Which OCD Brain Pattern Do You Have?
When you think of OCD (obsessive compulsive disorder), what comes to your mind? Visions of someone cleaning furiously or washing their hands multiple times? That’s the image most people have regarding this condition, which affects about 1 in 40 adults and 1 in 200 children. But OCD isn’t just one thing. There are different types of OCD, and brain SPECT imaging reveals different patterns in the brain associated with those types.
GET TO KNOW THE OCD TYPES
OCD is a condition that is characterized by obsessions and compulsions. Obsessions are recurring thoughts, impulses, or mental images that are intrusive, usually senseless, sometimes frightening, and often repulsive. Compulsions involve repetitive behaviors that are performed in response to obsessions and the anxiety they cause.
These obsessions and compulsions can take on many forms, although most tend to fall into the following 5 types.
- Contamination and cleaning: This type typically involves obsessive worries about being contaminated or coming into contact with contaminants that might make you or a loved one ill. This leads to compulsions, such as excessive cleaning, washing, or showering. An Amen Clinics patient named Gail used to clean her house for hours every night after work, but she derived no pleasure or sense of satisfaction from making the house gleam. She was also fixated on making her husband and kids wash their hands more than 10 times a day (and this was long before pandemic hand-washing practices took over). She also stopped having sex with her husband because she couldn’t stand the feeling of being messy. The couple was on the verge of divorce.
- Checking: With this type of OCD, you are likely to be wracked with fears about some type of harm that may come to you or someone you love. For example, you may be afraid of an armed intruder hurting you or a fire destroying your home. In response, you may compulsively check that doors are locked or that you turned off the stove.
- Symmetry and order: Some people have feelings of dread that if everything isn’t “just so” in perfect symmetrical order will lead to some form of harm. This type is tied to spending inordinate amounts of time trying to keep everything in order.
- Forbidden thoughts: This involves obsessing over unwanted, disturbing, and repulsive thoughts. At Amen Clinics, an 83-year-old patient named Sylvia had intrusive sexual thoughts that made her feel dirty. She was so disgusted by them that she would lock all her doors, draw the curtains, turn off the lights, and sit in the middle of a dark room in an effort to stop the abhorrent sexual thoughts that came into her mind.
- Hoarding: Considered a type of OCD, this type causes distressing thoughts whenever you think about discarding something due to a perceived need to retain it. This may lead to compulsive shopping, stockpiling items, or piles of “important” things piling up. As an example, look at Bill, a high-powered attorney who visited Amen Clinics for symptoms of OCD and hoarding. He refused to let anyone ride in his car and would always say there wasn’t enough room for passengers even though he drove a large sedan. It turned out that about 70% of the space in his car was filled with trash and piles of work papers that he couldn’t part with.
OCD BRAIN TYPES
1. Overactive Brains
SPECT scans show that in most OCD types—contamination and cleaning, checking, symmetry and order, and forbidden thoughts—the brain’s frontal lobes are overactive. The scans light up so much, it’s like the brain is on fire.
Take Gail, for instance. Her SPECT study showed marked increased activity in her frontal lobes and an area called the anterior cingulate gyrus. This area is involved in shifting from one idea to another or from one action to another. When there is too much activity here, people like Gail tend to get “stuck” on thoughts and behaviors, even if they get no pleasure from them. Seeing this helped find the right treatment plan for Gail, who within 6 weeks, felt significantly more relaxed. Her ritualistic behavior diminished, and she stopped forcing her husband and children to wash their hands every time they turned around.
Other findings on SPECT scans in people with these types of OCD include heightened brain activity in a region called the basal ganglia. This area helps set the body’s anxiety level and plays a role in habit formation.
2. Sleepy Brains
People who are hoarders sometimes have a different brain pattern. For example, Bill’s SPECT scans didn’t reveal the classic OCD patterns, but rather it showed that his brain was “sleepy,” or underactive in some areas involved in organization. This helped explain why he ended up with a car full of useless stuff that he felt powerless to discard.
Without looking at his brain scans, Bill might have been given medications for classic OCD, which likely would have exacerbated his condition. Seeing his brain patterns helped find the right treatment protocol for him. Over time, he was able to clean out his car without being overwhelmed by distressing thoughts, and he was finally able to keep things more organized at work, so he no longer piled important papers in his car.
OCD (regardless of which type you have), and other conditions like anxiety, ADD/ADHD, and depression 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. If all our specialists are busy helping others, you can also schedule a time to talk.