2-Minute Neuroscience: Obsessive-Compulsive Disorder (OCD)

​Obsessive-compulsive disorder, or OCD, is a condition characterized by obsessions and/or compulsions. Although the neuroscience of OCD is not completely understood, in this video I discuss one supported perspective on what happens in the brain to cause the obsessions and compulsions that occur in OCD.

TRANSCRIPT:

Obsessive-compulsive disorder, or OCD, is a condition characterized by obsessions and/or compulsions. Obsessions are recurrent unwanted thoughts, while compulsions are repetitive behaviors or mental acts often performed in response to obsessions, typically with the goal of reducing anxiety and discomfort. It’s important to note that OCD is often very distressing, and is not just a preference for orderliness, as the term is sometimes used to imply.

The neuroscience of OCD is not completely understood, and it’s likely that different neural circuits may be involved based on a person’s age and symptom profile, among other factors. One supported perspective on the neuroscience of OCD, however, points to a prominent role for circuits that connect the orbitofrontal cortex with a group of structures called the basal ganglia. According to this perspective, increased activity in the orbitofrontal cortex is associated with a heightened focus on concerns that spawn obsessive thoughts. When the orbitofrontal cortex is activated in response to something the brain perceives as a danger or concern, it communicates with the basal ganglia. A simplified version of basal ganglia circuitry suggests it consists of two opposing pathways: an excitatory pathway called the direct pathway, and an inhibitory pathway called the indirect pathway. When the orbitofrontal cortex sends a signal to the basal ganglia, it often leads to an action designed to alleviate the discomfort caused by the perceived danger; that action is mediated by the direct pathway. In a healthy person, the indirect pathway then inhibits further action. In someone with OCD, however, the direct pathway is over-excitable, drowning out the activity of the indirect pathway and causing a difficult time switching to a different behavior or turning focus away from the concern causing the discomfort. Thus, according to this model, overactivity in the orbitofrontal cortex and the direct pathway of the basal ganglia increases the occurrence of both obsessions and compulsions.

REFERENCES:

Lanciego JL, Luquin N, Obeso JA. Functional neuroanatomy of the basal ganglia. Cold Spring Harb Perspect Med. 2012 Dec 1;2(12):a009621. doi: 10.1101/cshperspect.a009621. PMID: 23071379; PMCID: PMC3543080.

Pauls DL, Abramovitch A, Rauch SL, Geller DA. Obsessive-compulsive disorder: an integrative genetic and neurobiological perspective. Nat Rev Neurosci. 2014 Jun;15(6):410-24. doi: 10.1038/nrn3746. PMID: 24840803.

Saxena S, Rauch SL. Functional neuroimaging and the neuroanatomy of obsessive-compulsive disorder. Psychiatr Clin North Am. 2000 Sep;23(3):563-86. doi: 10.1016/s0193-953x(05)70181-7. PMID: 10986728.

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[Rainjojo]

This disorder is absolute hell, I can’t even think normally without obsessing over an addiction and acting out on it as if I have no control, which is ironic because I know I do I just want it to go away. I hyperfocus to see if it’ll work but I’m carving the addiction even more, I sometimes feel like dying would be a mercy

[jasonelias]

My ocd has pushed me to the very bottom of the earth. I would not want this on even on my worse enemy. It kills me every day. I cannot go even 5 minutes without exausing and tiring myself from mental rituals. I wish people around me would understand. Mine makes me believe wild thoughts that are by no means true. It scares me and fills my body with fear and anxiety. I know these obsessions aren't true but for some reason I believe them until I perform my rituals... until the anxiety comes back again and I have to do it again. The cycle never stops. I am 20, in college, good looking, and am on my way to becoming a doctor and live a life that most people would love to live. I wish I could start enjoying life. I will never stop pushing and I will keep on trying my very best. Best of luck to all of you here. May we all rid of this curse in the near future.

