OCD Treatment

OCD often begins in childhood or adolescence, but it can also develop later in life

Over the past 100 years, treatments for obsessive-compulsive disorder (OCD) have significantly advanced. OCD was first classified as a separate anxiety disorder in the early 1900s, and since then, cognitive-behavioral therapy (CBT) and antidepressant medications such as tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) have become standard treatment options. However, these treatment approaches are effective in only 40-50% of patients.

Recently, research has suggested that ketamine infusion therapy, which is administered under medical supervision, may be effective in relieving symptoms of OCD for a significant number of individuals. In some studies, ketamine therapy has produced an immediate reduction in OCD symptoms after a single infusion. While further research is needed to understand the potential of ketamine therapy for OCD fully, it has the potential to be a transformative treatment for those who have not responded to other treatment options.

5 Symptom Subtypes of OCD

Although OCD symptoms generally fall into one of these five subtypes, OCD symptoms can change in nature over time.

  • Contamination Obsessions with Washing/Cleaning: Those suffering from this symptom subtype tend to ruminate on feelings of discomfort associated with germs/contamination and will wash and clean excessively.
  • Harm Obsessions with Checking Compulsions: Those experiencing this symptom subtype will often have intense thoughts regarding possible harm, either to themselves or others, and will use checking rituals to relieve their distress.
  • Obsessions Without Visible Compulsions: Those experiencing this symptom subtype will often have unwanted obsessions regarding sexual, religious, or aggressive themes. Triggers related to these obsessions are usually avoided at all costs.
  • Symmetry Obsessions with Ordering, Arranging, and Counting Compulsions: Those suffering from this symptom subtype may need to rearrange objects constantly. It can also involve thinking or saying sentences or words repeatedly until one feels it has been accomplished perfectly.
  • Hoarding: This symptom subtype involves the collection of items of little or no value until one’s living space is consumed with so much clutter it becomes nearly uninhabitable. This behavior is often sparked by obsessive fears of losing items one feels may be needed one day.

Obsession Symptoms

Obsessive thoughts are a core symptom of OCD, characterized by persistent and intrusive thoughts, feelings, or images that cause distress or anxiety. People with OCD may try to alleviate these obsessive thoughts through compulsive behaviors. Obsessive thoughts can interfere with personal goals and daily routines and may include themes such as:

  • Fear of contamination: excessive concern about germs or dirt
  • Needing things to be tidy and symmetrical: a strong desire for order and precision
  • Aggressive or horrific thoughts: recurrent thoughts about harming oneself or others
  • Disturbing sexual or religious thoughts: inappropriate or troubling thoughts related to sexual or religious themes.

Symptoms of Obsession May Include:

  • Fear of germs when handling objects others have touched
  • Overwhelming distress when objects are out of order
  • Upsetting thoughts of hurting yourself or someone else
  • Strong impulses to shout obscenities or act inappropriately
  • Avoidance of situations that can trigger obsessions to the point of obsession itself

Compulsion Symptoms

Compulsions are repetitive behaviors often performed in response to obsessive thoughts to reduce anxiety. Compulsive behaviors are a hallmark of obsessive-compulsive disorder (OCD), characterized by repetitive actions that an individual feels the need to perform in response to obsessive thoughts. These behaviors can range in complexity and may include rules or rituals that an individual with OCD follows to control their anxiety and obsessive thoughts. However, compulsions often only provide temporary relief from anxiety and do not offer any inherent pleasure.

Compulsions often follow themes such as:

  • Cleanliness: repeatedly washing hands or surfaces to an excessive degree
  • Counting: repeatedly counting objects or performing specific counting rituals
  • Orderliness or symmetry: arranging objects in a specific way or feeling the need for everything to be perfectly symmetrical
  • Following strict regiments: adhering to strict routines or rituals
  • Requiring reassurances: seeking constant reassurance about things such as whether doors are locked, or appliances are turned off

Some common signs and symptoms of compulsive behaviors may include:

  • Excessive hand washing that leads to skin irritation or damage.
  • Repeatedly checking locks or appliances to ensure that they are turned off.
  • Worrying excessively about whether objects or tasks are properly completed, even after repeatedly checking them.
  • Counting in specific patterns or repeating certain words or phrases silently.
  • Arranging objects in a specific way, such as aligning canned goods to face the same direction.

Risk Factors

Several factors may increase the risk of developing obsessive-compulsive disorder (OCD), including:

  • Family history: having a family member with OCD can increase an individual’s risk of developing the condition.
  • Stressful life events: experiencing a significant or traumatic event may trigger the intrusive thoughts, rituals, and emotional distress characteristic of OCD.
  • Other mental health disorders: individuals with other mental health conditions, such as anxiety, depression, or substance abuse disorders, may be more at risk for developing OCD.

It is important to note that the presence of these risk factors does not guarantee that an individual will develop OCD, and it is not fully understood why some people develop the condition while others do not.

Ketamine for OCD

It is not fully understood how ketamine may effectively treat obsessive-compulsive disorder (OCD) and other mental health conditions. However, recent research suggests that ketamine may have an inhibitory effect on the NMDA receptor in the lateral habenula, a brain region involved in the encoding of negative rewards or cause-and-effect relationships related to negative outcomes. People with OCD have been found to have abnormal regulation of the neurotransmitter glutamate, and as a non-competitive NMDA antagonist, ketamine may prevent glutamate from activating the NMDA receptor.

The inhibition of the NMDA receptor may lead to an accumulation of free glutamate, which then activates AMPA receptors. When excess glutamate activates AMPA receptors, it can stimulate the release of a chemical called brain-derived neurotrophic factor (BDNF). BDNF, in combination with a protein called mammalian target of rapamycin (mTOR), may promote the growth of new neural connections. This new growth may help rewire the brain from hyperactive areas associated with negative reward signals, potentially providing long-term relief from mental health conditions. Further research is needed to understand the mechanisms behind ketamine’s potential therapeutic effects fully.

Treating OCD

At Renew Health in Allen, Texas, we offer a range of treatment options for those who are struggling with OCD. While traditional approaches like cognitive-behavioral therapy and antidepressants may be effective for some people, they are not always sufficient in providing relief. We are pleased to offer ketamine infusion therapy as a potential treatment option, driven by studies showing that ketamine therapy can effectively reduce OCD symptoms for many individuals, sometimes even after a single infusion.

If you or someone you know is searching for a more comprehensive and personalized treatment approach for OCD, we encourage you to contact us to learn more about our program. Our team is dedicated to helping patients find relief and support on their journey toward recovery.

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