Medications to treat OCD

- Cingulotomy is surgery for severe OCD. Cingulotomy is a surgical disruption of circuits in the cingulate cortex
- 1/3 of people benefited from this surgery


Neurosurgery to treat OCD

- Cognitive Behavioral Therapy
- Medications
- Neurosurgery

Syracuse University

Michigan State University

This list includes different types of methods for treating and/or managing different anxiety disorders. These include:
-	Acceptance and Commitment Therapy
-	Drug Treatment
-	Mindfulness-Based Stress Reduction
-	Psychodynamic-Interpersonal Treatment

Treatment and Management Methods for Anxiety Disorders

Obsessive-compulsive disorder (OCD) is characterized by the presence of obsessions and/or compulsions. Obsessions are defined as intrusive and unwanted thoughts, mental images, fears, sensations, or urges. Compulsions are repetitive behaviors or mental acts that an individual feels driven to perform, often in response to an obsession. These cycles of obsessions and compulsions are typically distressing, time-consuming, and can significantly disrupt a person's daily activities.

Obsessive-Compulsive Disorder (OCD)

Breedlove, S. & Watson, N. (2017). Behavioral neuroscience, eighth edition. Oxford University Press.

Behavioral Neuroscience 8th Edition

Generalized Anxiety Disorder (GAD) is one of the most commonly seen disorders in primary care and mental health services. As a result of low funding and lack of access to mental health services for many (e.g. counseling), briefer programs designed to treat these disorders are becoming more and more necessary. Acceptance and Commitment Therapy is a particularly promising option due to its ability to treat more than one disorder at a time, and its many other benefits. 

Acceptance and Commitment Therapy used with Individuals with Generalized Anxiety Disorder and Depression 

- SSRIs
- SNRIs
- Tricyclic antidepressants
- Benzodiazepines
- B- blockers
- Buspirone
- MAOIs
- Anxiolytics

Drug Treatments for Anxiety Disorders

Being able to regulate one’s emotions has been shown to be very important in the treatment of Social Anxiety Disorder (SAD). There is evidence that practicing mindfulness by utilizing Mindfulness Based Stress Reduction and continuing it long-term can benefit attentional deployment. Those with SAD have a dysregulation of attention processes, shown by extreme focus and attentional avoidance of stimuli they perceive as a threat. Therefore, the positive effects MBSR has on attentional processes may target the mechanisms that contribute to SAD.

Mindfulness-Based Stress Reduction for patients with Social Anxiety Disorder 

Treatments of OCD

Acceptance and Commitment Therapy (ACT) has been used amongst individuals with diagnosed PTSD after Traumatic Brain Injury (TBI) with the intent to improve mood processes, PTSD specific outcomes and related symptoms, ACT outcomes, and overall quality of life

Acceptance and Commitment Therapy Used with Individuals with PTSD after Traumatic Brain Injury

Crits-Christoph, P. (2002). Psychodynamic-interpersonal treatment of generalized anxiety disorder: Science and practice. Clinical Psychology, 9(1), 81-84. doi:https://doi.org/10.1093/clipsy.9.1.81

Psychodynamic-interpersonal treatment of generalized anxiety disorder

Psychodynamic-interpersonal treatment for generalized anxiety disorder (GAD) frames the patient's worried thoughts about potential danger as a defense mechanism. The therapist helps the patient recognize these underlying worries, enabling them to realize that the anticipated harm is less likely or threatening than they imagine.

Psychodynamic-Interpersonal Treatment for Generalized Anxiety Disorder

- OCD and Tourette's syndrome are often comorbid (occurring together)
- Both disorders have abnormalities of the basal ganglia
- Tourette's syndrome treatment is focused on adjusting dopamine in the brain while treatment for OCD focuses on serotonin in the brain


Comorbidity of Obsessive Compulsive Disorder

Bhandari, S. (2020, September 4). OCD: Types, Symptoms, Causes, Diagnosis, Treatment, and Related Conditions. WebMD. https://www.webmd.com/mental-health/obsessive-compulsive-disorder. 

