Obsessive Compulsive Disorder (OCD)

Obsessive-Compulsive Disorder (OCD)

Obsessive-compulsive disorder (OCD) is a common mental health condition defined by unwanted thoughts (obsessions) and repetitive behaviors or mental acts (compulsions).

Symptoms Of OCD

OCD symptoms fall into two categories: obsessions and compulsions. Obsessions are:

• Unwanted, intrusive thoughts, urges, or mental images that cause anxiety or distress
• Persistent and recurring
• Often related to contamination, harm, symmetry, or forbidden thoughts

Compulsions Are:

• Repetitive behaviors or mental acts performed in response to obsessions
• Aimed at reducing anxiety or preventing a feared event
• Often excessive and not realistically connected to what they are meant to prevent

People With OCD Might Experience Symptoms Like:

• Washing hands repeatedly because of a fear of contamination
• Checking locks or appliances over and over
• Arranging objects in a precise order
• Mental rituals such as counting

Symptoms can take up more than an hour a day and significantly interfere with daily life.

Diagnostic Criteria

A diagnosis of OCD is based on criteria in the DSM-5 (the Diagnostic and Statistical Manual of Mental Disorders):

1. Presence of obsessions, compulsions, or both
2. The obsessions or compulsions are time-consuming (more than 1 hour per day) or cause significant distress or impairment
3. The symptoms are not better explained by another mental disorder or medical condition

Severity varies from mild to moderate to nearly constant and incapacitating.

Key Characteristics Of OCD

1. Insight: people often recognize their obsessions as unrealistic but still struggle to control them.
2. Distress: obsessions and compulsions cause significant anxiety or distress.
3. Time-consuming: symptoms typically take at least an hour a day.
4. Interference: OCD significantly affects daily functioning, relationships, or work and school.

OCD In The Brain

Research associates OCD with differences in brain structure and function, including:

1. Overactivity in circuits involving the orbitofrontal cortex, anterior cingulate cortex, and striatum
2. Differences in neurotransmitter systems, especially serotonin
3. Differences in processing information and responding to uncertainty

These differences may contribute to persistent thoughts and repetitive behaviors.

Treatment Options

Established treatment options for OCD include:

1. Cognitive Behavioral Therapy (CBT), particularly Exposure and Response Prevention (ERP)
2. Medications, such as selective serotonin reuptake inhibitors (SSRIs)
3. Transcranial Magnetic Stimulation (TMS)

Transcranial Magnetic Stimulation (TMS) For OCD

TMS is a non-invasive treatment option for OCD, especially for people who have not responded enough to conventional treatments. Mind Spa uses the Apollo TMS Therapy System, which is FDA-cleared for OCD and for major depressive disorder.

How TMS Works For OCD

TMS uses repeated magnetic pulses to stimulate brain regions involved in OCD, which can include the dorsolateral prefrontal cortex, the orbitofrontal cortex, and the presupplementary motor area. The goal is to change activity in the circuits linked to OCD symptoms.

Effectiveness Of TMS For OCD

Research on TMS for OCD includes:

• A peer-reviewed multicenter, sham-controlled study of deep TMS in adults with treatment-resistant OCD reported greater symptom reduction with active treatment than with sham. That study used a different TMS device than Mind Spa's.
• Post-marketing research reports symptom improvement in some patients, and some maintained that improvement over time. Individual results vary.

TMS Treatment Process

TMS for OCD typically involves:

• Multiple sessions over several weeks, on a schedule your provider explains before you start
• No anesthesia or hospitalization
• Staying awake and alert during each session
• Driving yourself home and returning to your day afterward

Considerations For TMS Treatment

TMS may be worth discussing with a provider if you:

• Have not responded enough to conventional treatments like medication and psychotherapy
• Experience significant disruption to daily life from OCD symptoms
• Prefer a non-medication option

Talk with a healthcare professional to decide whether TMS is the right option for you. At Mind Spa, TMS for OCD can be paired with therapy and medication management.

Important Information

Mind Spa uses the Apollo TMS Therapy System, which is FDA-cleared for OCD and major depressive disorder. Individual results vary and are not guaranteed.

Mind Spa is not a crisis service. If you are in crisis, call or text 988. Veterans can dial 988 and press 1.

Mind Spa is open Monday to Friday, 9am to 5pm, at 5340 S. Quebec St., Suite 230S, Greenwood Village, CO 80111. Call 303-327-0350 or complete the new patient paperwork to get started.

References:

1. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.
2. Ruscio, A. M., Stein, D. J., Chiu, W. T., & Kessler, R. C. (2010). The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey Replication. Molecular Psychiatry, 15(1), 53-63.
3. Hirschtritt, M. E., Bloch, M. H., & Mathews, C. A. (2017). Obsessive-Compulsive Disorder: Advances in Diagnosis and Treatment. JAMA, 317(13), 1358-1367.
4. Torres, A. R., Ramos-Cerqueira, A. T., Ferrão, Y. A., Fontenelle, L. F., do Rosário, M. C., & Miguel, E. C. (2011). Suicidality in obsessive-compulsive disorder: prevalence and relation to symptom dimensions and comorbid conditions. The Journal of Clinical Psychiatry, 72(1), 17-26.
5. Angelakis, I., Gooding, P., Tarrier, N., & Panagioti, M. (2015). Suicidality in obsessive compulsive disorder (OCD): A systematic review and meta-analysis. Clinical Psychology Review, 39, 1-15.

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