obsessive compulsive syndrome, obsessive compulsive disorder(OCD) is a psychoneurotic disorder, manifested by obsessive thoughts and actions of the patient. The concept of "obsession" is translated from Latin as a siege or blockade, and "compulsion" as coercion. Healthy people have no problem brushing off unpleasant or frightening thoughts, images, or impulses. Individuals with OCD cannot do this. They constantly ponder such thoughts and get rid of them only after performing certain actions. Gradually intrusive thoughts begin to conflict with the subconscious of the patient. They become a source of depression and anxiety, and rituals and repetitive movements cease to have the expected effect.

In the very name of the pathology lies the answer to the question: what is OCD? Obsession is a medical term for obsessive ideas, disturbing or frightening thoughts, while compulsion is a compulsive act or ritual. It is possible to develop local disorders - only obsessive with a predominance of emotional experiences, or only compulsive, manifested by restless actions. The disease is a reversible neurotic process: after psychotherapeutic and drug treatment his symptoms disappear completely.

Obsessive compulsive disorder occurs in representatives of all socioeconomic levels. Men under the age of 65 are predominantly affected. At an older age, the disease is diagnosed in women. The first signs of pathology appear in patients by the age of ten. There are various phobias and obsessive states that do not require immediate treatment and are adequately perceived by a person. In thirty-year-old patients, a pronounced clinic of the syndrome develops. At the same time, they cease to perceive their fears. They need qualified medical care in a hospital setting.

People with OCD are plagued by thoughts of countless bacteria and wash their hands a hundred times a day. They are not sure if the iron is turned off, and they return home from the street several times to check it. Patients are sure that they can harm loved ones. To prevent this from happening, they hide dangerous items and avoid casual communication. Patients will double-check several times whether they forgot to put all the necessary things in their pocket or bag. Most of them carefully monitor the order in the room. If things are out of place, emotional tension arises. Such processes lead to a decrease in working capacity and a poor perception of new information. The personal life of such patients usually does not add up: they either do not create a family, or their families quickly disintegrate.

Painful obsessive thoughts and actions of the same type lead to depression, reduce the quality of life of patients and require special treatment.

Etiology and pathogenesis

The causes of obsessive-compulsive disorder are currently not fully understood. There are several hypotheses regarding the origin of this disease.

Provoking factors include biological, psychological and social.

Biological factors in the development of the syndrome:

• acute infectious diseases - meningitis, encephalitis,
• autoimmune diseases - group A hemolytic streptococcus causes inflammation of the basal ganglia,
• genetic predisposition,
• alcohol and drug addiction,
• neurological diseases,
• metabolic disorders of neurotransmitters - serotonin, dopamine, norepinephrine.

Psychological or social factors of pathology:

1. special religious beliefs
2. stressful relationships at home and at work
3. excessive parental control all areas of a child's life
4. severe stress, psycho-emotional outburst, shock,
5. long-term use of psychostimulants,
6. experienced fear due to the loss of a loved one,
7. avoidance behavior and misinterpretation of one's thoughts,
8. psychological trauma or depression after childbirth.

Panic and fear can be imposed by society. When the news is about an attack by robbers on the street, it causes anxiety, which is helped to cope with special actions - constant looking back on the street. These compulsions help patients only at the initial stage of mental disorders. In the absence of psychotherapeutic treatment, the syndrome suppresses the human psyche and turns into paranoia.

Pathogenetic links of the syndrome:

• the emergence of thoughts that frighten and torment the sick,
• concentration on this thought against desire,
• mental stress and increasing anxiety,
• performance of stereotyped actions that bring only short-term relief,
• return of intrusive thoughts.

These are the stages of one cyclic process leading to the development of neurosis. Patients become addicted to ritual activities that have a narcotic effect on them. The more patients think about the current situation, the more they are convinced of their inferiority. This leads to an increase in anxiety and a deterioration in the general condition.

Obsessive Compulsive Syndrome can be inherited through generations. This disease is considered moderately hereditary. However, the gene causing this condition has not been identified. In some cases, not the neurosis itself is inherited, but a genetic predisposition to it. Clinical signs of pathology arise under the influence of negative conditions. Proper upbringing and a favorable atmosphere in the family will help to avoid the development of the disease.

Symptoms

Clinical signs of pathology in adults:

1. Thoughts of sexual perversion, death, violence, intrusive memories, fear of hurting someone, getting sick or getting infected, worry about material loss, blasphemy and sacrilege, obsession with purity, pedantry. Towards moral and ethical principles intolerable and irresistible urges are contradictory and unacceptable. Patients are aware of this, often resist and are very worried. Gradually, a feeling of fear develops.
2. Anxiety following obsessive, repetitive thoughts. Such thoughts cause panic and horror in the patient. He is aware of the groundlessness of his ideas, but is not able to control superstition or fear.
3. Stereotypical actions - counting the steps on the stairs, frequent washing hands, the "correct" arrangement of books, double-checking turned off electrical appliances or closed taps, the symmetrical order of objects on the table, repetition of words, counting. These actions are a ritual supposedly relieving obsessive thoughts. For some patients, reading prayers, clicking joints, biting lips helps to get rid of tension. Compulsions are a complex and intricate system, in the event of the destruction of which, the patient conducts it again. The ritual is performed slowly. The patient, as it were, is delaying time, fearing that this system will not help, but internal fears will intensify.
4. Panic attacks and nervousness in the crowd are associated with the risk of contact with the "dirty" clothes of people around, the presence of "strange" smells and sounds, "oblique" looks, the possibility of losing one's things. Patients avoid crowded places.
5. Obsessive-compulsive syndrome is accompanied by apathy, depression, tics, dermatitis or alopecia of unknown origin, excessive preoccupation with one's own appearance. If left untreated, patients develop alcoholism, isolation, rapid fatigue, thoughts of suicide appear, mood swings, quality of life decreases, conflict increases, disorders of the gastrointestinal tract, irritability, concentration decreases, and abuse of sleeping pills and sedatives occurs.

In children, the signs of pathology are less pronounced and occur somewhat less frequently. Sick children are afraid to get lost in the crowd and constantly hold adults by the hand, tightly clasping their fingers. They often ask their parents if they are loved because they are afraid to end up in an orphanage. Having once lost a notebook at school, they experience severe stress, forcing them to count the school supplies in their briefcase several times a day. The dismissive attitude of classmates leads to the formation of complexes in the child and skipping classes. Affected children are usually gloomy, unsociable, suffer from frequent nightmares and complain of poor appetite. A child psychologist can help stop further development syndrome and rid the child of it.