OCD WebMD

U.S. Department of Health and Human Services. (2019, October). Obsessive-Compulsive Disorder. National Institute of Mental Health. https://www.nimh.nih.gov/health/topics/obsessive-compulsive-disorder-ocd/. 

OCD NIMH

Obsessive-compulsive disorder (OCD) is a disorder in which people have recurring, unwanted thoughts, ideas or sensations (obsessions) that raises their level of anxiety and drive them to perform certain ritual or actions (compulsions) that serves to lower their anxiety about their thoughts. The compulsive behaviors can significantly interfere with a person’s daily activities and social interactions. Some people with OCD have faced psychological distress and worse "symptoms" in the wake of the pandemic.

Obsessive-Compulsive Disorder (and COVID-19)

Sexual minorities experience unique stress in the form of external discrimination, microaggressions, internalized stigma and homophobia, social rejection, and identity discomfort and concealment. The accumulation of these identity-based stressors is believed to explain the increased incidence of OCD in this population and have an effect on the content of their obsessive thoughts and types of compulsions.

Obsessive-Compulsive Symptoms in Sexual Minorities

Many studies reveal conflicting information regarding the associations between traumatic experiences and OCD or hoarding symptoms. Previous studies have found a plethora of information regarding differences and similarities between the trauma experiences of those with OCD and those with hoarding symptoms. It is still unclear exactly what types of traumatic events are associated with each, if any, the association between the time a traumatic event occurred and symptom development (i.e., prior to the onset or after the onset of symptoms), and how many traumatic events these individuals with these disorders have experienced or may experience in the future. A study in 2014 sought to answer these questions.

The Links between Traumatic Events and OCD and/or Hoarding Symptoms

Obsessive Compulsive Disorder and Obsessive-Compulsive Personality Disorder Comparison 

Reference for Obsessive-Compulsive Disorder and Obsessive-Compulsive Personality Disorder Comparison

Mathes, B.M., Morabito, D.M. & Schmidt, N.B. Epidemiological and Clinical Gender Differences in OCD. Curr Psychiatry Rep 21, 36 (2019). https://doi.org/10.1007/s11920-019-1015-2

Reference for “ Epidemiological and Clinical Gender Differences in OCD”

In the context of Obsessive-Compulsive Disorder, obsessions are defined as persistent, unintentional, and unwanted thoughts that are highly intrusive, unpleasant, and cause significant distress. These are distinct from everyday worries, like concerns about job security, or occasional unwanted thoughts, such as recalling an awkward comment. Individuals with OCD typically recognize that their obsessive thoughts are irrational but experience extreme difficulty in suppressing or ignoring them.

Characteristics of Obsessions in OCD

In the context of Obsessive-Compulsive Disorder, compulsions are defined as repetitive, ritualistic actions or mental acts performed to alleviate the distress caused by obsessions or to prevent a feared outcome. These acts are not inherently pleasurable and often lack a realistic connection to the problem they are intended to address.

Characteristics of Compulsions in OCD

When obsessive-compulsive disorder is not treated, it typically becomes a chronic, long-term condition. This can lead to persistent psychological and interpersonal difficulties throughout an individual's life.

Chronicity of Untreated OCD

Body Dysmorphic Disorder (BDD) is a condition where an individual is intensely preoccupied with a perceived flaw in their physical appearance, which is often nonexistent or barely perceptible to others. This preoccupation can cause the person to believe they are unattractive, ugly, or deformed. The intense focus on these imagined defects leads to repetitive, ritualistic behaviors and mental acts. These compulsions can include constantly checking one's appearance in the mirror, attempting to conceal the perceived flaw, making comparisons to others, and in some cases, seeking cosmetic surgery.

Body Dysmorphic Disorder (BDD)

A student, Alex, keeps the pens, books, and laptop on their desk in perfect alignment, straightening them multiple times a day. Which of the following additional details would be most critical in determining whether this behavior is a symptom of obsessive-compulsive disorder (OCD) rather than simply a personality trait?

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