Brain research is in its infancy. What we think we know about obsessive-compulsive disorder and other neurobiological disorders today will likely change tomorrow. Researchers around the world are piecing together the puzzle of OCD.
Selective serotonin reuptake inhibitors (SSRIs), such as Prozac, Luvox, Zoloft, and Paxil, are effective in controlling OCD. This leads us to believe that serotonin regulation is involved in the cause of OCD. Serotonin is one of the brain's vital chemical messengers and plays a role in many biological processes, including mood, aggression, impulse control, sleep, appetite, body temperature, and pain.
In addition to the problem with serotonin regulation, brain imaging studies have shown abnormalities in several parts of the brains of people with OCD. These include the caudate nucleus, (part of the basil ganglia), the thalamus, orbital cortex and cingulate gyrus.
Discovering that specific abnormalities in the way my brain works helped me realize that OCD was "all in my head." But not in the way we usually think of this cliche. It is our brains that aren't working right. So does that mean we are without hope? Lost in our obsessive thoughts and compulsive behaviors?
No way! As I mentioned, several medications help to correct the serotonin imbalance and relieve symptoms of OCD. But the news gets better. Studies have found that cognitive-behavior therapy can bring about changes in brain structure and function. With his colleagues at UCLA, Jeffrey Schwartz, author of Brain Lock, demonstrated, with PET scans, actual changes in energy use in specific parts of the brain after patients underwent behavior therapy.
So what is cognitive-behavior therapy? The word, "cognitive" in cognitive-behavior therapy (CBT) refers to techniques that help change the faulty beliefs common to people with OCD. "Behavior" refers to techniques that help change actions. The most effective cognitive-behavior therapy technique for OCD is called exposure and ritual prevention (ERP). It is also referred to as exposure and response prevention.
I'll explain exposure and ritual prevention further in my next article. Simply put, it means to expose yourself to the thoughts you fear, and prevent the rituals you now use to alleviate the fear. It sounds scarey, and often it is. But it is worth the effort to break free from OCD. I'll end with a few quotes. I love quotes. They make me stop and think.
"There is perhaps nothing so bad and so dangerous in life as fear." - Jawaharlail Nehru
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