OCD in pregnant women has its own characteristics. It develops in the last trimester of pregnancy or 2-3 months after childbirth. The obsessive thoughts of the mother are the fear of harming her baby: it seems to her that she is dropping the baby; she is visited by thoughts of sexual attraction to him; she has difficulty making decisions about vaccinations and feeding choices. To get rid of intrusive and frightening thoughts, a woman hides objects with which she can harm a child; constantly washes bottles and washes diapers; guards the sleep of the baby, fearing that he will stop breathing; examines him for certain symptoms of the disease. Relatives of women with similar symptoms should encourage her to see a doctor for treatment.

Video: analysis of the manifestations of OCD on the example of Sheldon Cooper

Diagnostic measures

Diagnosis and treatment of the syndrome are carried out by specialists in the field of psychiatry. Specific signs of pathology are obsessions - obsessive thoughts with stable, regular and annoying repetitions. They cause anxiety, anxiety, fear and suffering in the patient, are practically not suppressed or ignored by other thoughts, are psychologically incompatible and irrational.

For physicians, compulsions are important, which cause overwork and suffering in patients. Patients understand that compulsions are unrelated and excessive. For specialists, it is important that the manifestations of the syndrome last more than an hour a day, complicate the life of patients in society, interfere with work and study, and disrupt their physical and social activity.

Many people with the syndrome often do not understand or accept their problem. Psychiatrists advise patients to undergo a full diagnosis, and then begin treatment. This is especially true when obsessive thoughts interfere with life. After a psychodiagnostic conversation and differentiation of pathology from similar mental disorders, specialists prescribe a course of treatment.

Treatment

Treatment of obsessive-compulsive syndrome should begin immediately after the onset of the first symptoms. Carry out complex therapy, consisting in psychiatric and medical effects.

Psychotherapy

Psychotherapeutic sessions for obsessive-compulsive syndrome are considered more effective than drug treatment. Psychotherapy cures neurosis gradually.

Get rid of similar illness the following techniques help:

• Cognitive Behavioral Therapy - resistance to the syndrome, in which compulsions are minimized or completely eliminated. Patients in the course of treatment become aware of their disorder, which helps them to get rid of it forever.
• “Thought stop” is a psychotherapeutic technique that consists in stopping memories of the most vivid situations, manifested by an obsessive state. Patients are asked a series of questions. To answer them, patients must view the situation from all angles, as in slow motion. This technique makes it easier to face fears and control them.
• The method of exposure and warning - the patient is created conditions that provoke discomfort and cause obsessions. Before this, the patient is counseled on how to resist compulsive rituals. This form of therapy achieves sustained clinical improvement.

The effect of psychotherapy lasts much longer than that of drug treatment. Patients are shown the correction of behavior under stress, training in various relaxing techniques, a healthy lifestyle, proper nutrition, fight against smoking and alcoholism, hardening, water procedures, breathing exercises.

Currently, group, rational, psycho-educational, aversive, family and some other types of psychotherapy are used to treat the disease. Non-drug therapy is preferable to drug therapy, since the syndrome is perfectly amenable to correction without drugs. Psychotherapy has no side effects on the body and has a more stable therapeutic effect.

Medical treatment

Treatment of a mild form of the syndrome is carried out on an outpatient basis. Patients undergo a course of psychotherapy. Doctors find out the causes of the pathology and try to establish trusting relationship with the sick. Complicated forms are treated with the use of medications and psychological corrective sessions.

Patients are prescribed the following groups of drugs:

1. antidepressants - Amitriptyline, Doxepin, Amizol,
2. neuroleptics - "Aminazin", "Sonapaks",
3. normothymic drugs - "Cyclodol", "Depakin Chrono",
4. tranquilizers - "Phenozepam", "Clonazepam".

It is impossible to cope with the syndrome on your own without the help of a specialist. Any attempts to control your mind and defeat the disease lead to a deterioration in the condition. In this case, the psyche of the patient is destroyed even more.

Compulsive-obsessional syndrome does not apply to mental illness, because it does not lead to a change and personality disorder. It is a neurotic disorder that is reversible with proper treatment. Mild forms of the syndrome respond well to therapy, and after 6-12 months its main symptoms disappear. Residual effects of pathology are expressed in a mild form and do not interfere ordinary life patients. Severe cases of the disease are treated for an average of 5 years. Approximately 70% of patients report an improvement in their condition and are clinically cured. Since the disease is chronic, relapses and exacerbations occur after discontinuation of drugs or under the influence of new stresses. Cases of a complete cure are very rare, but possible.

Preventive actions

Prevention of the syndrome is to prevent stress, conflict situations, creating a favorable environment in the family, eliminating mental injuries at work. It is necessary to properly educate a child, not to give rise to feelings of fear in him, not to instill in him thoughts about his inferiority.

Secondary psychoprophylaxis is aimed at preventing relapses. It consists in regular medical examination of patients, conversations with them, suggestions, timely treatment of the syndrome. FROM preventive purpose phototherapy is carried out, since light promotes the production of serotonin; restorative treatment; vitamin therapy. Experts recommend that patients get enough sleep, diet, give up bad habits, and timely treatment of concomitant somatic diseases.

Forecast

Obsessive-compulsive syndrome is characterized by a chronic process. Complete recovery of the pathology is quite rare. Usually there are relapses. In the process of treatment, the symptoms gradually go away, and social adaptation begins.

Without treatment, the symptoms of the syndrome progress, disrupt the patient's ability to work and the ability to be in society. Some patients commit suicide. But in most cases, OCD has a benign course.

OCD is essentially a neurosis that does not lead to temporary disability. If necessary, patients are transferred to more light work. Advanced cases of the syndrome are considered by VTEC specialists, who determine the III group of disability. Patients are issued a certificate for light work, excluding night shifts, business trips, irregular working hours, direct exposure to harmful factors on the body.

Adequate treatment guarantees patients stabilization of symptoms and relief of vivid manifestations of the syndrome. Timely diagnosis of the disease and treatment increase the chances of patients for success.

Video: about obsessive-compulsive disorders

Mild evidence of obsessive-compulsive disorder may occur in up to 30% of adults and up to 15% of adolescents and children. Clinically confirmed cases account for no more than 1%.

The appearance of the first symptoms is usually attributed to the age of 10 to 30 years. Apply for medical care usually people 25-35 years old.

In pathology, two components are distinguished: obsession (compulsion) and compulsion (compulsion). Obsession is associated with the occurrence of obsessive, constantly recurring emotions and thoughts. It can be provoked by coughing, sneezing, or another person touching the doorknob. A healthy person will note to himself that someone sneezed and move on. The patient is obsessed with what happened.

Obsessive thoughts fill his entire being, give rise to anxiety and fear. This happens due to the fact that some object, a person becomes important and valuable for him. The environment, however, appears too dangerous.

Compulsions are actions that a person is forced to perform to protect themselves from the moments that provoke obsessive thoughts or fears. Actions can be a response to what happened. In some cases, they are of a preventive nature, that is, they are the result of some idea, idea, fantasy.

