Has anyone noticed how OCD tends to come in certain cycles of first being moderate and well tolerated for a little while, days, maybe weeks, then being medium with a little agitation of symptoms for a short while, then all of a sudden it is full force again. It almost cycles like bipolar, except it is OCD.
I myself didn't experience this, Rena, but from studying a lot of the scientific literature I know that your type of OCD is most 'normal' (pardon me the expression). The description 'waxing and waning' is ubiquitous.
Now, if only we knew what causes this effect... it would be a great step forward. I could hypothesize the following:
- when symptoms are tolerable, there's already a higher expression (production and cell membrane insertion) of the 'serotonin transporter' going on. This way, serotonin is taken up more intensely by nerve cells; freely available serotonin is decreasing. Symptoms increase when a series of steps is implemented, and this process may take weeks. At the end of the series is a decrease in BDNF, a substance that normally keeps nerve cells alert and at good working quality and stability. But since it decreases in content, areas in the brain become more rigid, inflexible, and can't properly adjust to circumstances anymore.
This could account for you lesser ability to suppress unwanted fears, or to rationalize them away. They become repetitive and irritating.
Another cause could be: imbalance in the brain contents of the neurotransmitter glutamate (the most ubiquitous one, in fact). In some areas, there is hyperactivity (notably the occipital frontal cortex and the anterior cingulate cortex); and in others there is too little activity (the thalamus). The net result is the same as above. If hyper- and hypoactivity show a cycling pattern, then that might explain the waxing and waning.
Lastly, the cells that produce the neurotransmitter serotonin could be underactive (these are located in the Raphe nucleus). So there is too little freely available serotonin. This idea is more far-fetched, as I doubt whether the Raphe cells can enter a cycling pattern in the production of serotonin.
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