What Causes Neurotransmitter Imbalances?

Obsessive-compulsive disorder (OCD) is a type of anxiety disorder. It is a group of neuropsychiatric diseases with compulsive thinking and compulsive behavior as the main clinical manifestations. It is characterized by the coexistence of conscious obsession and anti-compulsion. Willing thoughts or impulses repeatedly invade the patient's daily life. Although patients experience that these thoughts or impulses originate from themselves and are extremely resistant, they are always unable to control them. The intense conflict between them makes them feel great anxiety and pain, which affects study and work, interpersonal communication and even daily life.

Basic Information

English name

obsessive-compulsive disorder

Visiting department

Psychiatry

Multiple groups

Under 25

Common causes

Genetic, neuro-endocrine disorders, adverse events and other factors

Common symptoms

Forced thinking, behavior, or both coexisting for more than two consecutive weeks

Causes of OCD

The etiology of obsessive-compulsive disorder is complex and inconclusive, and it is currently believed to be mainly related to psychosocial, personality, genetic and neuro-endocrine factors.

Many studies have shown that patients often suffer from adverse life events when they first develop symptoms, such as tension in relationships, trials of marriage, and frustration in study and work. OCD patients have a more or less tendency to pursue perfection and demand high standards for themselves and others. Some patients have a compulsive personality before their illness, which is manifested by excessive cautiousness, a strong sense of responsibility, and hope that everything can be perfect Therefore, it is inflexible when dealing with bad life events and it is difficult to adapt. The contradictions and anxieties experienced by patients can only be expressed through compulsive symptoms.

In addition, a large number of studies in recent years have found that the onset of obsessive-compulsive disorder may have a certain genetic predisposition, and there are also functional disorders in the neuro-endocrine area, causing neurotransmitters such as serotonin and dopamine to become imbalanced and fail to perform their physiological functions.

Clinical manifestations of obsessive-compulsive disorder

The symptoms of obsessive-compulsive disorder can be summarized as compulsive thinking and compulsive behavior.

Compulsive thinking can be further divided into compulsive ideas, compulsive emotions, and compulsive intentions. The content is diverse, such as repeatedly wondering whether the doors and windows are tightly closed, whether they will get sick when they encounter dirty things, why the sun rises from the east and the west falls, and there is an urge to jump down on the balcony. Compulsive behavior is often an action that has to be taken to reduce the anxiety caused by compulsive thinking. The patient knows that it is unreasonable, but has to do it. For example, if the patient has the idea of doubting whether the door or window is tightly closed, the door and window will be repeatedly checked to ensure safety. ; Patients who are afraid of getting sick when they encounter dirty things will wash their hands repeatedly to keep it clean. Some patients with prolonged illnesses often repeat certain actions over time, forming a certain procedure over time. For example, when washing hands, they must start from the fingertips and continue to wash to the wrist. If the order is reversed or the middle is interrupted, it will be restarted. Starting to wash is often time consuming and painful.

Obsessive-compulsive symptoms have the following characteristics:

1. It is the patient's own thinking or impulse, not imposed by the outside world.

2. At least one thought or action must still be resisted in vain by the patient, even if the patient no longer resists other symptoms.

3. The idea of performing the action itself will make the patient feel uncomfortable (it is not regarded as a real pleasure simply to relieve tension or anxiety), but if it is not implemented, it will cause great anxiety.

4. Ideas or impulses are always unpleasantly recurring.

Obsessive-compulsive disorder test

Complete relevant physical, mental and auxiliary examinations to rule out organic diseases.

OCD diagnosis

Diagnosis should be based on medical history, mental examination, physical examination and necessary auxiliary examinations to eliminate obsessive-compulsive symptoms caused by organic diseases and other mental illnesses. According to the International Classification of Diseases published by the World Health Organization Tenth Edition (ICD-10) To make a positive diagnosis, patients must have compulsive thinking or compulsive behavior, or both, on most days in two consecutive weeks. These symptoms cause pain or impede activity. Obsessive-compulsive symptoms need to meet the four characteristics of clinical manifestations.

Differential diagnosis of obsessive-compulsive disorder

First of all, it is necessary to identify normal repetitive behaviors, so as not to make all the soldiers and the diagnosis enlarged. Almost everyone will have some repetitive behaviors or actions in a predetermined order. For example, they will pull the door repeatedly two or three times before leaving the house to ensure that the door is closed. To brush your teeth, you will always take a cup with water in your left hand and a toothbrush with your right hand. Squeeze the toothpaste with your left hand. Generally, this habit is to improve efficiency, and it does not cause pain or affect normal life. Patients with clear obsessive-compulsive symptoms need to be distinguished from:

Schizophrenia

Patients with this disease can also have obsessive-compulsive symptoms, but often do not take obsessive-compulsive distress, and do not actively seek treatment. The content of obsessive thinking is grotesque and bizarre and has psychotic symptoms such as hallucinations. It is generally easy to identify, but patients with severe obsessive-compulsive disorder Sometimes accompanied by transient psychotic symptoms, attention should be paid to identification.

2. Depression

Patients with this disease may have obsessive-compulsive symptoms, and patients with obsessive-compulsive disorder may also develop depression. The identification is mainly to identify which are the primary symptoms that appear first.

