Integrative Psychiatry and TMS

This disorder is characterized by either obsessions or compulsions.

Obsessions are defined by :

1. Recurrent and persistent thoughts, impulses, or images that are experienced, at some time during the disturbance, as intrusive and inappropriate and that cause marked anxiety or distress

2. The thoughts, impulses, images are not simply excessive worries about real-life problems

3. The person attempts to ignore or suppress such thoughts, impulses, or images, or to neutralize them with some other thought or action

4. The person recognizes that the persistent thoughts, impulses, or images are a product of his or her mind

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Compulsions are defined by:

1. Repetitive behavior (e.g., hand washing, ordering, checking) or mental acts (e.g., praying, counting, repeating words silently) that the person feels driven to perform in response to an obsession, or according to rules that must be applied rigidly

2. The behavior or mental acts are aimed at preventing or reducing distress or preventing some dreaded event or situation; however, these behaviors or mental acts either are not connected in a realistic way with what they are designed to neutralize/ prevent or are clearly excessive

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It is unknown why some people develop Obsessive Compulsive Disorders. The genetic factor may play a significant role. More than half of the patients with OCD have a sudden onset of symptoms, which are usually precipitated by a stressful event, such as pregnancy, a sexual problem, or the death of a relative. Because many persons manage to keep their symptoms secret, there is often a delay of 5 to 10 years before patients come to psychiatric attention.

In treatment, the best success is observed when Psychotherapy is used in combination with Pharmacotherapy. The most effective psychotherapeutic modality is Behavioral Therapy. Commonly used medications are: Prozac, Luvox, Paxil, Celexa, Lexapro, and Clomipramine. Higher than regular dosages are usually necessary to achieve therapeutic effect.