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Dr. D. Love
Dr. D. Love, Doctor
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Experience:  Family Physician for 10 years; Hospital Medical Director for 10 years.
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Obsessive Compulsive Disorder and Impulse control:I have

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Obsessive Compulsive Disorder and Impulse control:
I have pure O, which is a distinct form of OCD that relates to more serious obsessions: sex, violence, religion, etc. Most compulsions are mental in nature. I also have Asperger's.
I suffer a lot from intrusive violent thoughts that are incredibly distressing. Sometimes, because I have the thoughts so much, I have an "impulse" or "feeling" to listen to the thoughts and perform a harmful action, even though I never have done. The fear/impulses seem "real" - the anxiety is incredible - when I was at my worst, it was as if the OCD was telling me to pick up a knife and harm myself and others, even though I don't have a violent bone in my body and have never harmed anybody.
How can impulses be explained in the brain? Can anxiety mimic different emotional states? I know the thoughts are extremely disturbing and ego-dystonic, so why do they feel so real? What is the role of dopamine, adrenaline and noradrenaline? Are these linked to impulses that feel "real" - it's as if the OCD is almost urging me to do something I don't want to do. If I perform a compulsion to relieve the anxiety, am I activating reward/fear circuits in the brain? Is this a case of neuroplasticity? What am I doing to the brain when I perform a compulsion? Is it negative reinforcement as seen in the principles of behavioural psychology?
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I notice that no expert has yet responded to this question, but this is likely because we do not understand what happens in the brain to the extent that you are asking in your question.

It is still unclear which brain chemicals are affected by OCD. There is some evidence that serotonin is the affected chemical in some people, and the serotonin uptake inhibitors has shown some effectiveness in people with OCD. There also is some evidence that glutamate, GABA, or dopamine are affected in some people.

Anatomically, there is a portion of the brain that appears to be affected in people with OCD, specifically pathways from the front portion of the brain to deeper portions of the brain called the striatum, the thalamus, and the caudate nucleus. However, there is not the level of knowledge that would be able to address the detail that you have requested.
Dr. D. Love, Doctor
Category: Medical
Satisfied Customers: 19436
Experience: Family Physician for 10 years; Hospital Medical Director for 10 years.
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