3. Anxiety

Both can have anxiety manifestations. Anxiety in obsessive-compulsive disorder often arises due to repeated occurrence of obsessive-compulsive thinking or inability to implement compulsive behavior.

4. Compulsive symptoms caused by drugs

Some drugs, such as clozapine, can cause obsessive-compulsive symptoms in the treatment of schizophrenia, but the patient does not feel distressed, and the symptoms gradually relieve and disappear after stopping the drug.

5. Organic mental disorder

Organic lesions in certain parts of the brain, such as bleeding or infarction, can cause obsessive-compulsive symptoms, so it is necessary to ask related medical history of cerebrovascular diseases and complete auxiliary examinations such as cranial magnetic resonance during diagnosis.

OCD treatment

Although the etiology of obsessive-compulsive disorder has not been elucidated yet, according to the existing research, it is not difficult to find that its pathogenesis is not only related to human personality and psychological factors, but also to the imbalance of neurotransmitter secretion in the brain. Therefore, whether it is psychological treatment or drug treatment, it plays a pivotal role in alleviating the patient's condition.

Psychotherapy

Obsessive-compulsive disorder, as a psychological disease, has a complicated mechanism, and patients with similar symptoms may have very different psychological mechanisms. In psychotherapy, the therapist establishes a good doctor-patient relationship with the patient, listens to the patient, helps him to discover and analyze the inner contradictions, promotes the patient to solve the problem, increases his ability to adapt to the environment, and reshapes a healthy personality.

Clinically used methods include: psychodynamic therapy, cognitive-behavioral therapy, supportive psychotherapy, and Morita therapy. Among them, cognitive-behavioral therapy is considered to be the most effective psychological treatment method for obsessive-compulsive disorder, mainly including thinking blocking and prevention of exposure reactions. The thinking blocking method is to divert attention or apply external control when patients have recurrent compulsive thinking, such as setting alarm bells to block compulsive thinking, and relax training when necessary to relieve anxiety. Exposure prevention is under the guidance of the therapist to encourage patients to gradually face various situations that can cause compulsive thinking without producing compulsive behaviors. For example, patients are very afraid that they must wash their hands repeatedly to ensure that they will not get sick. In several treatments, you need to gradually contact your sweat, soles, door handles of public toilets, and toilet seats without washing your hands. Because the patient's concerns do not actually happen, the anxiety accompanied by compulsive symptoms will be treated multiple times. It then relieves until it subsides, thereby controlling the symptoms of obsessive-compulsive symptoms.

2. Drug treatment

The onset of obsessive-compulsive disorder is related to a variety of neurotransmitter imbalances in the brain, which are mainly manifested as disturbances in serotonin system function. The currently used anti-compulsive drugs are antidepressants, which are characterized by being able to regulate the function of neurotransmitters such as serotonin in the brain, thereby improving the effects of obsessive-compulsive symptoms. The most commonly used are selective serotonin reuptake inhibitors (SSTIs), including fluvoxamine, paroxetine, sertraline, fluoxetine, citalopram, and the tricyclic antidepressant clomipramine Pa Ming, when necessary, also use propranolol and benzodiazepines to help relieve anxiety and improve insomnia in patients. For refractory obsessive-compulsive disorder, risperidone, quetiapine, olanzapine, and aripiprazole are often used as synergists to improve the efficacy. Like psychotherapy, the effect of drug treatment is not immediate. Generally, SSRIs need 10 to 12 weeks to achieve sufficient anti-compulsive effect, and if the treatment is effective, the medication needs to be maintained for 1 to 2 years to consolidate the effect.

3. Physical therapy

For patients with refractory obsessive-compulsive disorder, modified electrical shock and transcranial magnetic stimulation can be selectively used according to specific conditions. Neurosurgery is regarded as the last option for the treatment of obsessive-compulsive disorder. Due to the adverse reactions such as spastic seizures and sensory loss, the surgical indications must be strictly grasped.

OCD prevention

The onset of obsessive-compulsive disorder is related to social psychology, personality, genetics and neuroendocrine factors. The first two of them can be intervened to prevent them from happening. As a parent, you should build a stable, safe, and harmonious living environment for your children. You should not be overly demanding. Your life can be more flexible, you should pay attention to communication with each other, and promote a healthy personality. OCD self-screening:

1. Do you have stupid, dirty, or terrible unnecessary thoughts, thoughts, or impulses?

2. Do you have excessive fear of dirt, bacteria or chemicals?

3. Are you always worried about forgetting something important, such as the door is not locked and the valve is not closed?

4. Are you worried that you will make or say offensive behavior or offensive words that you do not want to do?

5. Do you always worry about losing important things?

6. Do you have to do something repeatedly, or do you have to think repeatedly to make it easy?

7. Do you overbath or overwash?

8. Do you have to be repetitive to do one thing to be assured?

9. Do you avoid certain occasions or individuals in order to worry about offensive language or behavior hurting others?

10. Do you keep a lot of useless things you think you can't throw away?

If one or more of the above symptoms persist, and bother your life and cause you pain, don't fight alone. Ask a professional doctor to let you help you overcome OCD.