Compulsion can be not only motor, but also mental. It consists in the constant repetition of the same phrase, for example, a conspiracy aimed at protecting a child from illness.

The obsession and compulsion of the component form an OCD attack. In principle, we can talk about the cyclic nature of pathology: the appearance of an obsessive thought leads to its filling with meaning and the emergence of fear, which, in turn, causes certain protective actions. At the end of these movements, a period of calm begins. After a while, the cycle restarts.

With the predominant presence of obsessive thoughts and ideas, they speak of intellectual obsessive-compulsive disorder. The predominance of obsessive movements indicates motor pathology. Emotional disorder is associated with the presence of constant fears, turning into phobias. A mixed syndrome is said to be when obsessive movements, thoughts, or fears are detected. Despite the fact that all three components are part of the disorder, the division according to the predominance of one of them is important for the choice of treatment.

The frequency of symptom manifestation makes it possible to distinguish pathology with an attack that occurred only once, regularly occurring incidents and a constant course. AT last case it is impossible to distinguish periods of health and pathology.

The nature of obsession affects the features of the disease:

1. Symmetry. All items must be arranged in a certain order. The patient checks all the time how they are placed, corrects them, rearranges them. Another type is the tendency to constantly check to see if appliances are turned off.
2. Beliefs. It can be all subjugating beliefs of a sexual or religious nature.
3. Fear. The constant fear of getting infected, getting sick leads to the appearance of obsessive actions in the form of cleaning the room, washing hands, using a napkin when touching something.
4. Accumulation. Often there is an uncontrollable passion to accumulate something, including absolutely unnecessary to a person things.

The reasons

There is no clear and unambiguous reason why obsessive-compulsive disorders are formed today. Allocate hypotheses, most of which seem logical and reasonable. They are combined into groups: biological, psychological and social.

Biological

One of the well-known theories is neurotransmitter. The basic idea is that in OCD there is too much uptake of serotonin in the neuron. The latter is a neurotransmitter. He is in the transmission nerve impulse. As a result, the impulse cannot reach the next cell. This hypothesis prove that, taking antidepressants, the patient feels better.

Another neurotransmitter hypothesis is associated with an excess of dopamine and dependence on it. The ability to resolve the situation associated with an obsessive thought or emotion leads to “pleasure” and increased production of dopamine.

The hypothesis associated with PANDAS syndrome is based on the idea that antibodies produced in the body to fight streptococcal infection, for some reason, affect the tissues of the basal ganglia of the brain.

The genetic theory is associated with a mutation of the hSERT gene responsible for the transfer of serotonin.

Psychological

The nature of obsessive-compulsive disorder was considered by psychologists of various directions. So, Z. Freud associated it mainly with the unsuccessful passage of the anal stage of development. Feces at that moment seemed to be something valuable, which eventually led to a passion for accumulation, accuracy and pedantry. He connected obsession directly with the system of prohibitions, rituals and "omnipotence of thought." Compulsion, from his point of view, is associated with a return to the trauma experienced.

From the point of view of the followers of behavioral psychology, the disorder arises from fear and the desire to get rid of it. For this, repetitive actions, rituals are developed.

Cognitive psychology focuses on mental activity and fear of imaginary meaning. It arises from a sense of hyper-responsibility, a tendency to overestimate danger, perfectionism and the belief that thoughts can be fulfilled.

Social

The hypothesis of this group connects the appearance of pathology with traumatic environmental circumstances: violence, death of loved ones, change of residence, changes at work.

Symptoms

The following symptoms indicate obsessive-compulsive disorder:

• the appearance of recurring thoughts or fears;
• monotonous actions;
• anxiety;
• high level anxiety;
• panic attacks;
• phobias;
• appetite disorders.

Adults in some cases are aware of the groundlessness of their fears, thoughts, senselessness of actions, but they cannot do anything with themselves. The patient loses control over his thoughts and actions.

In children, the disorder is extremely rare. It usually occurs after 10 years of age. Associated with the fear of losing something. A child, afraid of losing his family, tends to constantly clarify whether his mother or father loves him. He is afraid of getting lost himself, so he holds his parents tightly by the hand. The loss of any subject at school or the fear of it makes the child double-check the contents of the satchel, wake up at night.

Obsessive-compulsive disorder can be accompanied by nightmares, tearfulness, moodiness, dejection, and decreased appetite.

Diagnostics

The diagnosis is determined by a psychiatrist. The main diagnostic methods are conversation and tests. During the conversation, the doctor identifies characteristics associated with the manifestation of significant symptoms. So, thoughts should belong to the patient, they are not the product of delusions or hallucinations, and the patient understands this. In addition to the obsessive ones, he has ideas that he can resist. Thoughts and actions are not perceived by him as something pleasant.

Testing is based on the Yale-Brown obsessive-compulsive scale. Half of its items assess how pronounced obsessions are, the other half help analyze the severity of actions. The scale is completed at the time of the interview based on the manifestation of symptoms for last week. Analyzed level psychological discomfort, duration of symptoms during the day, impact on the patient's life, ability to resist and control symptoms.

The test determines 5 different degrees of disorder - from subclinical to extremely severe.

The disease is distinguished from depressive disorders. In the presence of symptoms of schizophrenia, organic disorders, neurological syndromes obsession is considered part of these diseases.

Treatment

The main methods of treating obsessive-compulsive disorder are psychotherapy, the use of drugs, and physiotherapy.

Psychotherapy

The disease can be treated using hypnosis, cognitive-behavioral, aversive methods of psychoanalysis.

The main goal of the cognitive-behavioral method is to help the patient in understanding the problem and resisting diseases. The patient can be placed in an artificially created stress situation, and during the session, the doctor and the patient try to cope with it. The psychotherapist comments on the fears and the meaning that the patient puts into his thoughts, stops his attention on actions, helps to change the ritual. It is important that a person learns to isolate which of his fears really make sense.

According to the researchers, the compulsive part of the syndrome lends itself better to therapy. The effect of the treatment lasts for several years. Some patients experience increased levels of anxiety during treatment. It goes away with time, but for many it is important reason for other therapies.

Hypnosis allows you to save the patient from obsessive thoughts, actions, discomfort, fears. In some cases, the use of self-hypnosis is recommended.

Within the framework of psychoanalysis, the doctor and the patient discover the causes of experiences and rituals, work out ways to get rid of them.

The aversive method is aimed at causing the patient discomfort, unpleasant associations when performing obsessive actions.

Psychotherapeutic methods are used individually and in a group. In some cases, especially when working with children, family therapy is recommended. Its purpose is to establish trust, increase the value of the individual.

