Obsessive Compulsive Disorder
‍_(OCD)

Obsessive-Compulsive Disorder (OCD) is a mental health condition marked by repetitive, unwanted thoughts (obsessions) and actions (compulsions). Common compulsive behaviors include washing hands, checking things repeatedly, and touching objects in a specific order. Obsessive thoughts often involve harmful, violent, or socially unacceptable ideas that can cause guilt or distress due to violating personal or societal morals. Patients usually recognize these thoughts as irrational and resist them. OCD may be suspected if a person experiences obsessions and compulsions for over an hour each day, interfering with daily life.OCD can involve obsessions, compulsions, or both. Obsessive thoughts tend to cause anxiety or discomfort, while compulsive actions aim to neutralize that distress. People with OCD may want to stop these thoughts and actions but feel unable to, leading to discomfort and emotional pain. Sometimes, only obsessions or compulsions are present, though often, both appear. While compulsive actions may temporarily relieve anxiety, they usually increase it in the long term.The exact cause of OCD is unknown, though it is believed to result from a mix of genetic, environmental, and psychological factors. Recent research in medication and brain imaging suggests that OCD may relate to issues in specific brain circuits, which can improve with medication or behavioral therapy. OCD often starts in childhood or early adolescence and can sometimes be misdiagnosed as autism, general developmental disorders, or Tourette’s syndrome due to the similarity of some symptoms. There are two main types of medications for treating OCD: Western medications and traditional herbal medicine. First, Western medications often make use of selective serotonin reuptake inhibitors (SSRIs) increase serotonin activity in nerve endings, which helps to suppress OCD symptoms. These medications are proven effective, but symptoms can return or withdrawal effects may occur if stopped suddenly, so any changes in dosage should be carefully managed with a specialist.In traditional Korean medicine (TKM), OCD is classified into four main types, and treatment is tailored to each. The four types are: liver qi stagnation, heart-spleen deficiency, heart yin deficiency, and heart-gallbladder deficiency. OCD treatment in TKM prioritizes restoring brain function balance to alleviate psychological symptoms. Specific herbal medicines are prescribed based on the OCD type to stimulate brain vitality, and acupuncture is used to reduce overactive autonomic nerves and promote mental and physical relaxation. Combined with counseling, these treatments aim to stabilize and balance brain function, helping patients regain control over stress and environmental triggers, thereby returning to a healthier daily life.Treatment Case: 14-year-old femaleThe patient was a 14 year old, shy young girl with difficulty making eye contact. She visited with obsessive behaviors as her main symptom. She spent a lot of time washing her hands and showering, checking repeatedly to ensure she was clean. She would also check her writing multiple times to see if it was correct, double-check if she had finished drinking water, and repeatedly put on and take off her clothes, all of which caused her distress.Her development was slightly delayed during early childhood, and she had difficulty making eye contact, for which she received about two months of play therapy. Her obsessive checking behavior started in the 5th grade and progressively worsened, leading to an OCD diagnosis in child psychiatry. Although she tried medication, it was discontinued due to a lack of significant improvement. Her symptoms intensified when she experienced issues with friends or stress, which also made it difficult for her to focus in class or make friends.Examination showed that she struggled to complete the survey due to her checking behaviors, and her anxiety questionnaire was rated as moderate or higher. Her pulse was thin and fast, her tongue tip was red, and her abdomen was tense. She was diagnosed with excessive heat in the heart and liver (심간열성) and received herbal medicine, acupuncture, moxibustion, and TKM-based psychotherapy. Herbal medicine was prescribed, aimed at reducing heat in the heart and liver, improving circulation throughout the body, and promoting mental relaxation. Electroacupuncture and moxibustion were performed once a week. Used relaxation breathing and grounding techniques to relieve mental and physical tension.After two weeks, her mother noticed no significant change in her compulsive behaviors, but the girl felt slightly more at ease. After four weeks, her mother observed some improvement. While her symptoms were still intense during flare-ups, they were less frequent overall, with an average intensity of about 7-8 on a 10-point scale. After week 6, the frequency and intensity of her obsessive thoughts had decreased to 5-6 out of 10. She reported reduced checking behavior and less associated anxiety, especially with writing tasks. After week 10, her washing routines improved; she spent around 40 seconds on handwashing, down from over a minute, and could drink water without needing to check.After week 12, her symptoms had reduced to around 0-2 on a scale of 10, and she reported no major issues in daily life. After a month of maintenance treatment, her care was concluded.Her repetitive behaviors previously slowed her school tasks and made it difficult to socialize during meals with friends. These issues improved, and her mother felt her daughter’s mood brightened as a result.