OCD

Obsessive compulsive disorder is a mental illness in which affected individuals experience unusually frequent impulses, thoughts or images often alerting them of potential danger or problems. The frequency of this alerts becomes increasingly distressing as there is a compulsion to check and/or initiate safety acts to prevent the perceived danger. After a while the person realises these are senseless or false alarms. However because the brain has overtime become so conditioned to communicate these false messages and generate responses, any effort to avoid or resist the urges or compulsion results in extreme anxiety which is only relieved by giving in to the impulse. The faulty neural circuitry involves complex connections linking the orbito-frontal cortex with other subcortical regions that mediate emotive responses such as in the limbic cortex and subthalamus. The fear generated over-rides any attempt at response inhibition leading to compulsive acts. Proponents of a primordial function for the disinhibitory acts in OCD argue that it serves an innate behaviour that in prehistoric species was adaptive. 

Key features:

1. Non situational  preoccupation in the form of :
   • Ruminations (or obsessions)- which could be in the form of words, thoughts(often doubts), ideas, impulses or images
   • Or actions- rituals or compulsions(acts)
2. They are recurrent being present most days.  There is subjective compulsion to act on these distressing thoughts despite conscious  resistance
3. Recognized as one’s own thoughts – insight maintained
4. Courses significant distress! i.e. it is Ego-dystonic: the individual consciously resists the thought/impulse/ruminations/image  Etc but in the process generates  tension usually only briefly relieved by giving in to the urge or compulsion.

The disorder is maintained by an over valued idea that performing the act or compulsion in some magical way will prevent an unwanted event happening.  Underlying this idea is the initial relief from anxiety the individual experiences. This is however so short lasting that a  vicious cycle is soon established.
OCD presents as an anxiety state