Medicines

Treatment of severe obsessive-compulsive disorder is recommended with the use of drugs. They complement, but do not cancel the methods of psychotherapy. The following groups of drugs are used:

1. Tranquilizers. They reduce stress, anxiety, reduce panic. Phenazepam, Alprazolam, Clonazepam are used.
2. MAO inhibitors. Drugs in this group help to reduce depressive sensations. These include Nialamid, Fenelzin, Befol.
3. Atypical neuroleptics. Medications are effective for disorders of serotonin uptake. Assign Clozapine, Risperidone.
4. Selective serotonin reuptake inhibitors. These drugs prevent the destruction of serotonin. The neurotransmitter accumulates in receptors and has a longer effect. The group includes Fluoxetine, Nafazodone, Serenata.
5. Normotimics. Medicines are aimed at stabilizing mood. This class includes Normotim, Topiramate, lithium carbonate.

Physiotherapy

It is recommended to take various water procedures. These are warm baths with a cold compress applied to the head for 20 minutes. They are taken up to 3 times a week. Useful wiping with a towel dipped in cold water, pouring. Swimming in the sea or river is recommended.

Forecast

Obsessive-compulsive disorder is a chronic pathology. Usually, the use of any treatment stops and softens its manifestations. The disease can be cured in a mild to moderate degree, however, in the future, in some emotionally difficult situations possible exacerbation.

A severe disorder is difficult to treat. Likely to relapse.

Lack of treatment can lead to impaired performance, the emergence of suicidal intentions (up to 1% of patients commit suicide), some physical problems (frequent washing of hands leads to skin damage).

Prevention

Primary prevention includes preventing the occurrence of traumatic factors, including conflicts at home, at school, at work. If we are talking about a child, it is important to avoid imposing on him thoughts about his inferiority, instilling fears, guilt.

It is recommended to include bananas, tomatoes, figs, milk, dark chocolate in the diet. These foods contain tryptophan, from which serotonin is formed. It is important to take vitamins, get enough sleep, avoid alcohol, nicotine, drugs. The rooms should have as much light as possible.

Obsessive-compulsive disorder, even in a mild degree, cannot be ignored. The condition of such a patient may worsen over time, leading to severe disorders in emotional sphere inability to adapt in society. Psychotherapeutic and drug methods allow a person to return to normal life.

Obsessive Compulsive Disorder (OCD) is an anxiety disorder characterized by compulsive states that are associated with symptoms such as anxiety, apprehension, fear or anxiety (obsessive thoughts), pathological cyclical actions aimed at reducing comorbid anxiety (compulsive urges), or a combination of obsessive thoughts and compulsive urges. Symptoms of the disorder include: excessive washing and cleaning of various objects, repetitive checking, excessive hoarding, preoccupation with sexuality, violent and religious thoughts related to relationships, obsessions related to relationships, dislike of individual numbers and nervous reactions, such as opening and closing a door a certain number of times before entering or leaving a room. These symptoms are time consuming, can lead to loss of relationships with others, and are often the cause of worsening emotional and financial position. The actions of those suffering from OCD are paranoid and potentially psychotic. However, people with OCD in general may be aware of their obsessive thoughts and compulsive urges as irrational and suffer from their implementation later on. Despite irrational behavior, OCD is often seen in patients with above-average intelligence. Many physiological and biological factors may be involved in obsessive-compulsive disorder. Standardized rating scales such as the Yale-Brown Obsessive-Compulsive Scale can be used to assess the severity of symptoms. Other disorders with similar symptoms include: obsessive-compulsive personality disorder, autism spectrum disorder, or disorders in which perseveration (hyperfocus) is a feature of ADHD, PTSD, physical disorders, or just a problematic habit. Treatment for OCD includes the use behavioral therapy and, in some cases, selective serotonin reuptake inhibitors (SSRIs). The type of behavioral therapy used involves increasing the exposure to the factor that is causing the problem until compulsive behavior is observed. Atypical antipsychotics such as quetiapine may be useful when used in addition to SSRIs in refractory cases, but their use is associated with an increased risk side effects. Obsessive-compulsive disorder affects children and adolescents, as well as adults. Approximately one-third to one-half of adults with OCD report the onset of the disorder in childhood, indicating the duration of anxiety disorders throughout life. The term "obsessive-compulsive" comes from the English lexicon and is often used in an informal or caricatured manner to describe someone who is overly pedantic, perfectionist, brooding, or fixated.

Signs and symptoms

obsessive thoughts

Intrusive thoughts are thoughts that repeatedly arise and persist despite efforts to ignore or resist them. People with OCD often perform actions or compulsive urges in an attempt to alleviate the anxiety associated with the compulsive thoughts. Within and among subjects, initial intrusive thoughts, or obsessive thinking, vary in legibility and realism. A relatively vague obsession may include general feeling confusion or tension, accompanied by the belief that life cannot continue normally as long as the imbalance persists. A more pronounced obsession is the thought or imagining that someone close is dying, or the imposition associated with "the right relationship." Other obsessions concern the possibility that someone or something other than oneself—such as God, the Devil, or disease—could harm either the person with OCD or the people or things that person cares about. Other subjects with OCD may report feeling invisible rashes on their body, or have a sensation that inanimate objects have come to life. Some people with OCD exhibit obsessions of a sexual nature, which may include obsessive thoughts or images of "kissing, touching, caressing, oral sex, anal sex, intercourse, incest, and rape" with "strangers, acquaintances, parents, children, family members, friends, colleagues, animals, and religious figures" and may also include "heterosexual or homosexual content" with subjects of any age. As with other intrusive, unpleasant thoughts or perceptions, most normal people» people have disturbing thoughts of a sexual nature from time to time, but people with OCD may attach excessive importance to thoughts. For example, obsessive fears about sexual orientation can be observed not only in relation to the people with OCD, but also in relation to the people around them, as a crisis of sexual self-determination. Moreover, the doubts that accompany OCD lead to uncertainty as to whether unpleasant thoughts can be influenced by causing self-criticism or self-hatred. People with OCD realize that their beliefs do not match reality; however, they feel they must act as if their beliefs are correct. For example, a subject who is prone to pathological hoarding may tend to treat inorganic objects as if they had spiritual life or the rights of living organisms, while at the same time being aware that such behavior is irrational, on a more intellectual level.

primary obsessive state

OCD in some cases manifests itself without pronounced compulsive impulses. Nicknamed "Simple-O", or referred to as Primary obsessive OCD OCD without overt compulsive urges can, by one estimate, account for approximately 50 to 60 percent of OCD cases. Primary obsessive OCD has been called one of the most depressing and intractable forms of OCD. People with this form of OCD suffer from depressing and unwanted thoughts that occur frequently, and these thoughts are usually based on the fear that someone might do something that is generally out of character for them, potentially fatal to them or others. The thoughts are likely to be aggressive or sexual in nature. Instead of producing observable compulsive urges, a subject with this subtype may perform more secret, mental activities, or may practice avoiding situations that specific thoughts may impose. As a result of this avoidance, people may have difficulty fulfilling social or individual roles, even if they are high in those roles and even if they have performed well in the past. Moreover, avoidance can be misleading to others who are unaware of its origin or intended purpose, as was the case for a man whose wife began to wonder why he did not want to hold their newborn child. Hidden mental rituals can take most subject's time throughout the day.

