OCD: Brain Networks Stuck in Overdrive?

Several recent brain imaging studies point to overactive neural networks as a contributor to Obsessive Compulsive Disorder, or OCD.

OCD behavior is typically used in shows and movies for comic effect, such as Sheldon Cooper’s (Big Bang Theory) obsession with germs. Another less comical example is the Hoarders reality show, which delved into how hoarding compulsions can turn homes into unsafe and unlivable environments.

OCD is characterized by intrusive, recurrent thoughts (the obsession), and repetitive behaviors (the compulsion), designed to ward off future feared events that are the focus of many obsessions. OCD can cause severe anxiety and disrupt daily life for many people struggling with the disorder.

A Stuck Feedback Loop in the Brain

A growing body of evidence points to overactive neural networks in the brain that drive this OCD “feedback loop”. The main neural network implicated is the wordy cortico-striatal-thalamo-cortical loop:

This brain network is responsible helping us survive day to day – goal directed behaviors like eating, learning new information, performing in school, your job, etc. In OCD (and some other disorders), this neural network can be thrown off balance, producing less than desirable behavior and outcomes.

Causes of OCD

There is still some debate on the triggers of OCD, but it appears to be a combination of environmental and genetic factors. Environmental triggers can include early life trauma and stress, along with brain injury/neuroinflammation episodes.

Shared familial history of OCD also indicates a genetic predisposition to the disorder. OCD can start at any time, beginning as early as preschool and continuing to adulthood. Age at onset tends to be earlier in males that in females: between ages 6 and 15 years for males and between ages 20 and 29 years for females.

Treatment Options for OCD

OCD treatment falls into two main categories: serotonin reuptake inhibitors (SRI) medications, and cognitive behavioral therapy. SRI (and newer SSRI) medications can provide a modest benefit of reducing OCD symptoms for around 50% of patients who take SRIs.

Cognitive behavioral therapy (CBT) can be effective at managing and reducing OCD symptoms. A new resource, IntrusiveThoughts.org, provides information on a range of cognitive strategies for managing OCD on a daily basis, including structured exposure therapy – facing anxiety-producing obsessive thoughts with the help of a therapist.

For an interesting (and very honest) view on OCD, take a look at this video from a woman who describes her OCD experience.