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OBSESSIVE COMPULSIVE DISORDER ()

By Dr. Phang Cheng Kar (M.D.)Senior Medical Lecturer & Psychiatrist,Universiti Putra Malaysia (UPM)

OCD has a one-month prevalence of 1.3%OCD has a lifetime prevalence of 2.5%Four millions adult Americans have OCD

Disclaimer

This power point presentation is part of a FREE educational talk delivered in KL Buddhist Mental Health Association (BMHA) by Dr. Phang Cheng Kar.

The materials can be reused without permission as long as its for educational, non-commercial purpose & with good intention.

This should NOT be used as substitute for consultation with medical or mental health professionals.

Signs & symptoms

Causes & conditionings

Treatment medication & psychological

Q & A, e.g. where to get Rx?Contents

Signs & symptomsSigns & symptoms

Causes & conditionings Causes & conditionings

Treatment medication & psychologicalTreatment medication & psychological

Q & A, e.g. where to get Rx?Q & A, e.g. where to get Rx?

Signs & symptoms

OBSESSION

Repetitive thoughts, images or impulse

Distressing or anxiety provoking

Ridiculous or non-sensical

COMPULSION

Mental or physical rituals

To neutralize an obsession

Excessive & interfere with life

Different themes of OCD

OBSESSION

Contamination

Symmetry

Aggression

Sexual

Religious

Somatic

Hoarding

Miscellaneous

COMPULSION

Cleaning & washing

Checking

Repeating

Counting

Confessing

Arranging

Reassurance

Miscellaneous

Check door

Wash hands

Flush toilet

Repeat

Repeat again

Repeat again, once more

Repeat again, once more, another time

An OCD Things-To-Do List

Different themes of OCD - %

OBSESSION

Contamination: 32.9%

Aggression: 16.6%

Need for Exactness: 8.5%

Religious: 6.3%

Somatic: 6.2%

Sexual: 5.3%

Hoarding/Saving: 4.0%

Miscellaneous: 20.2%

COMPULSION

Checking: 28.1%

Cleaning/Washing: 25.9%

Mental: 11.5%

Repeating: 11.0%

Ordering/Arranging: 5.3%

Hoarding/Collecting: 3.2%

Counting: 2.6%

Miscellaneous: 12.4%

Note: Due to shame and taboo, OCD with sexual, religious & aggression theme are often under-reported & under-diagnosed.Source: Westwood Institute for Anxiety Disorders

Obsession

Anxiety

Compulsion

TemporaryRelief

OCD cycle

Obsession

Anxiety

Compulsion

Temporary

Cause of OCD

Genetics

Neurotransmitter imbalance, e.g. serotonin

OCD Brain - short circuit

Thinking errors, e.g. need to be 101% sure

Brain damage, e.g. certain type of dementia

Infection during childhood, e.g. PANDAS

Stress & other psychological factors worsen OCD (not direct causation)

OCD Brain - the danger ALARM is on 24 hours a day

Orbital Cortex scanning for danger

Anterior Cingulate Gyrus instant gut feeling that something isnt wrong

Amygdala connect to past memories a/w fear/panic

Caudate nucleus on/off the danger alarmSource:

Orbital CortexAnterior Cingulate GyrusAmygdalaCaudate nucleusSource: Wikipedia Commonhttp://www.anxietyspecialist.co.uk/obsessive-compulsive-disorder-bristol.htm

The worrying OCD brain

Source: Westwood Institute for Anxiety DisordersHyperactivity in ORBITAL CORTEX of the brain looking for DANGER

A compulsive OCD brain

Scientists have discovered that people with OCD and their close family members show under-activation of brain areas responsible for stopping habitual behaviour. (Credit: Adam Hampshire)Source: http://www.sciencedaily.com/releases/2008/07/080717140456.htm

Thinking errors in OCD

Thoughts are over-valued.
("If I keep thinking this, it must be really important.")

Doubt is translated into actual danger.
("Thinking it is dangerously close to doing it. If I keep thinking it, I must be getting closer to doing it.")

Thought content must be controlled.
("I've got to use will power!")

Total certainty is not only possible but imperative.
("How can I be absolutely sure I won't.")

Need to avoid culpability.
("If I'm careful enough, I can't be held responsible for bad things.")

Magical power to keep things from happening.
("If I can control this bad thought, my loved ones will be safe.")

Wish to erase all risk.
("If I'm careful enough, I can control the risk.")

Source: Anxiety & Stress Disorders Institute of Maryland

Treatment SSRI Medications

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Second level

Third level

Fourth level

Fifth level

Source: Wikipedia commonSource: PixabaySSRI medications regulate a neurochemical, i.e. serotonin which is needed for a normal functioning of the OCD circuit.Source of graphics:

Neurons Wikipedia CommonMedicines - Pixa

Calming the OCD mind

"Having OCD is like being allergic to life -
every waking moment is spent in
a state of mental hyper-sensitivity. Alex Measday

Reduction in caudate nucleus activity after treatmentSource: Westwood Institute for Anxiety Disorders

Psychological Rx of OCD MR5

Relabeling its OCD, not me

Refocus distraction

Relaxation fun, yoga, qi gonq, meditation

Restraint exposure & response prevention

Revalue the good side of OCD, e.g. creativity & responsible

MINDFULNESS

Do it ONCE but with all senses focusing on he here-and-now

Urge surfing

Cognitive defusion

Further readings

OCD Websites

http://www.geonius.com/ocd/

International OCD Foundation

http://www.ocfoundation.org/

OCD Online

http://www.ocdonline.com/defineocd.php

Dealing with OCD

http://www.anxietyandstress.com/dealingwithocd.html

THANK YOU

I hope I didnt say anything wrong that will harm you (318 X)

Yale-Brown Obsessive Compulsive Scale

Themes of OBSESSION

Contamination

Symmetry

Aggression

Sexual

Religious

Somatic & hoarding

Miscellaneous

Themes of COMPULSION

Cleaning & washing

Checking

Repeating & counting

Arranging & hoarding

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Seventh Outline LevelClick to edit Master text styles

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Second level

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