Compulsive urges

Some people with OCD perform compulsive acts because they inexplicably feel the need to do so, others act compulsively to alleviate anxiety that stems from specific obsessive thoughts. The subject may feel that these actions can to some extent prevent the frightening event or push the event out of his thoughts. In either case, the subject's reasoning is so specific or distorted that it causes significant distress to the subject with OCD and those around them. Excessive skin trauma (i.e. dermatillomania) or hair-pulling (i.e. trichotillomania) and nail biting (i.e. onychophagia) are on the obsessive-compulsive spectrum. Subjects with OCD are aware that their thoughts and behaviors are not rational, but they feel that giving in to these thoughts can prevent feelings of panic or fear. Some common compulsive urges include counting certain things (such as steps) in specific ways (such as two), as well as performing other repetitive actions, often with atypical susceptibility to numbers or patterns. People may repeatedly wash their hands or gargle, make sure certain objects are in a straight line, repeatedly check that they have locked a parked car, constantly arrange things in a certain way, turn lights on and off, keep doors closed all the time, touch an object a certain number of times before leaving the room, go the usual way, stepping only on tiles of a certain color, start a certain order in using the stairs, for example, to end the stairs on a certain foot. The compulsive urges of OCD are characterized by tics; movements, as in other movement disorders such as chorea, dystonia, myoclonus; movements seen in stereotypical movement disorder or in some people with autism; movements of convulsive activity. There may be a significant degree of comorbidity between OCD and tic-related disorders. People define compulsive urges as a way to avoid intrusive thoughts; however, they are aware that this avoidance is temporary and that the obsessive thoughts will soon return. Some people use compulsive behaviors to avoid situations that may encourage obsessions. While many people do certain things over and over again, they don't always do things compulsively. For example, getting ready for bed, learning a new skill, religious practices are not compulsive urges. Whether or not a behavior is a compulsive urge or just a habit depends on the context in which the behavior is observed. For example, arranging and arranging DVDs for eight hours a day might be expected of someone who works in a video store, but would look abnormal in other situations. In other words, habits make one's life efficient, while compulsions disrupt it. In addition to the anxiety and fear that usually accompanies OCD, those with the disorder may spend hours doing compulsive activities each day. In such situations, it becomes difficult for the subject to do his job and keep family or public roles. In some cases, this behavior can cause secondary physical symptoms. For example, people who compulsively wash their hands with antibacterial soap and hot water may experience reddening of the skin that becomes rough as a result of dermatitis. People with OCD can give rationale for their behavior; however, these logical explanations do not fit common behavior but are specific to each case. For example, a person who compulsively checks the front door may argue that the time and stress of one extra check of the front door is much less than the time and stress associated with a robbery, and thus checking is the best remedy. In practice, after such a check, the person is still not sure and believes that it is still better to check again, and given explanation can continue indefinitely.

Dominant Ideas

Some OCD sufferers display thoughts known as dominant ideas. In such cases, the person with OCD is genuinely unsure whether the fears that drive them to perform compulsive acts are rational or not. After some argument, it is possible to convince the subject that his fears may be unfounded. It may be more difficult to apply ERP therapy to such patients because they may not be willing to interact, at least at first. There are severe cases in which the sufferer has unshakable confidence in the context of OCD that is difficult to distinguish from psychosis.

Cognitive performance

A 2013 meta-analysis confirmed that OCD patients have mild but widespread cognitive deficits; to a large extent it relates to spatial memory, in lesser degree to verbal memory, verbal fluency, executive functioning, and processing speed, while auditory attention was not significantly affected. Spatial memory was assessed using the results of the Corsi block test, Rey-Osterit's "Complex figure" test of recovery from memory, and the test of spatial memory. short term memory among the errors found. Verbal memory was assessed by the Verbal Learning Test of Delayed Memory Reproduction and the Logical Memory Test II. Speech fluency was assessed with a category and letter recognition speed test. Auditory attention was assessed by a number memorization test. The speed of information processing was assessed by Form A of the "leaving traces" test. In fact, people with OCD show impairments in formulating an organizational strategy for information coding, attention shifting, and motor and cognitive inhibition.

Related states

People with OCD may be diagnosed with other conditions alongside or in place of OCD, such as the aforementioned obsessive compulsive personality disorder, clinical depression, bipolar disorder, general anxiety disorder, anorexia nervosa, social phobia, bulimia nervosa, Tourette syndrome, Asperger's Syndrome, Attention Deficit Hyperactivity Disorder, Dermatillomania (compulsive skin injury), Body Dysmorphic Disorder and Trichotillomania (hair pulling). In 2009, it was reported that depression among OCD sufferers is partly a warning, as the risk of suicide is high; more than 50 percent of patients show suicidal tendencies, and 15 percent attempt suicide. Subjects with OCD also experience night owl syndrome to a significantly greater extent than the general population. Moreover, severe OCD symptoms are necessarily accompanied by more restless sleep. A decrease in total sleep time and its effectiveness is observed in patients with OCD, with a delay in the onset and end of sleep, as well as an increase in the prevalence of night owl syndrome. In terms of behavior, some research shows a link between drug addiction and the disorder in equal measure. For example, there is an increased risk of drug addiction among people with an anxiety disorder (perhaps as a way of coping increased level anxiety), but drug addiction among OCD patients may act as a type of compulsive behavior rather than as a coping mechanism for anxiety. Depression is also common among OCD sufferers. One of the explanations increased risk depression among OCD sufferers was made by Meineck, Watson and Clark (1998), who explained that people with OCD (or any other anxiety disorders) can be suppressed due to uncontrolled perception. Some subjects who show signs of OCD do not necessarily have OCD. Behavior that appears (or appears) to be compulsive or compulsive can also be attributed to many other conditions, including obsessive-compulsive personality disorder, autism spectrum disorders, disorders in which perseveration is a possible feature (ADHD, PTSD, physical disorders or habits), or subclinical disorders. Some individuals with OCD exhibit features commonly associated with Tourette syndrome, such as compulsive actions that may resemble motor tics; the terms "tic-related OCD" or "Tourette's OCD" apply to such a disorder.

The reasons

Scientists generally agree that both physiological and biological factors play a role in the causation of the disorder, although they vary in severity.

