What is OCD and how to control it?

“I have touched something and I am going to get contaminated, I have to wash or something is going to happen to someone in my family”, “I haven’t turned off the gas properly, I could start a fire”. These and other thoughts are what can invade the mind of a person with OCD, a mental health disorder that generates “intrusive” ideas. They are the obsessions that give rise to anxiety.

Carles Soriano, a researcher at the Bellvitge Biomedical Research Institute (IDIBELL), explains it to EFESalud. And from that strong obsession, a compulsion arises with the aim of stopping that anxiety.

“They think that the consequences of contamination are very serious. Furthermore, compulsion is a repetitive behavior that does not stop, never ends, People with this obsession can even wash their hands until they bleed,” adds Soriano about this disorder.

The person, for example, who is afraid of leaving the gas key on will check that it is properly closed again and again. He will leave, he will return, he will leave again, he will always have the doubt.

OCD, mania, and other disorders

The best-known OCD in order of frequency are precisely that of cleanliness: clean and clean person because he has the threatening doubt of whether he has become infected by touching some surface. But also that of hypochondria and that of order, according to Santandreu.

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In reality, both experts agree, there must be millions because those who suffer from it can “get into OCD with anything.” And there are also different degrees of OCD, from a milder disorder to a much stronger and more present one.

Santandreu points out that people often confuse slightly superstitious behavior or a mania with OCD when “it has nothing to do with it.”

“I have been asked ten million times if what Rafa Nadal does when he serves is a knock, and it is not,” says this expert. The difference is that “You can have small rituals, manias, but they don’t cause great anxiety if you don’t do them, but in OCD, they do.”

Nor does a perfectionist have to have OCD. “The difference is absolute, because the perfectionist does not have an irrational doubt-threat all the time, that is the difference,” says Santandreu.

And a person who is anxious or who worries a lot about things doesn’t have OCD either. In the case of obsessive-compulsive disorder, the worry with which it is hooked is always the same. It can even be like this for several years and then change to another one.

“When a person is simply a worrier, they worry about anything, with many different things that vary throughout the day,” says Santandreu.

What happens in a brain with OCD?

Researchers know little about what happens in a brain with OCD.

The brain can be divided into two large parts: the cortex that is on the outside and the structures that are inside, the so-called subcortical ones, Soriano details.

Within the latter there are very specific ones known as striatal nuclei, involved in various neurological pathologies such as Parkinson’s, for example. These nuclei are very varied, continues the IDIBELL researcher, and they participate in many behaviors: There is a nucleus that participates in motor activity, another in memory, among others.

In OCD, the connection between the striatal nuclei and the cortex, especially the frontal cortex, is altered.

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“There is a hyperexcitation of this connectivity between the striatal nuclei and the cortex and depending on which part of the striatum is altered, whether it is the one that is most related to motor issues or memory or reinforcement issues, OCD symptoms might differ a little”highlights Soriano.

How is it treated?

It is generally treated with pharmacological or psychological therapy, either separately or both in combination. In more extreme cases with surgery.

“Many people solve OCD with psychological therapy alone, but there are people who rely on psychotropic drugs, “which are usually a type of antipressant that reduces the symptoms, in some small cases it eliminates them completely, but as long as you take them, of course,” explains Santandreu, who in addition to writing a book about this disorder – Without fear – has written the prologue of the Jeffrey Schwartz’s book “Unlock Your Brain”.

For his part, the IDIBELL researcher emphasizes that all international guidelines recommend that the first strategy for treating OCD disorder be psychological.

And within the psychological therapies that work bestand there are the so-called conductive-behavioral ones.

“They are exposed to the situation that causes them obsessions, such as we are going to prevent you from ordering things or counting. It is about the person experiencing that discomfort and letting time pass and that anxiety not really being associated with the negative consequences that they believe are going to happen.”

In this way, they break the association between not having done the compulsion and the supposed negative consequence.

Credits: EFE Agency.