What causes OCD to develop 2

Why does OCD cause repeated obsessions, persistent and unwanted thoughts, urges or images

that are intrusive?

Tasia Carlsen

544505

Lord Tweedsmuir

April 12
OCD 2

"Obsessive Compulsive Disorder (OCD) is a mental health disorder that affects people of all

ages and walks of life, and occurs when a person gets caught in a cycle of obsessions and

compulsions" (Abramowitz, 2018). Millions are impacted daily by OCD, "Current estimates are

that approximately 1 in 40 adults in the U.S. (about 2.3% of the population) and 1 in 100

children have this condition." ("Facts About Obsessive", n.d.). OCD causes obsessions that

happen for usually an hour or more, per day. You can’t die from this mental illness, however,

"patients with OCD are 10 times more likely to commit suicide." (Institutet, 2016). OCD causes

repeated obsessions, persistent and unwanted thoughts, urges or images that are intrusive;

making normal life difficult everyday.

There are 3 different ways that one can acquire OCD, genetics, brain structure and environmental

factors. Lots of supporting evidence shows that genetics has a contributing factor to OCD,

"definitive single-domain or integrative models have not yet been established." (Grisham, 2008).

Only three genome-wide linkage studies of OCD have been done, "a study funded by the

National Institutes of Health examined DNA, and the results suggest that OCD and certain

related psychiatric disorders may be associated with an uncommon mutation, of the human

serotonin transporter gene (hSERT)" ("Causes Of OCD" n.d.). Other small studies have given us

more depth on the idea of genetics linking to OCD, "about 25% of OCD sufferers have an

immediate family member with the disorder. In addition, twin studies have indicated that if one

twin has OCD, the other is more likely to have OCD when the twins are identical, rather than

fraternal." ("Causes Of OCD" n.d.). Studies with twins have revealed that genetics
OCD 3

causes "approximately 45-65% of the risk for developing the disorder." ("Causes Of OCD" n.d.).

Brain structure is the next leading cause for OCD. Studies of OCD have found that injuries to a

part of the brain called the basal ganglia can cause OCD. "Bacterial infections, hypoxia (lack of

oxygen to the brain) and neurotoxic agents" (Gorbis, d), all can potentially cause damage to the

basal ganglia. The most important part of finding the basil ganglia "shows that physical damage

to a brain structure, can result in a neuropsychological (mental/emotional) condition." (Gorbis,

d). "From radiological studies, researchers learned that two brain structures that communicate

with the basal ganglia are more active in but patients with OCD." (Gorbis, d). Those two

structures act to detect brain circuit errors. Their harmonization with the basil ganglia proves

how OCD can form due to the structure of the brain. The structural dysfunction of the basil

ganglia causes patients to often have more obscure patterns in their OCD.

Another factor to the development of OCD is the environment. "Learning theorists, for example,

suggest that behavioral conditioning may contribute to the development and maintenance of

obsessions and compulsions." ("What Causes OCD" n.d.). Making it appear that compulsions are

learnt mechanisms to deal with stressful environments that induce anxiety, compulsions or urges.

The fear of germs is an example of how one displays those "learnt mechanisms", they often wash

their hands excessively to reduce their anxiety due to compulsions that turn into consistent

obsessions. Some wash their hands so much their skin becomes raw, red, and painful to the

touch, all in hopes to relieve their stress from the environment and "germs". "About 30 percent of

OCD sufferers first experience signs of the disorder during childhood." ("OCD Facts", 2018).

This is likely because of how influential the developing mind of a child is; due to the
OCD 4

environment that may cause high risks of anxiety. "40 million Americans over the age of 18 are

affected by anxiety, roughly 18 percent of the nation’s population."(Egen, 2015). This statistic

gives us a better understanding of how common it is to have anxiety or know someone with

OCD. Many people with anxiety may be suffering from minor to constant compulsions that can

be a large number of different unwanted actions.