Physiological

The view of evolutionary psychology is that moderate compulsive behaviors may have had evolutionary advantages. Examples would be the constant checking of hygiene, hearth, or environment against enemies. Similarly, hoarding may have evolutionary benefits. From this point of view, OCD may be the last statistical "tail" of such behavior, which is presumably associated with a high number of predisposing genes.

Biological

OCD is associated with pathological disorders of serotonin neurotransmission, although it can be both a cause and a consequence of these disorders. Serotonin is thought to play a role in the regulation of anxiety. To send chemical signals from one neuron to another, serotonin must bind to receptor centers located on a nearby nerve cell. It is hypothesized that serotonin receptors in OCD sufferers may be relatively understimulated. This statement is consistent with the observation that many OCD patients benefit from the use of selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that large quantity serotonin immediately available to others nerve cells. Possible genetic mutation may contribute to OCD. The mutation was found in the human serotonin transporter gene, hSERT, in bound friend with a friend of families with OCD. Moreover, data on identical twins support the existence of a "hereditary factor in neurotic anxiety." In addition, subjects with OCD are more likely to have first-order family members with similar disabilities than matched controls. In cases where OCD develops in childhood, there is a stronger family association with the disorder than in cases in which OCD develops in adulthood. Overall, genetic factors account for 45–65% of symptoms in children diagnosed with the disorder. Environmental factors also play a role in how anxiety symptoms are expressed; various studies on this topic are in progress and the presence of a genetic link has not been definitely established. People with OCD show increased volume gray matter in the bilateral lenticular nucleus, extending into the caudate nucleus, but reduced volumes of gray matter in the bilateral posterior medial frontal/frontal cingulate gyrus. These findings conflict with evidence for people with other anxiety disorders, who show reduced (rather than elevated) gray matter volumes in the bilateral lenticular/caudate nucleus, but also reduced gray matter volumes in the bilateral posterior medial frontal/frontal cingulate gyrus. The increased activity of the orbifrontal cortex is attenuated in patients who respond positively to SSRI drugs, a result presumably due to increased stimulation of the serotonin 5-HT2A and 5-HT2C receptors. The striatum associated with planning and initiating appropriate actions is also relevant; Mice genetically bred with a striatum disorder exhibit OCD-like behavior, grooming themselves three times more than normal mice. Recent evidence supports the possibility of a genetic predisposition to neurological development contributing to OCD. The rapid onset of OCD in children and adolescents may be caused by group A streptococcal syndrome (PANDAS) or immunologic reactions to other pathogens (PANS).

neurotransmitters

Researchers have already pinpointed the cause of OCD, but brain differences, genetic influences, and environmental factors have also been investigated. Images of the brains of people with OCD have shown that they have different brain patterns. brain activity from people without OCD and that the circuit's differing functioning in certain area brain, striatum, can cause the disorder. Differences in other regions of the brain and dysregulation of neurotransmitters, especially serotonin and dopamine, can also contribute to OCD. Independent Research similarly found unusual dopamine and serotonin activity in various regions of the brain in subjects with OCD. This can be defined as dopaminergic hyperfunction in the prefrontal cortex (mesocortical dopamine pathway) and serotonergic hypofunction in the basal nucleus. Glutamate dysregulation is also the subject of recent research, although its role in the etiology of the disorder is not clear. Glutamate acts as a dopamine cotransmitter on dopamine pathways that originate from the ventral tegmental area.

Diagnostics

Formal diagnosis can be performed by a psychologist, psychiatrist, clinical social worker, or other licensed mental health professional. To be diagnosed with OCD, a person must exhibit obsessions, compulsions, or both, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM). The Quick Reference Guide to 2000 Variants of the DSM states that certain features characterize clinically significant obsessions and compulsions. Such obsessions, according to the DSM, are recurrent and persistent thoughts, impulses, or representations that are felt to be intrusive and cause marked anxiety and depression. These thoughts, impulses, or representations are of a degree or type that is beyond normal concern about ordinary problems. The person may try to ignore or suppress such intrusive thoughts, or neutralize them with other thoughts or actions, and tends to recognize such thoughts as idiosyncratic or irrational. Compulsive urges become clinically significant when the person seeks to carry them out in response to the urge or in accordance with rules that must be strictly observed, and when the person feels or causes intense distress as a result. For this reason, while many people who do not have OCD can perform activities often associated with OCD (such as arranging things in a closet by height), what distinguishes clinically significant OCD is the fact that a person with OCD must perform these actions despite being experiencing a strong psychological stress. Is this behavior or thought processes aimed at preventing or reducing stress or preventing any frightening event or situation; however, these actions are logically or practically unrelated to the problem, or they are excessive. In addition to this, at some point in the course of the disease, the subject must realize that his obsessions and compulsive urges are unreasonable or excessive. Moreover, obsessions and compulsive urges are time consuming (occupying more than one hour a day) or cause impairments in social, occupational, or academic functioning. It is useful to quantify the severity of symptoms and impairment before and during OCD treatment. In addition to patient-calculated time per day accounting for obsessive-compulsive thoughts and behaviors, Fenske and Schwenk, in "Obsessive-Compulsive Disorder: Diagnosis and Management," argue that more precise tools should be used to determine a patient's condition (2009). .). These may be rating scales such as the Yale-Brown Obsessive-Compulsive Scale (Y-BOCS). By means of such indicators a more appropriate psychiatric consultation can be determined, because they are standardized.

Differential Diagnosis

OCD is often confused with the separate obsessive-compulsive personality disorder (OCPD). OCD is egodystonic, which means that the disorder is the opposite of the sufferer's self-image. Since egodystonic disorders are contrary to the patient's self-image, they cause a great deal of depression. OCPD, on the other hand, is ego-synthonic, meaning that the person accepts that the characteristics and behavior are consistent with their self-image, or, in other words, acceptable, correct, and appropriate. As a result, people with OCD are often aware that their behavior is wrong, dissatisfied with compulsive urges, but somehow feel compelled to carry them out, and may suffer from anxiety. In contrast, people with OCPD are not aware of the abnormality; they immediately explain that their actions are right, it is usually impossible to convince them otherwise, and they tend to enjoy their obsessions and compulsive urges. OCD is different from behaviors like gambling and overeating. People with these disorders usually show pleasure in their activities; OCD sufferers may be unwilling to perform their compulsive tasks and may not show pleasure in doing them.

Control

Behavioral therapy (BT), cognitive behavioral therapy (CBT), and medications are the first line treatments for OCD. Psychodynamic psychotherapy may help manage some aspects of the disorder. The American Psychiatric Association notes the lack of controllable symptoms and that psychoanalysis or dynamic psychotherapy is effective "at addressing the core symptoms of OCD." The fact that many subjects do not seek treatment may be partly due to prejudice against OCD.

