How Obsessive Compulsive Disorder Affects the Brain

Understanding how obsessive compulsive disorder affects the brain can help you manage the condition and make treatment more effective.

Most people have doubts, worries, and fears at moments throughout their lives. People with obsessive compulsive disorder, or OCD, however, feel frightened, apprehensive, and anxious all the time. If you have the condition, you might even feel like your brain gets “stuck” on certain images, urges, and thoughts. This happens because OCD directly affects the brain and changes the way your mind processes information. Obsessive thoughts can lead to compulsions or repetitive actions that seem to temporarily ease the agony. Living with OCD can make you physically tired and emotionally overwhelmed. Luckily, understanding how obsessive compulsive disorder affects the brain can help you manage the condition and make treatment more effective.

What is Obsessive-Compulsive Disorder?

Obsessive-compulsive disorder is a mental health condition that causes the brain to create repetitive worries and fears. Also referred to as obsessions, these worries, fears, and “bad thoughts” often occur suddenly and are difficult to manage. In fact, most people with OCD feel like they can’t stop worrying or thinking about “bad things.”

Some of the most common OCD obsessions include:

  • Fear of germs and contamination
  • Religious obsessions
  • Bad thoughts becoming a reality
  • Someone getting sick, being hurt, or dying
  • Aggressive thoughts about other people or themselves
  • Thinking about whether something is lucky or unlucky, bad or good, safe or unharmful
  • A need to have everything in a certain order
  • Unwanted sexual or violent thoughts

These obsessions trigger compulsions or behaviors people with OCD feel compelled to do in order to feel safe from their fears and fix their worries. Compulsions can include:

  • Counting things over and over again
  • Excessive washing and cleaning
  • Arranging things in a particular or symmetrical way
  • Checking and rechecking (such as continually checking that the door is locked or that the oven is off)
  • Erasing, rewriting, or re-doing things
  • Repeating words, phrases, or questions more
  • Touching, tapping, or stepping in an unusual or certain way
  • Mental compulsions such as counting and praying
  • Frequent, excessive reassurance-seeking (e.g. asking “Are you sure I’m going to be OK?”)
  • Avoiding situations that may trigger obsessions

These rituals may temporarily ease the obsessive “bad thoughts” but they also allow OCD to continue to affect your mind. Every time you perform a ritual and your worries and fears subside, the brain learns that doing a ritual brings relief, encouraging the obsessive-compulsive behavior pattern. Eventually, the brain becomes so accustomed to the pattern that people with OCD act on their compulsions the moment they have an obsessive thought, worry, or fear, affecting the way the brain looks, functions, and processes information.

What Does OCD Do to the Brain?

Usually, people with OCD know that they’re doing something that doesn’t need to be done, but they just can’t seem to stop their behavior. “It’s like their foot is on the brake telling them to stop, but the brake isn’t attached to the part of the wheel that can actually stop them,” Dr. Kate Fitzgerald explains. That’s because brains affected by obsessive compulsive disorder are overly responsive to communication errors and have less functionality in areas that regulate impulse control.

Obsessive Compulsive Disorder Can Cause Communication Problems in the Brain

Researchers know that obsessive-compulsive disorder is a result of communication problems in the brain. However, scientists are now realizing that OCD disrupts communication between the frontal cortex and another part of the brain known as the ventral striatum. While the frontal cortex regulates problem-solving, the ventral striatum plays an important role in what motivates and rewards us.

Usually, the ventral striatum and frontal cortex work together to solve our problems in a logical way that rewards us, motivating us to continue to make logical, rational decisions. But OCD interrupts the communication between these two parts of the brain. Instead of working together to come up with a rational solution to the problem, OCD tricks the brain into thinking that compulsions and rituals will solve the problematic obsessive thoughts instead. Even though this only works temporarily, the ventral striatum motivates OCD sufferers to keep trying the rituals again and again.

OCD Can Reduce Grey Matter in Parts of The Brain That Regulate Impulse Control

Studies show that patients with OCD tend to have less grey matter in certain parts of the brain. Generally, areas of the brain that have high amounts of grey matter help you:

  • Control impulses
  • Manage your senses
  • Process information, thoughts, and feelings
  • Develop, regulate, and exhibit motor skills like talking, writing, reaction time, balance, coordination, and drawing

Unfortunately, obsessive-compulsive disorder diminishes the amount of grey matter in the brain, making people with OCD less able to control their impulses. Low levels of grey matter can also change the way you process information, making you more likely to obsess over “bad thoughts” whether you intend to or not.

Obsessive compulsive disorder reduces the amount of grey matter in the medial frontal gyrus, medial orbitofrontal cortex, operculum, and orbitofrontal regions of the brain. Here’s how these areas regulate our thinking and actions:

  • Medial surface on the superior frontal gyrus. Gyri are the folds or bumps in the brain. The superior frontal gyrus helps regulate and mediate cognitive functions. Having less grey matter in this part of the brain prevents people with OCD from responding logically to obsessive thoughts. Diminished grey matter in this region of the brain also stops the brain from suppressing impulsive responses and habits, making people with OCD feel like they have to continue their compulsions and rituals.
  • Medial orbitofrontal cortex. A subregion of the prefrontal cortex, the medial orbitofrontal cortex, or mOFC, plays an important role in the decisions you make. Generally, this area of the brain identifies and suppresses spontaneous or sudden memories that don’t relate to current reality. Less grey matter in the mOFC weakens this part of the brain, making you unable to suppress sudden thoughts, allowing obsessive worries and fear to overwhelm your mind.
  • Frontal operculum. In healthy brains, the frontal operculum helps determine how you think, process, and plan your behavior. Unfortunately, OCD reduces the amount of grey matter in this part of the brain, triggering the compulsive, unplanned behavior people with OCD often display.
  • Orbitofrontal Cortex, or OFC. The OFC helps regulate your impulses and inhibition. When the OFC is damaged, you may know that your choices and behaviors are unnecessary and excessive, but still find yourself continuing to perform excessive activities, like repeatedly checking doors and locks. The OFC also interacts with the amygdala which helps control bodily changes associated with emotion. Unfortunately, OCD hijacks this region of the brain, triggering excessive touching, tapping, and stepping in specific ways.

OCD Can Diminish Serotonin Levels, Increasing Anxiety

Scientists are still trying to figure out how OCD diminishes serotonin levels, but they do know that most people with OCD have low serotonin levels. Serotonin is a chemical messenger in the brain that helps regulate your mood and aggression levels. Usually, serotonin keeps you calm, helps you sleep well, and causes you to feel at ease. But when obsessive-compulsive disorder affects your serotonin levels, you may feel like you’re constantly on edge and that you can never really calm down. Being hyper-aware of your environment can also make you more susceptible to OCD compulsions like excessively washing your hands, counting, or organizing.

Let Us Help You Manage OCD

Obsessive worries, fears, and “bad thoughts” don’t have to control your life. Here at StoneRidge Centers, we pride ourselves on having programs designed to help you manage mental health disorders like OCD. All of our programs combine expert brain science with compassionate care. We also use evidence-based therapy techniques, nutrition, and exercise to help restore our patient’s mental health.

You don’t have to battle OCD alone. Whether you’re looking for inpatient or outpatient treatment, we can help restore your brain to its optimum state of health. Let us help you get there. Call us today at 928-583-7799 if you or a loved one are living with OCD.

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