Time magazine has a feature article on the science and treatment of obsessive compulsive disorder or OCD, where a person is affected by intrusive thoughts, or feels compelled to complete repetitive actions, or both.
It is strongly linked to anxiety, and a typical pattern is where an intrusive thought causes stress, and the person feels compelled to complete one or more actions to reduce the anxiety.
This is not always the case, however, and some people suffer intrusive thoughts on their own, or, more rarely, compulsive acts on their own – although some researchers just think that the latter is just because some people don’t recognise their thoughts very well and compulsions are probably always linked to obsessions.
Crucially, the intrusive thoughts are ‘ego dystonic’, meaning they seem to be in conflict with the persons existing desires, beliefs or self-image, and so are quite distressing.
They can be about almost anything, and can occasionally seem a little bizarre, but typically focus on concerns about safety and danger.
For example, a parent might be plagued by thoughts that they will harm their child with a knife, despite the fact that they have been a model parent and have never put them in undue danger, or someone might worry that they will give ‘germs’ to their family which will kill them.
This can lead to compulsive behaviours, such as repeatedly checking there are no knives in the kitchen drawer, or continuous hand-washing to be absolutely sure that all the ‘germs’ are removed.
These may take hours everyday, meaning the person can be quite impaired in day-to-day life, and can become quite distressed if something prevents them from completing their compulsion.
The title of the article (‘When Worry Hijacks The Brain’) is a little inaccurate as it’s not really a problem with high levels of general worry (this is something known as GAD), it’s more often a problem with a specific thought that re-occurs.
Luckily, we know that psychological therapies, such as behaviour or cognitive behavioural therapy are some of the most effective treatments, with SSRI medication also having a significant beneficial effect.
Interestingly, the article mentions ‘strep throat‘, a common throat infection that is usually painful but harmless.
There’s now some limited evidence that in a tiny minority of childhood cases it is linked to OCD. A theory originally thought to be completely wacky, but now taken more seriously by medical researchers.
It’s still not clear whether the infection definitely causes the disorder in some cases, but it is being investigated as an interesting correlation that merits further investigation.