OCD TREATMENT IN SCOTTSDALE AZ

OCD Obsessive-Compulsive Disorder treatment is another specialty at my practice in Scottsdale AZ. OCD is treatable with antidepressants and behavior modification. The causes are chemical imbalances in the brain. OCD is characterized by obsessions which are intrusive irrational thoughts, unwanted ideas or impulses repeatedly manifesting in a person’s mind. Most people are diagnosed by about age 19 but the symptoms have usually presented at much earlier ages.

The person experiences disturbing thoughts, such as did I lock all the doors? My hands must be contaminated; I must wash them. I may have left the gas stove on. I am going to injure my child? On one level, the sufferer knows these obsessive thoughts are irrational. But on another level, he or she fears these thoughts might be true but cannot let go of them. Trying to avoid such thoughts creates great anxiety, in fact OCD. Compulsions are repetitive, slavish rituals such as hand washing, counting, checking, hoarding, or arranging. An individual repeats these actions, perhaps feeling momentary relief, but without feeling satisfaction or a sense of completion. Or they simply feel a bondage to these thoughts much in the same way as an addiction.

Most people at one time or another experience obsessive thoughts or compulsive behaviors. OCD occurs when an individual experiences obsessions and compulsions for more than an hour each day, or to the degree that interferes with their life. When the thoughts and behaviors get to a point of disabling a normal functioning life; it’s time to seek help. Comorbid depression seems to occur up to 50% of the time with OCD, and both disorders need to be treated.

Typical Symptoms of OCD

Fear they will harm others. Car hits a pothole on a city street and he fears it was actually a body.
Repeatedly check things, perhaps several times before feeling secure enough to go to sleep or leave the house. The stove, the door locks, the alarm, this can be slavish.
Feel dirty and contaminated. Mother is fearful of touching her baby because she might contaminate the child.
Constantly arrange and order things. Child can’t go to sleep unless he lines up all his shoes correctly.
Excessively concerned with body imperfections – insist on numerous plastic surgeries, or spend many, many hours a day body-building.
Ruled by numbers, believing that certain numbers represent good and others represent evil, excessive counting.

Causes of OCD

Imbalances in the neurotransmitters or even individuals with brain injuries will sometimes manifest symptoms of OCD. We know that if a placebo is given to people who are depressed or who experience panic attacks, often 40% will feel better. If a placebo is given to people who experience obsessive-compulsive disorder, only about 2% will feel better. When DBS deep brain stimulation is used to treat OCD, it has a fairly good success rate. These findings suggest that OCD is an imbalance in the regulation of dopamine as well as the other primary neurotransmitters.

Clinical researchers have identified certain brain regions involved with OCD; they have discovered a strong link between OCD and a brain chemical called serotonin. Serotonin is a neurotransmitter that helps nerve cells communicate and plays a role in mood. OCD also seems to have a genetic component to it or at least a familial aspect whereby the obsessive behavior of a parent is likely to show up in some of the children. There is new genetic data that claims that prenatal stress can actually change the genes of the fetus and therefore provide the genetic basis for many mental illnesses. Maybe early childhood behavior or stressful situations can change the genes as well.

Scientists have also observed that people with OCD have an increased metabolism in the basal ganglia and the frontal lobes of the brain. This, scientists believe, causes repetitive movements, rigid thinking, and lack of spontaneity. Successful treatment with medication or behavior therapy produces a decrease in the over-activity of this brain region. People with OCD often have high levels of the hormone vasopressin. This means something in the brain is stuck, like a broken record.

OCD Treatment

Some of the most effective medications for OCD are the NDRIs and SSRIs. Often after six to eight weeks the obsessive thoughts and ensuing compulsive behaviors significantly subside. Unfortunately, too many individuals don’t see results fast enough; and they stop taking the medication. NDRIs and SSRIs take up to six weeks to reach full efficacy. Remember that these thoughts and behaviors have been a part of your life for several years; it might take some time to “break the habit”. With OCD, we need to use higher-doses of the medications to get the desired effect over longer periods of time. OCD is a very stubborn condition. The remission rate in adults without treatment is low, and further complicated by the comorbidity with anxiety, depression or bipolar disorder.

The old-line medications may also be necessary such as Anafranil (clomipramine) which is a tricyclic antidepressant. Anafranil has been shown to be effective in treating obsessions and compulsions. The most commonly reported side effects of this medication are dry mouth, constipation, nausea, increased appetite, weight gain, sleepiness, fatigue, tremor, dizziness, nervousness, sweating, visual changes, and sexual dysfunction. There is also a risk of seizures, thought to be dose-related. People with a history of seizures should not take this medication.

Behavior Modification

Minor cases of OCD can often be overcome by cognitive behavior modification and learning to cope with OCD. If you have driven yourself crazy by repeatedly driving back home to check the doors, appliances. You can train yourself to ignore these thoughts. Sometimes it is as simple as telling yourself I have homeowners’ insurance, and keep driving! You will notice that within minutes of that decision the obsessive thought will have subsided. Sometimes these are valid concerns; however, if you do it to excess, chances are that they are obsessional thoughts and need to be ignored.

For more severe cases exposure and response prevention therapies are effective for many people with OCD. Patients are deliberately exposed to a feared object or idea, either directly or by imagination, and then discouraged or prevented from carrying out the usual compulsive response. For example, a compulsive hand-washer may be urged to touch an object he or she believes is contaminated and denied the opportunity to wash for several hours.

When the treatment works well, the patient gradually experiences less anxiety and becomes able to refrain from the compulsive actions for extended periods of time. Often the patient has to train him or her to identify and ignore the obsessive thoughts and over time the anxiety will often dissipate with the thoughts. Several studies suggest that medication and behavior therapy are equally effective in alleviating symptoms of OCD. About half of the patients with this disorder improve substantially with behavior therapy; the rest improve moderately. Response to treatment varies from person to person. Most people treated with effective medications find their symptoms reduced by about 40 percent to 50 percent.

That can often be enough to change their lives to transform them into functioning individuals. Extreme cases of OCD can be the toughest illnesses to treat when the patient is unresponsive to both medication and cognitive therapy. Treatment resistant OCD responds to DBS about 50% of the time. OCD is one of the more difficult mental health conditions to treat, and will require awareness, perseverance, and therapy to overcome. Some times even DBS Therapy

Identifying The Triggers of OCD

Give the medication and behavior modification time; realize with time you will notice that your thoughts and behaviors start to change for the positive. Usually, the thoughts will subside and other times you will have to confront them and make peace with them. Learn to identify and differentiate the difference between a justifiable fear and an obsessive thought. Please don’t give up hope. This condition can be overcome! Learn to replace the trigger thoughts with other thoughts. I typically have good results and I love treating this condition. Please contact my office if you think you have OCD and need treatment in the Scottsdale area. More on OCD

NEXT PAGE – MORE ABOUT OCD