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Sample essay topic, essay writing: Obsessive-compulsive Disorder - 1402 words
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.. he symptoms and the amount of distress caused by the symptoms as to which treatment would be the best approach. There may be two types of OCD patients. One has exaggerated reactions to normal thoughts, which can be treated with cognitive therapy, and whose beliefs are delusional and not responsive to cognitive therapy. (Behavioral Health Treatment: 1997) One patient may benefit from behavior therapy and another from medication. Some may start with medication to gain control of symptoms and then behavior therapy.
There is evidence that treatment with medications or behavior therapy induces changes in the brain coincident with clinical improvement. (www.ocdonline.com: 2000) Clinical trials have shown that drugs that affect the neurotransmitter, serotonin, can decrease the symptoms of OCD. The inhibitor specifically approved for OCD is clomipramine(Anafranil). Others used are flouxetine (Prozac), fluvoxamine (Luvox), and paroxetine (Paxil), which all have been approved by FDA. The side effects of these drugs are overstimulation, insomnia, nausea, and loss of sexual desire. The most popular used is Prozac. Studies show that more than three-quarters of patients are helped by these medications at least a little bit
In at least half of the patients, medications relieved symptoms, by diminishing the frequency and intensity of the obsessions and compulsions. The improvement usually takes at least three weeks or more. (www.ocdonline.com: 2000) OCD had been a difficult illness to treat until recently. However, clomipramine has several side effects. Almost everyone will suffer with side effects, such as, dry mouth, weight gain, constipation, drowsiness, and sometimes the inability to have an orgasm.
(American Family Physician: 2000) In a large-scale experiment, 55% of the patients taking clomaipramine achieved at least a 35% reduction in symptoms with seven percent given a placebo. Unfortunately, patients usually relapse unless they take the drug indefinitely. (Edna Foa: 1995) Baxter noted that metabolicrates in the forward portion of the frontal cortex distinguish obsessive-compulsive patients rather well from patients with serious forms of depression. The caudate nuclei and oribitral gyri contain large quantities of serotonin, which Insel and his colleagues believe plays a major role in obsessive-compulsive disorder. The ant-depressant drug, clomipramine, blocks the action of serotonin and often provides dramatic relief to OCD patients.
UCLA investigators say that clomipramine leads to sedation, impotence and tremors. The NIMH researchers have also found that a patient's obsessive thoughts will rapidly worsen after taking a drug that stimulates a specific class of serotonin perceptors. (Bruce Bower: 1987) Susan Ball, assistant professor of psychiatry at the Indiana University School of Medicine, suggests that there needs to be an assessment for the different kinds of symptoms. If a person is severely depressed and has severe obsessions and compulsions, then medication should be given first, allow the medication to kick in to reduce depression, and maybe the severity of OCD, and then do the behavioral therapy. (Behavior Health Treatment: 1997) Thirty percent of OCD patients do not respond well to medication and it the patient stops taking the pill, the symptoms return. (Sharon Begley: 1996)Another approach of treatment is Exposure and Response Prevention.
This is when the patient purposefully and voluntarily confronts the feared object or idea. And at the same time the patient is encouraged to refrain from the ritual that they are having problems with. As treatment progresses, patients experience less anxiety and are able to resist the compulsive urges. It has found to be successful for the majority of the patients who use it. Three hundred patients were treated by exposure and response prevention.
Up to 76% still showed relief from three months to six years after treatment. (www.ocdonline.com: 2000) Once the symptoms are defined, the therapist and patient rank thoughts and situations by the degree of anxiety and discomfort, and exposure proceeds upward on the scale. The exposure reduces the distress and the response prevention stops the compulsive behavior. (Edna Foa: 1995) Behavioral therapy is used to lessen the unwanted compulsions. People are exposed to the situations that produce the anxiety, and then resist from performing the rituals that usually ease that anxiety. The person must really want to use this method for it to be successful and to be able to tolerate the high levels of anxiety that result. (American Family Physician: 2000) In Foa's 3-week program, patients are not allowed to wash their hands at all.
