published in Epilepsy and Behavior found that up to 25% of patients with temporal lobe epilepsy also had OCD.

On SPECT images, this pattern can present as decreased activity in one or both temporal lobes, along with overactivity in the anterior cingulate gyrus. By actually looking at the brain with SPECT imaging, a doctor is able to see the biological issues that underlie a patient’s OCD. With this information, a personalized and targeted treatment plan can be created to help balance brain function and get symptoms under control. OCD and other mental health issues can’t wait. During these uncertain times, your mental well-being is more important than ever and waiting until life gets back to “normal” is likely to make your symptoms worsen over time. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.