- Date posted
- 2y
OCD in the brain / potential missing piece in treating OCD
I thought some people might find it interesting to learn a little more about how OCD works in the human brain. There’ll be some neuroscience jargon in this post but I’ll try to phrase things so that the lingo doesn’t get in the way what I’m going to say. Several brain regions have been linked to OCD. It’s not a simple disorder at all. Many areas involved are near the front of the brain in the prefrontal cortex, such as the anterior cingulate cortex (ACC). The ACC is involved in self-reflection, emotional responses, evaluating rewarding behaviors, etc. People with OCD tend to have overactive ACCs. Other parts of the brain involved in OCD include the basal ganglia, the supplementary motor area (SMA), and the thalamus. The basal ganglia are involved in motor commands and error detection. They “filter out” unnecessary or unhelpful movement commands that everyone’s brain automatically sends down to this area. In OCD, it’s thought that the basal ganglia are not as good at recognizing errors, meaning they perceive many more errors than someone without OCD would. This also explains why many people have the urge to do repetitive behaviors, since the basal ganglia filter movement commands. The SMA initiates plans for future movement before these plans even move down to reach the basal ganglia. New studies have found that abnormalities in the SMA may be the cause of some obsessive-compulsive behaviors. The thalamus is like a hub in your brain for transporting stimuli. Things your body perceives pass up through the thalamus to be sent to different parts of the brain, and thoughts that your brain generates pass down through the thalamus to be sent out to the body. Think of it like grand central station in your brain. People with OCD often have larger-than-usual thalami, possibly meaning that stronger signals of error can be sent throughout the brain. On a final note, there seems to be a big missing puzzle piece in treating OCD. In order to explain this missing piece, you need to know the difference between neurotransmitters like serotonin, and different regions of your brain, like the basal ganglia or the prefrontal cortex. There are MANY different brain regions that are separately named because they do different things. However, all activity in your brain comes from what neurotransmitters do. While there are tons of different brain regions, there are only so many neurotransmitters. So the same handful of hormones and chemicals work in the many different areas of the brain to cause all the things you experience and do. The most common medication therapy for OCD today is to take an SSRI, a type of medication that acts on serotonin. While serotonin is certainly involved in OCD, the missing puzzle piece comes from dopamine. The basal ganglia, which seem to play a BIG part in OCD, use the neurotransmitter dopamine to operate. Further, dopamine is responsible for movement, which includes repetitive behaviors. Medications that increase dopamine activity (adderall, etc) ridiculously worsen OCD symptoms. So part of the reason why current medication treatments for OCD probably don’t quite cut it is because serotonin is not the only player in causing OCD symptoms to manifest. I’m not suggesting self medication by any means, but hopefully future treatments will target dopamine as well as serotonin. I hope you found this interesting, and that I didn’t make it too hard to follow. I love talking about the brain, so if you find it intriguing, lmk! Also check out this article about a “loop of wrongness” in OCD. I found it super interesting. https://www.michiganmedicine.org/health-lab/stuck-loop-wrongness-brain-study-shows-roots-ocd#:~:text=Put%20simply%2C%20the%20study%20suggests,if%20they%20know%20they%20should.