The anxiety goes down by a habituation process, and the ritual goes down over time. (Behavioral Health Treatment: 1997) The rate of improvement of behavioral therapy is fifty to eighty percent and it is usually maintained for several years. In Foa's experiment, 75%of the patients given treatment showed significant improvements and a symptom reduction of more than thirty percent. (Edna Foa: 1995) Studies show that behavior therapy is found to be the most successful treatment for the majority of the patients who complete it. Changing the way a person acts and changing the way a person thinks can alter the biology of the brain. Swartz, a psychiatrist, says that the mind can change the brain.
There are also other treatment methods used. Habit rehearsal used. It is a variant of ERP. It is especially useful for touching compulsions, hair pulling, and skin picking. The patient charts the compulsive urges and tries to substitute it with other actions, such as deep breathing, muscle relaxation, or fist clenching.
Anxiety management, relaxation training, and assertiveness training are sometimes added. Cognitive Therapy helps people to learn to question the importance of their obsessions and the belief that rituals protect them. This variant of behavior therapy emphasizes changing a person's beliefs and thinking patterns. Mutual aid groups are also increasingly popular, because they allow people with OCD to help themselves by helping others. Surgery is used as a last resort in cases where nothing else works. Surgical procedures serve to interrupt and eventually alter the routing of the neural transmission in the circuit that runs through the frontal cortex and basal ganglia. (Harvard Mental Health Letter: 1998) Treatment improved obsessions in 85% of the patients receiving behavior therapy, 52% of those receiving medication, and 19% of those receiving a placebo. The improvement rates for rituals were 100% for therapy, 43% for medication, and 12% for a placebo.
Patients who continued to take the drugs sixteen months later were doing as well as those who had behavior therapy, but the patients who had stopped using the drugs lost their gains. (Edna Foa: 1995) Edna Foa states, "There is no question among experts that behavioral therapy works better than medication."The cause of obsessive-compulsive is still unclear. There is a lot of evidence that proves the problem is biological. Tests show that there is an imbalance in the brain between someone without a mental illness or with a different mental illness. I agree somewhat, but I think that the environment has a big influence on what we do and how we act.It is clear that behavioral therapy is more successful than medication.
It seems as though the exposure and response therapy leads to the best results. I however, agree with Sharon Begely that the mind can change the brain. Since the mind can change the brain, the medication is useless. It depends upon the person with the illness as to which treatment they shall take. For behavioral therapy to work, the patient really needs to want to get better.
If the person is really dedicated, then eventually the brain will change, and there won't be a problem with the frontal lobes. Unless a person wants to be stuck taking drugs for the rest of their life, I recommend they do behavioral therapy. Eventually they will overcome their compulsions and be able to control their obsessions. Works CitedKendall, Phillip C. and Constance Hamman.
(1998). Abnormal Psychology: Obsessive Compulsive Disorder: Understanding Human Problems. Boston New YorkOCD: What it is and how to treat it. (March 1, 2000). American Family Physician,V61 pg. 1532General Review: Obsessive Compulsive Part I.
(Oct. 1998) Harvard Mental Health Letter, v15 I 4General Review: Obsessive Compulsive Part II. (Nov. 1998) Harvard Mental Health Letter, v15 i5OCD Meds not likely to replace therapy: the challenge is to tailor the right combination of treatments for patient. (Jan.
1997). Behavioral Health Treatment, v2 n1 pg1Begely, Sharon and Nina A. Biddle. For the obsessed, the mind can fix the brain. (Feb. 26, 1996) Newsweek, v127 n9 pg.
60Help for obsessive-compulsive disorder. (aug. 1995). USA Today, v124 pg. 12Foa, Edna B.
How do treatments for obsessive compulsive disorder compare?. (July 1995). Harvard Mental Health Letter v12 n1 pg.8Obsessive Compulsive Disorder: review of drug treatment. (Sept. 15, 1994).
American Family Physician, v50 pg. 831.
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