[CelebrityGossip_]

I've been suffering from OCD for 7years. The thing is, I know that these thoughts are just thoughts. I know that whether I perform the compulsive action or not, nothing will happen. I understand it all, but still cannot get out of this. I've been in therapy for 3years, I've been working on myself, I've also been suffering from depression and to be honest battling with these mental illnesses I've become stronger and I started to see myself as I am, not what society percieves of me, just the way I truly am. So if anybody is reading this comment, I see you, I'm with you and just know that your biggest friend and supporter is yourself, rely on yourself and believe in your abilities, cause you're the only one that truly knows who you really are!❤

[VenXT]

I have OCD, it was extremely severe when I was a kid, but as I've grown up, it's become almost non-existent, or much more manageable
It started after I experienced head trauma when I was 8. I fell down the stairs and gave my self a nasty concussion, which put me in the hospital for 3 days. The same year I ran into a tetherball poll playing tag and reconcussed myself.
I ended up developing intrusive thoughts, mostly based in fear, and would have to perform some sort of ritual. "If you don't flip the light switch 4 times, a burglar will break in and shoot you" or "If you don't breathe in 3 times through your nose and 3 time out of your mouth, you will die on your sleep" Very specific, and even at a young age, I knew it was irrational, but the fear was still very real, so I would follow suit. The intrusive thought would just pop into my head, almost every minute of the day.
The doctors would try dozens of antidepressants and anti anxiety medications, but all that managed to do was introduce me to mind altering substances at a young age which eventually got out of control.

As I stated, the older I got the better I became at managing my OCD. I still had compulsions as a teenager, but was able to take some control over what they were. I would create more subtle compulsions to deal with the thoughts like a quick flick of the hand or a quick wink, and as I hit my 20s, I no longer felt the need to do the compulsions at all
I'm lucky in the sense that my case improved with age, I do still suffer from the occasional panic attack and am prone to anxiety, but I've deleveloped coping skills like grounding or slowing down my breathing to bring my heart rate down, and that has also become much more manageable
I know this was long, but I wanted to provide some insight, I hope this helps

[peacegod]

OCD is fear based. I also believe it is sort of an addiction as well. I also believe it stems from childhood... Looking at this video, OCD is wiring of the brain issue. I believe through proper therapy and us attempting to agree with ourselves that we cannot control everything, the healing can be done in our brain. Sounds easy, but it's not.

[declanoshaughnessy]

Stress is a major role to play a part in all of it best wishes and best of health to all ♥️♥️

[paulwilliams]

I've been crippled with ocd all my life I'm 50 3 times a minute for 15 years, but I'm still here, I had kids late and now I'm a dad, ocd ruined alot of my life but as hard as it still is I'm OK, I love my kids, don't Eva give up, I will struggle tomorrow but I'll deal with it, love you all x

[devyngaffney]

Thank you for explicitly stating ocd is not just "quirky perfectionism 🤪" and is is alot more distressing

[Feldgrau]

I’ve had ocd since I was six or seven, it started as physical compulsions and slowly progressed to mental compulsions which are insanely hard to deal with, I label things good or bad every second of my life, thanks for the vid

[romb]

I like the idea of "2 min". Long enough to understand the info, short enough to not getting bored. 👍

[kasiakatarzyna]

Thank you for this film. I have had OCD since childhood and have tried many times to find how my brain differs from that of a healthy person. However, often the scientific articles were too complicated. Your video is short on topic and easy to understand. You also have subtitles which is a very cool plus. Best regards from Poland. 🇵🇱

[Rationalist]

Thank goodness! Finally a video on this

[kcatsang]

I've had OCD since a early age and now just realizing that IT IS a problem, my OCD is centered around safety, to help cope with trauma from a early age- I'm doing wayy better now though but it lingers still 😭 I hope it becomes all a bad dream Someday

[bxp]

OCD can be significantly reduced by mindfulness, those struggling with it I highly recommend it. Simply each day focus intensely on the breath for 20-30 mins each day

[syedmasood]

ive found that ocd is linked to anxiety and that anxiety is the cause and trigger to my ocd so whenever i get the urge i breathe and reduce my anxiety that way which works very well and the key is to do that while also making sure your mind is clear and relaxed so that when the anxiety fades, your back to normal that way or at least i am