There are lots of different specific types of OCD, however, they're all grouped into a bunch of

broad categories. First, compulsive checking. It's the most common type of OCD, "the purpose

of compulsive checking is to reduce distress associated with uncertainty or doubt over feared

consequences for oneself or others." (Williams, d.). They worry that they might cause harm to

people by not being cautious and checking that one last time. Sometimes convincing their mind

that fixating on a potentially bad event will heighten the chances of it occurring. "People with

OCD tend to feel overly responsible for causing harm, it is not uncommon for them to repeatedly

check to ensure that they have not accidentally caused harm to others." (Williams, d.). Some

overly regularly check their home to see if the door is locked, any switches are left on, or

appliances left plugged in. Just the thought of a faulty wire causing a fire is enough to go check

and reassure themselves that everything is disassembled and not going to cause any harm.

Second is contamination, with this type of OCD they will spend time believing that things are

dirty regardless if it's clean. A woman from the UK who has contamination OCD spends "3

hours every night" washing here face and "hasn’t touched her husband or children for 3

years"("OCD Woman Washes", 2017), damaging their relationships.

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Furthermore more, mental contamination is the third category. Mental contamination is like

regular contamination OCD, however, it's like an internal dirtiness feeling. "Some suffer ...

feelings of discomfort and dirtiness [that] can ... be caused without physical contact with

something that is dirty or germy. Instead, feelings of contamination can be triggered by

association with a contaminated person who has betrayed or harmed the sufferer in some way, or

even by their own thoughts, images or memories." (Coughtrey, 2015). One may have a sour

argument with their loved one and feel dirty, and need to clean their body. Memories of

traumatic events can also trigger compulsions, forcing them to clean. Fourth is intrusive

thoughts. Everyone has odd irrational thoughts from time to time but most are able to over look

those thoughts and move on, however, "for sufferers of OCD, they can trigger debilitating

anxiety. Getting rid of these thoughts is not easy. OCD sufferers compulsively try to neutralize

or disprove them." ("Medication Side Effects", n.d.). These thoughts can consist of violence, sex,

blasphemy, suicide and beyond, they're usually able to tell themselves those thoughts are

completely out of character and are able to resist; but it compulsively will pry at their minds.

Moreover, hoarding is fifth, "some people with OCD have fears or feelings that something bad

or catastrophic will happen if they throw something away. In other situations, individuals have

feelings of incompleteness if something is given or thrown away." (Phillipson, 2016). They feel

the need to document their lives through holding onto possessions, letting things build up instead

of letting go. Hoarding builds so quickly due to the thought of contamination. If they touch

anything in the store it has to be bought because of the fear to "contaminate" others. They may
OCD 6

drop a "contaminated" object on the floor and feel unable to pick it up, allowing the objects to

build. "Holding onto items for fear that they might be needed sometime in the future, such as

books, newspapers, school papers, or clothing" are common with hoarding. In many hoarding

situations these objects can end up filling an entire room. Some overfill their homes so much that

they loose their own pets, making them suffer a painful death. “Tlc Uk” did a video called

"hoarding: buried alive", on a couple that hoarded so horribly that "during their clean up ... they

[found] their deceased cat amongst rubbish"

There are treatments for OCD, it's a matter of trial and error for people to feel better, everyone’s

bodies are different. One method commonly tried is medication. There are ups and downs to

trying a new medication, "some people with OCD respond well to the first medication they are

prescribed; others need to adjust dosages or try more than one type of SSRI, under medical

supervision of course, to find the one that is most effective for them." ("Medication Side

Effects", n.d.), the side effects can vary when trying these medications, ranging anywhere from

mild dizziness/and or headaches to being unable to sleep and even feeling agitated, shaky or even

more anxious. "Often it may take 12 weeks or more to notice the benefits" ("Medication Side

Effects", n.d.) after first taking medication. Side effects do occur but most people only feel them

mildly. "These can be troublesome at first, but they’ll generally improve with time, usually

within one or two weeks." ("Medication Side Effects", n.d.). However, taking pills for the rest of

someone’s life isn’t always ideal.