Behavioral Therapy

A specific technique used in behavioral/cognitive behavioral therapy is called action presentation and avoidance (also known as presentation and response avoidance), or ERP; it involves gradually learning how to bear the anxiety associated with not performing ritual actions. First, for example, some can touch something only by getting “dirty” very easily (because the cloth has been in contact with another cloth, touch only with the tip of the finger, for example, a book from a “dirty” place, such as a school.) This "performance". "Action prevention" is not washing your hand. Another example would be leaving home and checking the lock only once (representation) without going back and checking again (action prevention). A person quickly enough gets used to the anxiety-producing situation and realizes that his level of anxiety drops significantly; they may then progress to touching something more "contaminated" or failing to re-check the lock - failing to perform ritual actions such as washing hands or checking. Reaction presentation/prevention (ERP) has a strong evidence base. It is considered the most effective treatment for OCD. However, this claim has been questioned by some researchers who criticize the quality of many of the studies. It is widely accepted that psychotherapy in combination with psychiatric drugs is more effective than either drug alone. However, more recent studies have shown no difference in outcomes for those treated with a combination of drugs and CBT compared to CBT alone.

Medicines

Medications as treatment include selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants such as clomipramine. SSRIs are a second-line treatment for adults with obsessive-compulsive disorder (OCD) who have mild functional disorder, and first-line treatment for adults with moderate or severe impairment. For children, SSRIs can be considered a second-line treatment for those with moderate to severe impairment, with careful monitoring of psychiatric side effects. SSRIs are effective in treating OCD; patients treated with SSRIs are twice as likely to respond to treatment compared to placebo. Efficacy has been shown in both short-term (6–24 weeks) treatment trials and interrupted trials lasting 28–52 weeks. Atypical antipsychotics such as quetiapine are also useful when used in addition to SSRIs in the treatment of treatment-resistant OCD. However, these drugs are often poorly tolerated and also have metabolic side effects that limit their use. None of the atypical antipsychotics are beneficial when used alone.

Electroshock therapy

Electroconvulsive therapy (ECT) is effective in some severe and difficult to treat cases.

Psychosurgery

As with some medications, support groups and psychological treatments do not improve obsessive-compulsive symptoms. These patients may choose psychosurgery as a last resort. In this procedure, a surgical injury is applied to a region of the brain (anterior cingulate cortex). In one study, 30% of participants benefited significantly from the procedure. Deep brain stimulation and stimulation cranial nerve are possible surgical means, but do not require damage to the brain tissue. In the United States, the Food and Drug Administration has approved deep brain stimulation for the treatment of OCD in accordance with humanistic guidelines requiring that the procedure be performed exclusively in medical institution an appropriately qualified specialist. In the US, psychosurgery for OCD is the last resort and is not performed until the patient responds to drug treatment (full dose) plus many months of intensive cognitive behavioral therapy with ritual/action presentation and avoidance. Similarly, in the UK, psychosurgery cannot be performed until the course of treatment has been completed by an appropriately qualified cognitive behavioral therapist.

Children

Therapeutic treatment may be effective in reducing ritualistic behavior in OCD in children and adolescents. Family involvement, in the form of behavioral observations and reports, is a key component to the success of this treatment. Parental intervention also provides positive reinforcement for children who exhibit appropriate behaviors as an alternative to compulsive urges. After one or two years of therapy, during which children learn the nature of their obsessions and learn coping strategies, such children become more wide circle friends, show less shyness and become less self-critical. Although the causes of OCD in groups childhood Ranging from pathological brain disorders to psychological biases, stress from life circumstances, such as frightening and traumatic deaths of family members, may also contribute to the childhood case of OCD, and knowledge of these stressors may be of value in treating the disorder.

Epidemiology

OCD occurs in 1 to 3% of children and adults. It is equally observed in both sexes. In 80% of cases, symptoms appear before the age of 18. A 2000 study by the World Health Organization found some degree of variability in the prevalence and incidence of OCD around the world, with rates Latin America, Africa and Europe are two to three times higher than Asia and Oceania. One Canadian study found that the prevalence of OCD had little correlation with race. However, respondents who identify Judaism as their religion are overrepresented among OCD patients.

Forecasting

Psychological interventions such as behavioral and cognitive-behavioral therapy, as well as drug treatment can provide significant relief from the symptoms of OCD in the average patient. However, OCD symptoms may persist at a moderate level even after an adequate course of treatment, and a completely symptom-free period is rare.

Story

From the 14th to the 16th century, it was claimed in Europe that people subject to blasphemous, sexual, or other obsessive thoughts were possessed by the devil. Based on this reason, the treatment involved expelling the "evil" from the "possessed" person through exorcism. In the early 1910s, Sigmund Freud attributed obsessive-compulsive behavior to unconscious conflicts that manifest as symptoms. Freud described the clinical history typical case"phobia of touch", which began in early childhood when the person had desire touch objects. In response to this, man developed external prohibition» against this type of touch. However, "this prohibition did not succeed in eliminating" the desire to touch; all he could do was suppress the desire and "make it involuntary."

Society and culture

Movies and television often present an idealized portrayal of disorders such as OCD. These descriptions can lead to increased public awareness, understanding and sympathy for such disorders. In 1997's As Good As It Gets, actor Jack Nicholson portrays a man "with obsessive-compulsive disorder (OCD)". “Throughout the film, [he] exhibits ritualized behaviors (i.e., compulsive acts) that disrupt his interpersonal and professional life", "a cinematic depiction of psychopathology [that] accurately portrays the functional interaction and stress associated with OCD." The 2004 film The Aviator depicts a biography of Howard Hughes starring Leonardo DiCaprio. In the film, "Hughes is subject to OCD symptoms that are intermittently severe and disabling." "Many of Hughes' OCD symptoms are fairly classic, in particular his fears of contagion." The Magnificent Scam (2003), directed by Ridley Scott, portrays a con man named Roy (Nicolas Cage) who suffered from obsessive-compulsive disorder. The film "begins with Roy at home, suffering from numerous compulsive symptoms that take the form of a need for order and cleanliness and a compulsive urge to open and close doors three times while counting loudly before walking through them." British poet, essayist and lexicographer Samuel Johnson is an example of a historical figure with a retrospective diagnosis of OCD. He carefully thought out rituals for crossing the thresholds of doorways and repeatedly walked up and down the stairwells, counting the steps. American aviator and director Howard Hughes suffered from OCD. "About two years after his death, Hughes' real estate attorney called on the former CEO APA Raymond D. Fowler, Ph.D., conducted a psychological observation to determine Hughes' mental and emotional state in Last year life to understand the origin of his mental disorder. Fowler determined that "Hughes's fear of germs continued throughout his life, and he paralleled the development of obsessive-compulsive symptoms while making efforts to protect himself from germs." Hughes' friends also mentioned his compulsive urge to dress less revealingly. English footballer David Beckham has been vocal about his struggles with OCD. He said he counted all his clothes, and his magazines lay in a straight line. Canadian comedian, actor, TV presenter and voice actor Huey Mandel, well known for hosting the game show The Deal, wrote an autobiography, "The Line: Don't Touch Me," describing how OCD and mysophobia (fear of germs) affected his life. American show host Mark Summers wrote Everything in Its Place: My Trials and Victories Over Obsessive-Compulsive Disorder, describing the impact of OCD on his life.