[TwisterOfficialRap]

I'll never forget the day when I was 10 years old me and my family went for a walk and I remember having the thought appear in my head "your mother is fat", which bugged me at the time because as a child I didn't know whether that meant I think that she is, basically my ten year old mind was questioning why this is a thought that is in my head. I couldn't shake the thought it would reappear on that day and only ceased when I would tell myself "shut-up head" as if I am directing that speech towards a separate entity - differentiating the origin of that thought - that is to say "my head" came up with that though and it is separate from me. OCD definitely has an anxiety mechanism within it's principles of functioning, this further descriptive anecdote describes this: my mother was very conscious of her weight when I was a child growing up and I have one particular memory where my cousin as a child at the time made a comment about my mum's weight in front of everyone and I have the memory of her crying in the bathroom the next day and my dad consoling her. I feel like the memory of this mixed with my love for my mother played a role in my OCD at this age when I would be fear driven by the thought of "my mum is fat" as this thought is something intertwined with my personal memory and plays on my own fear of how this subject upset her at the time.

Despite the fact that my "shut-up head" compulsion would relieve the anxiety I would feel at the time, this obsessive thought would not only consistently reappear but haunt me for many years to come, amongst other obsessions which I developed towards things I specifically care about like my family, relationships, myself and self-features and more. My OCD has always been something I've been aware of since that age of 10 but it was fairly calm during my teenagehood in the sense of I would have periods where it would become worse but periods were I wouldn't be affected by obsessive thoughts, then there were periods were the obsessive thoughts were present but I had compulsions and mechanisms in place to deal with them. As a child and young teen I would mainly have compulsions which were physically acted out so to speak like counting items, tapping/touching things a number of times or flicking the light switch on and off a certain number of times to "avoid something terrible" or the like. However, I feel like because I was aware that this behaviour wasn't common (a.k.a not 'normal' - which I don't like using this word) and therefore I would be judged for it, my compulsions overtime developed to become more mental based - that way I could relieve myself from my obsessions without outwardly displayed any obsessive behaviours to anyone around me. For a while I believed my OCD was "pure-o OCD" (purely obsessional) due to how sources describe it as mental imagery and entirely thought based OCD, however I now understand that OCD is a brain type/mechanism which is comprised of a few elements such as the physiological component (communication between orbifrontal cortex and basal ganglia system), anxiety mechanism and anxiety processing centres etc. (just to list a few factors in the OCD equation). There are a plethora of different types of OCD's out there although I believe that OCD is a brain mechanism as I mentioned and that all these different labels for different OCD types such as "sensory OCD", "purely obsessional OCD", "magical thinking OCD" etc. are simply describing different people's OCD's focuses, not describing the actual deeper workings of the OCD mechanism within the brain.

One other very important note to make is, I moved out of my family's house and lived on my own for the very first time in my life when I was 18 for university. I'd never lived away from my family before. The first month or so into it I was fine and settling in however I will never forget how enormously my OCD had just blew up in such a short space of time. To this day, no other period or time in my life rivals the magnitude of OCD and anxiety I was experiencing. I couldn't do normal tasks like going to the bathroom, getting out of bed, cooking food without trip wiring my OCD in some way. Bear in mind, how I had been dealing with OCD in my teenagehood beforehand with it seemingly becoming more manageable and under control as I developed becoming older up until this very point when everything changed. I'd read briefly online that many people with OCD are most at comfort when around their family or within the comforting walls of their familiar homes. This would make sense in theory as to why I had rapid onset major OCD symptoms, for example: I had never lived on my own before away from family in a big city and eventually moved back home as a result of my mental health.

Quick side note on the above story is that, my sister who never left home to go to uni or live on her own, she lived at home during her time being 18 and she also developed worser OCD symptoms than anything she ever experienced before (she had OCD symptoms before at different stages but definitely nowhere near as prevalent as me), BUT SHE HAD THE RAPID OCD ONSET AT THE SAME AGE TOO - despite being at home with her family. So this straight away tells me that OCD has at least one factor being physiological/genetic since both me and my sister experienced OCD having a sudden spike in symptoms around this same age in different settings/circumstances.