OCD 7

Although "about 7 out of 10 people with OCD will benefit from ... medication" ("Medications

For OCD", n.d.), the same statistic goes for the exposure response prevention. "The Exposure in

ERP refers to exposing yourself to the thoughts, images, objects and situations that make you

anxious and/or start your obsessions." (Björgvinsson, 2018). "Response prevention" meaning

making a decision if they are going to act on compulsive behaviour under the pressure of

anxiety. When "exposing" themselves to things that "trigger" their OCD it causes high anxiety.

(ERP) Is often very difficult at first but "when you don’t do the compulsive behaviors, over time

you will actually feel a drop in your anxiety level." (Björgvinsson, 2018). For many patients that

need ERP, it’s far out of reach. Many people are unable to afford treatment or there’s no

therapists near them that treat using ERP. A lot of people need ERP to break their vicious mental

cycle but avoid it because they know it means facing their fears.

Lastly is behavioural therapy treatment (CBT). "CBT is a form of talking therapy, however

unlike other talking therapies like counselling, it is much more structured and tailored around the

individuals ‘here and now’ problems, and rarely focuses on the patient’s past." ("What Is

(CBT)?", n.d.). It's meant to be a shorter type of therapy ranging from weeks to months rather

than years. CBT is the most common choice and it’s also quite effective. "Research has shown

that 75% of people with OCD are significantly helped by Cognitive Behavioural Therapy, with

some local IAPT services reporting recovery rates of up to 80%." ("What Is (CBT)?", n.d.). The

good part about behavioural therapy is it's not "scary". This type of treatment is typically

someone with OCD's first choice. OCD is chronic, "you can get it under control and become

recovered but, at the present time, there is no cure. It is a potential that will always be there in the

background, even if it is no longer affecting your life." (Penzel, d.).

OCD 8

Research paper quotes:

https://iocdf.org/about-ocd/

"Obsessive Compulsive Disorder (OCD) is a mental health disorder that affects people of all

ages and walks of life, and occurs when a person gets caught in a cycle of obsessions and

compulsions." (Abramowitz, 2018)

http://beyondocd.org/ocd-facts

"Current estimates are that approximately 1 in 40 adults in the U.S. (about 2.3% of the

population) and 1 in 100 children have this condition." ("Facts About Obsessive", n.d.)

https://www.sciencedaily.com/releases/2016/07/160719094234.htm

"Patients with OCD are 10 times more likely to commit suicide" (Institutet, 2016)

https://www.researchgate.net/publication/5555629_Genetic_and_environmental_influences_on_

obsessive-compulsive_disorder

"definitive single-domain or integrative models have not yet been established." (Grisham, 2008)
OCD 9

http://beyondocd.org/information-for-parents/helping-a-child-who-has-ocd/causes-of-ocd-in-

children

"A study funded by the National Institutes of Health examined DNA, and the results suggest that

OCD and certain related psychiatric disorders may be associated with an uncommon mutation of

the human serotonin transporter gene (hSERT). " ("Causes Of OCD" n.d.)

"About 25% of OCD sufferers have an immediate family member with the disorder. In addition,

twin studies have indicated that if one twin has OCD, the other is more likely to have OCD when

the twins are identical, rather than fraternal." ("Causes Of OCD" n.d.)

Twins showed the % of gentics that cause ocd: "approximately 45-65% of the risk for

developing the disorder." ("Cause Of OCD" n.d.)

http://m.hope4ocd.com/the-biology-of-ocd.php

"bacterial infections, hypoxia (lack of oxygen to the brain) and neurotoxic agents" (Gorbis, d)

"shows that physical damage to a brain structure results in a neuropsychological

(mental/emotional) condition." (Gorbis, d)

"From radiological studies, researchers learned that two brain structures that communicate with
OCD 10

the basal ganglia are more active in patients with OCD." (Gorbis, d)

http://beyondocd.org

/ocd-facts/what-causes-ocd

"Learning theorists, for example, suggest that behavioral conditioning may contribute to the

development and maintenance of obsessions and compulsions." ("What Causes OCD" n.d.)

https://www.promisesbehavioralhealth.com/mental-health/8-facts-anxiety-anxiety-disorders/

"40 million Americans over the age of 18 are affected by anxiety — roughly 18 percent of the

nation’s population." (Egen, 2015)

https://theoakstreatment.com/blog/ocd-facts-and-statistics/

"About 30 percent of OCD sufferers first experience signs of the disorder during childhood."

