Expert Article
A closer look at OCD
With OCD Awareness Week taking place this month, psychotherapist Noel Bell asks if there is a neurobiological basis for understanding OCD, which can help to provide greater insight for those with the condition Writing | Noel Bell
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bsessive compulsive disorder (OCD) is a common mental health condition, whereby an individual engages in obsessive thoughts and compulsive behaviours. The condition can lead to punishing rituals, and can have a negative impact on life functioning. Knowledge of what is happening in the brain can help sufferers to better cope with the condition, so what is the neurobiological basis for understanding OCD?
The science behind OCD
Research into the neurobiology of OCD tends to be divided into how the repetition of thoughts occurs (which might be termed the mechanism of OCD), and the content of OCD-related thoughts (for example worries about contamination or harm to others).
While researchers have sought to explain the mechanism of OCD through scientific inquiry, it is difficult to find a consensus amongst neuroscientists about exact causes. Functional brain imaging studies have, however, produced a model for the pathophysiology of OCD, which involves hyperactivity in certain subcortical and cortical regions. The following description might sound very technical, but stay with me. It is possible to see the cause of OCD stemming from communication difficulties between the following brain areas: 1. A neuronal loop running from the orbital frontal cortex (where we get a sense that something is wrong) 2. To the cingulate gyrus (a sense of unease until a mistake is corrected) 3. Striatum (caudate nucleus and
putamen, which act as a form of gear shift allowing us to forget about something) 4. Globus pallidus and thalamus (i.e. cortico-striato-thalamic pathways) 5. And looping back again Essentially, this shows that the thought process that causes OCD is a journey where we sense trouble, feel uncomfortable when we sense that something isn’t right, and the point of moving on from that feeling is looping round again and again. Brain scans have shown that these areas become hyperactive in OCD patients, as well as showing that the cingulate gyrus and caudate nucleus are permanently on – what Dr Jeffrey Schwartz, an American psychiatrist and researcher in the field of neuroplasticity and its application to OCD, calls “brain lock”. Continues >>> October 2018 • happiful • 81