I want to wrap my insight story up by saying how for the majority of days (not every single day) since 2019 I smoke cannabis which is something I started in Feb 2019 up until this point I still use it in a regulated fashion. At first it seemed magical and as if a veil was lifted, I was able to think clearly in a way were I wouldn't constantly pause on my thoughts and become stuck on certain thoughts in an OCD loop. This was what I needed after my horror OCD experience at uni. Some days the high from weed would help my mental health by alleviating any OCD symptoms and other days not so much. On some days the OCD was powerless and I was able to understand better and clearly gain a grasp of how irrational and illogical certain compulsions and behaviours were, not like I didn't know before but just before I couldn't see through it/escape it at the time - the high allowed me to see through this more clearly and therefore helped reduce symptoms.

However, I want to make the point that sometimes the high made my OCD symptoms worse and there would be days (especially if I felt more generally anxious on that day) were my OCD was more of an issue as my high made me focus on the symptoms more. So although cannabis can be a medicinal tool which in some cases may help someone with OCD, it's important to consider the other factors involved which may affect how you perceive your OCD, such as the strain of the weed, the amount you smoke, stress/anxiety, etc.

Today I am choosing to delve into as much research and insights as possible to guide my understanding on the exact workings and mechanisms of OCD in order to not only structure my lifestyle routines to benefit me as much as possible but what potential medication I may start taking to help reduce symptoms. I heard getting a right amount of sleep can make a big difference to someone with OCD and the symptom they experience, as well as other factors such as eating a balanced healthy diet, drinking plenty of water, meditating and exercising. So there's definitely a lot to soak in... I believe that in our modern world today we are only beginning to learn the true depth and nature of the human mind and how it works, we are only at a stage what one might consider to be the first step in tackling the worldwide phenomena of OCD. Look after yourselves brothers and sisters, always be kind to your mind. <3

[ageofhistoryiiguy]

I have OCD (diagnosed by a doctor) and it was way worse when I was little than it is now. When I was little I would have to repeat my sentences constantly and NOBODY was allowed to move or speak while I tried to say the perfect sentence. Sometimes it would take up to 1 hour for me to get the right sentence. It’s much better as a teenager and I can thank Zoloft for that.

Edit: by perfect sentences I mean,
1. Can’t breathe while saying it

2. Can’t stutter when saying it

3. Can’t blink when saying it

4. Can’t move when saying it

There is a bunch of other things but those 4 are the only ones I can remember.

[emmyberry]

Recently starting medication has helped me manage my OCD and anxiety disorder so much. This was super interesting to see exactly what occurs in my brain! I think the OCD thought patterns are almost hardwired in there to some degree though, I was diagnosed as a very young child and it’s taken a lot of work to think more “”normally””

[Gielderst]

My OCD Is pretty much constant. Aside from when I sleep. But when I'm awake I almost constantly check what and how I'm doing my actions to reassure myself I'm doing them right. And I'm constantly repeating my actions in my thoughts. And I do them in particular orders. I also look around me a lot to check If I've not dropped something or forgotten something. And probably many other things which I can hardly describe. And I realize this all but I just can't help but do my " ritual actions " to calm my anxiety or whatever it's called. And this makes me hate myself and feel depressed almost all the time. Cause I realize how messed up I am but I can't help free my mind from this constant strange obsessive thinking or whatever it is. It's like I even find it likeable that I repeat all the weird compulsions to calm myself thinking it's all fine and perfect around me and there's nothing to worry about. It's just a constant mental torture and exhausts my head all the time and I have difficulty focusing without the weird thoughts interfering. I just wish I hadn't been born at times. Realizing how messed up my mind is. Guess I'll just have to live with this curse which few understand.

[RikAindow]

Reddit has an OCD bot which brought me here. I'm glad it did as this video is very informative.