("OCD Facts", 2018)

http://www.ocdtypes.com/checking-ocd.php

"The purpose of compulsive checking is to reduce distress associated with uncertainty or doubt

over feared consequences for oneself or others." (Williams, d.)

"people with OCD tend to feel overly responsible for causing harm, it is not uncommon for them
OCD 11

to repeatedly check to ensure that they have not accidentally caused harm to others." (Williams,

d.)

https://youtu.be/z6bUMBhCphQ

"OCD woman washes face 3 hours every night"

"Hasent touched her husband or children for 3 years" ("OCD Woman Washes", 2017)

https://blog.oup.com/2015/01/mental-contamination-obsessive-compulsive-disorder/

"some sufferers the feelings of discomfort and dirtiness can also be caused without physical

contact with something that is dirty or germy. Instead, feelings of contamination can be triggered

by association with a contaminated person who has betrayed or harmed the sufferer in some way,

or even by their own thoughts, images or memories." (Coughtrey, 2015)

http://beyondocd.org/information-for-individuals/symptoms/ocd-related-hoarding

"some people with OCD have fears or feelings that something bad or catastrophic will happen if

they throw something away. In other situations, individuals have feelings of incompleteness if

something is given or thrown away". ("OCD Symptoms", n.d.)

" Holding on to items for fear that they might be needed sometime in the future, such as books,

newspapers, school papers, clothing" ("OCD Symptoms", n.d.)

OCD 12

https://youtu.be/qWY5xfhvjyI

"during their clean up ... they find their deceased cat amongst rubbish" ("Dead Cat Found", 2018)

https://www.intrusivethoughts.org/what-is-ocd/

"For sufferers of OCD, they can trigger debilitating anxiety. Getting rid of these thoughts is not

easy. OCD sufferers compulsively try to neutralize or disprove them." (Phillipson, 2016)

https://www.ocduk.org/overcoming-ocd/medication/medication-side-effects/

"some people with OCD respond well to the first medication they are prescribed; others need to

adjust dosages or try more than one type of SSRI, under medical supervision of course, to find

the one that is most effective for them." ("Medication Side Effects", n.d.)

"often it may take 12 weeks or more to notice the benefits" ("Medication Side Effects", n.d.)

"These can be troublesome at first, but they’ll generally improve with time, usually within one or

two weeks." ("Medication Side Effects", n.d.)

https://iocdf.org/about-ocd/ocd-treatment/meds/

"About 7 out of 10 peoplewith OCD will benefit from either medication or Exposure and

Response Prevention (ERP)." ("Medications For OCD", n.d.)

OCD 13

https://iocdf.org/about-ocd/ocd-treatment/erp/

"The Exposure in ERP refers to exposing yourself to the thoughts, images, objects and situations

that make you anxious and/or start your obsessions." (Björgvinsson, 2018)

"over time you will actually feel a drop in your anxiety level." (Björgvinsson, 2018)

https://www.ocduk.org/overcoming-ocd/cognitive-behavioural-therapy/

"CBT is a form of talking therapy, however unlike other talking therapies like counselling, it is

much more structured and tailored around the individuals ‘here and now’ problems, and rarely

focuses on the patient’s past." ("What Is (CBT)?", n.d.)

"Research has shown that 75% of people with OCD are significantly helped by Cognitive

Behavioural Therapy, with some local IAPT services reporting recovery rates of up to 80%."

("What Is (CBT)?", n.d.)

http://beyondocd.org/expert-perspectives/articles/ten-things-you-need-to-know-to-overcome-ocd

" You can get it under control and become recovered but, at the present time, there is no cure. It

is a potential that will always be there in the background, even if it is no longer affecting your

life." (Penzel, d.)