Study

Sugar natural origin inositol has been confirmed to be useful in the treatment of OCD. Nutritional deficiencies can also contribute to OCD and other mental disorders. Vitamin and mineral supplements can help with these disorders and provide nutrients required for proper mental functioning. μ-opioids such as hydrocodone and tramadol may relieve symptoms of OCD. Opiates may be contraindicated in subjects concomitantly taking CYP2D6 inhibitors such as paroxetine. Much current research is devoted to the therapeutic potential of agents that affect the release of the neurotransmitter glutamate or its binding to receptors. They include riluzole, memantine, gabapentin, N-acetylcysteine, topiramate, and lamotrigine.

Don't part with hand sanitizer? Is your wardrobe laid out in a closet "on the shelves" in every sense? These habits may simply be a reflection of character or beliefs, but sometimes they cross an invisible line and turn into obsessive-compulsive disorder (OCD, scientifically speaking) that affects almost 1% of Americans.

How to distinguish a habit from a medical diagnosis that requires the help of a specialist? The task is not easy, according to Professor Jeff Zymansky. But some symptoms speak openly about the problem.

Frequent hand washing

An obsessive urge to wash hands or use hand sanitizer is common among OCD sufferers, so much so that they have even been categorized as “cleaners.” main reason obsessive hand washing is the fear of bacteria, less often - the desire to protect others from their own "impurity".

When to seek help: If you can't get rid of germs even after washing your hands, you're afraid you didn't wash them thoroughly enough, or you might have caught AIDS from a supermarket cart, chances are you're one of the washers. Another clear sign is the rituality of washing: you think that you must lather and rinse your hands five times, while lathering each individual nail.

Obsession with cleaning

People with OCD and a passion for handwashing often fall into another extreme: they are obsessed with cleaning the house. The cause of this obsessive state also lies in germophobia or the feeling of being "unclean". Although cleaning relieves the fear of germs, the effect does not last long, and the need for new cleaning becomes stronger than before.

When to seek help: If you spend several hours daily cleaning your home, chances are you have obsessive-compulsive disorder. If satisfaction from cleaning occurs in 1 hour, it will be more difficult to make a diagnosis.

Obsessive Action Check

If you need to make sure that the stove is turned off and the front door is closed 3-4, or even 20 times, this is another common (about 30%) manifestation of obsessive-compulsive disorder syndrome. Like other compulsions, repeated checks arise out of fear for one's own safety or a deep sense of irresponsibility.

When to seek help: It's perfectly reasonable to double-check something important. But if compulsive checks get in the way of your life (you start being late for work, for example) or take on a ritualistic form that you can't break, you may be a victim of OCD.

Unexplained craving to count

Some people with obsessive-compulsive disorder give great value counting and counting everything that catches their eye: the number of steps, red cars passing by, etc. Often the reason for counting is superstition, the fear of failure if some action is not performed a certain “magical” number of times.

When to seek help:“It all depends on the context,” Szymanski explains. Does this behavior make sense for you? You can count the steps from the door to the car, for example, out of boredom. But if you can’t get rid of the numbers in your head and continuous counting, it’s time to contact a specialist.”

Total organization

People with obsessive-compulsive disorder are able to perfect the art of organization. Things on the table should lie evenly, clearly and symmetrically. Is always.

When to seek help: If you want your desk to be clean, tidy, and organized, it may be easier for you to work, and you do it out of a completely normal need for order. People with OCD, on the other hand, may not need it, but still organize the surrounding reality, which otherwise begins to scare them.

Fear of Trouble

Everyone has anxious thoughts about a possible unpleasant incident or violence. And the more we try not to think about them, the more insistently they appear in the head, but in people with OCD, fear reaches an extreme, and the troubles that have happened cause too strong a reaction.

When to seek help: It is important to establish a boundary between periodic unpleasant thoughts and fears and excessive worries. OCD is possible if you avoid, for example, walking in the park for fear of being robbed, or calling a loved one several times a day to inquire about their safety.

Intrusive thoughts of a sexual nature

As well as thoughts of violence, obsessive-compulsive disorder often has obsessive thoughts about obscene behavior or taboo desires. OCD sufferers may unwittingly imagine that they are hitting on co-workers or strangers, or begin to doubt their sexual orientation.

When to seek help:“Most people will tell you: No, I don't want to do this at all and it doesn't reflect my inner convictions at all,” Szymanski comments. “But a person with OCD will say differently: These thoughts are disgusting, they don’t come to anyone but me, and what will they think of me now ?!” If a person's behavior changes because of these thoughts: he begins to avoid gay acquaintances or people who appear in his fantasies - this is already an alarming sign.

Unhealthy Relationship Analysis

People with OCD are known for their obsessive tendency to analyze relationships with friends, colleagues, partners, and family members. For example, they can worry and analyze for a particularly long time whether the incorrect phrase they said became the reason for the detachment of a colleague or a misunderstanding - a reason to part with a loved one. This state can extremely increase the sense of responsibility and the complexity of perceiving unclear situations.

When to seek help: Breaking up with a loved one can “loop” in your head, which is normal, but if these thoughts increase like a snowball over time, developing into a complete undermining of self-confidence and a negative attitude towards yourself, it is worth seeking help.

Finding support

People with obsessive-compulsive disorder often try to alleviate their support from friends and loved ones. If, for example, they are afraid to goof off at a party, they ask their friends to “rehearse” in advance possible situation, and not just once.

When to seek help: Asking friends for help is a perfectly normal part of friendship, but if you find yourself asking the same question on a regular basis - or your friends tell you - it could be a sign of OCD. Worse than that, getting approval and support from loved ones can worsen the manifestation of this obsessive condition. It's time to turn to professionals.

Dissatisfaction with your appearance

Dysmorphophobia - the conviction that there is some kind of flaw in one's appearance, often accompanies OCD, and makes people obsessively evaluate their body parts that seem ugly to them - nose, skin, hair (by the way, unlike malnutrition, dysmorphophobes do not focus their attention on weight or diets).

When to seek help: It is quite normal not to be delighted with some part of your body. Another thing is when you spend hours at the mirror looking at and criticizing this place.