New research published this week shows the long-term efficacy of brain surgery to treat obsessive-compulsive disorder (OCD). OCD is an emotionally-distressing mental illness that interferes with functioning.
In the most extreme cases, OCD disrupts all quality of life. Doctors have long known that surgery is a treatment option, and the latest studies show that it can be a good choice for patients who do not respond to traditional treatments.
Obsessive Compulsive Disorder Defined
OCD has two aspects: obsession and compulsion. An obsession is a persistent thought, impulse or image that you can’t shake off. An example of an obsessive thought is the belief that you forgot to turn off the stove. The compulsion is then the action that fulfills the thought.
A compulsion is either a repetitive behavior or mental act that someone with an obsession must perform. The behavior or mental act is intended to minimize distress or prevent a feared event, but it actually accomplishes neither. For example, a person with the obsessive thought that the stove is still on will feel compelled to repeatedly check the stove.
In order to qualify for a diagnosis of OCD, either an obsession or a compulsion must be present. The obsession and compulsion must cause distress, consume more than an hour of time a day, or restrict regular functioning, such as stopping someone from going to work or having a relationship. The person suffering with the symptoms must also be able to recognize that his or her thoughts or behaviors are extreme or irrational.
Typically, treatment for OCD includes medications and cognitive-behavioral therapy (CBT). In general, psychiatrists first treat OCD patients with antidepressants that increase serotonin levels. If the antidepressants are not effective, doctors add antipsychotic medications and mood stabilizers. Finding the right balance of medications to treat OCD is often difficult, and it may take several months to find the right combination.
Cognitive Behavioral Therapy (CBT(, often used to treat panic disorders, has been helpful for many OCD patients. CBT teaches patients to recognize and change their thought patterns so they do not feel pushed to complete compulsive behaviors. Exposure and response prevention is one CBT approach that forces patients to confront feared objects and learn to control their anxiety around that object. Not every OCD patient responds to CBT, and many object to the exposure aspect, which can make them feel anxious.
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