Anxiety, fear of trouble, repeated handwashing are just a few of the signs of a dangerous obsessive-compulsive disorder. The fault line between normal and obsessive states can turn into an abyss if OCD is not diagnosed in time (from Latin obsessive - obsession with an idea, siege, and compulsive - coercion).

What is obsessive-compulsive disorder

The desire to check something all the time, the feeling of anxiety, fear have varying degrees of severity. It is possible to speak about the presence of a disorder if obsessions (from Latin obsessio - “representations with a negative coloring”) appear with a certain frequency, provoking the occurrence of stereotypical actions called compulsions. What is OCD in Psychiatry? Scientific definitions boil down to the interpretation that it is a neurosis, a syndrome of obsessive-compulsive disorders caused by neurotic or mental disorders.

Oppositional defiant disorder, which is characterized by fear, obsession, depressive mood, lasts for an extended period of time. This specificity of obsessive-compulsive malaise makes the diagnosis difficult and simple at the same time, but a certain criterion is taken into account. According to the accepted classification according to Snezhnevsky, based on the characteristics of the course, the disorder is characterized by:

• a single attack lasting from a week to several years;
• cases of relapse of a compulsive state, between which periods of complete recovery are recorded;
• continuous dynamics of development with periodic intensification of symptoms.

Contrasting obsessions

Among the obsessive thoughts that occur with compulsive malaise, alien to the true desires of the individual himself arise. The fear of doing something that a person is not able to do by virtue of character or upbringing, for example, blaspheming during a religious service, or a person thinks that he can harm his loved ones - these are signs of contrast obsession. Fear of harm in obsessive-compulsive disorder leads to a studious avoidance of the subject that caused such thoughts.

obsessive actions

At this stage, obsessive disorder may be characterized as a need to perform some action that brings relief. Often mindless and irrational compulsions (compulsions) take one form or another, and such wide variation makes it difficult to make a diagnosis. The emergence of actions is preceded by negative thoughts, impulsive actions.

Some of the most common signs of obsessive-compulsive disorder are:

• frequent washing of hands, taking a shower, often with the use of antibacterial agents - this causes fear of pollution;
• behavior when fear of infection forces a person to avoid contact with doorknobs, toilet bowls, sinks, money as potentially dangerous peddlers of dirt;
• repeated (compulsive) checking of switches, sockets, door locks, when the disease of doubt crosses the line between thoughts and the need to act.

Obsessive-phobic disorders

Fear, albeit unfounded, provokes the appearance of obsessive thoughts, actions that reach the point of absurdity. Anxiety, in which an obsessive-phobic disorder reaches such proportions, is treatable, and rational therapy is the four-step method of Jeffrey Schwartz or the study of a traumatic event, experience (aversive therapy). Among the phobias in obsessive-compulsive disorder, the most famous is claustrophobia (fear of closed spaces).

obsessive rituals

When negative thoughts or feelings arise, but the patient's compulsive ailment is far from the diagnosis - bipolar affective disorder, one has to look for a way to neutralize the obsessive syndrome. The psyche forms some obsessive rituals, which are expressed by meaningless actions or the need to perform repetitive compulsive actions similar to superstition. Such rituals the person himself may consider illogical, but an anxiety disorder forces him to repeat everything all over again.

Obsessive Compulsive Disorder - Symptoms

Obsessive thoughts or actions that are perceived as wrong or painful can be harmful to physical health. Symptoms of obsessive-compulsive disorder can be solitary, have an uneven severity, but if you ignore the syndrome, the condition will worsen. Obsessive-compulsive neurosis may be accompanied by apathy, depression, so you need to know the signs by which you can diagnose OCD (OCD):

• the emergence of unreasonable fear of infection, fear of pollution or trouble;
• repeated obsessive actions;
• compulsive actions (defensive actions);
• excessive desire to maintain order and symmetry, obsession with cleanliness, pedantry;
• "stuck" on thoughts.

Obsessive Compulsive Disorder in Children

It is less common than in adults, and when diagnosed, compulsive disorder is more often detected in adolescents, and only a small percentage are children of 7 years of age. Gender does not affect the appearance or development of the syndrome, while obsessive-compulsive disorder in children does not differ from the main manifestations of neurosis in adults. If parents manage to notice signs of OCD, then it is necessary to contact a psychotherapist to select a treatment plan using medications and behavioral, group therapy.

Obsessive Compulsive Disorder - Causes

A comprehensive study of the syndrome, many studies have not been able to give a clear answer to the question about the nature of obsessive-compulsive disorders. Psychological factors (stress, problems, fatigue) or physiological (chemical imbalance in nerve cells) can affect a person’s well-being.

If we dwell on the factors in more detail, then the causes of OCD look like this:

1. stressful situation or traumatic event;
2. autoimmune reaction (a consequence of streptococcal infection);
3. genetics (Tourette syndrome);
4. violation of brain biochemistry (decrease in the activity of glutamate, serotonin).

Obsessive Compulsive Disorder - Treatment

An almost complete recovery is not excluded, but long-term therapy will be required to get rid of obsessive-compulsive neurosis. How to treat OCD? Treatment of obsessive-compulsive disorder is carried out in a complex with sequential or parallel application of techniques. Compulsive personality disorder in severe OCD requires medication or biologic therapy, while in mild OCD, the following techniques are used. This is:

• Psychotherapy. Psychoanalytic psychotherapy helps to cope with some aspects of compulsive disorder: correcting behavior during stress (exposure and warning method), training in relaxation techniques. Psychoeducational therapy for obsessive-compulsive disorder should be aimed at deciphering actions, thoughts, identifying the causes, for which family therapy is sometimes prescribed.
• Lifestyle correction. Mandatory revision of the diet, especially if there is a compulsive eating disorder, getting rid of bad habits, social or professional adaptation.
• Physiotherapy at home. Hardening at any time of the year, bathing in sea water, warm baths with an average duration and subsequent wiping.

Medical treatment for OCD

A mandatory item in complex therapy, requiring a careful approach from a specialist. The success of medical treatment of OCD is associated with the correct choice of drugs, duration of administration and dosage when symptoms worsen. Pharmacotherapy provides for the possibility of prescribing drugs of one group or another, and the most common example that can be used by a psychotherapist to recover a patient is:

• antidepressants (paroxetine, sertraline, citalopram, escitalopram, fluvoxamine, fluoxetine);
• atypical antipsychotics (risperidone);
• normotimics (Normotim, Lithium carbonate);
• tranquilizers (diazepam, clonazepam).

Video: obsessive-compulsive disorder

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" is 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, obsessive 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, its symptoms completely disappear.

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 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 of all spheres 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 infected, worry about material loss, blasphemy and sacrilege, obsession with cleanliness, pedantry. In relation to moral and ethical principles, unbearable and irresistible attractions 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, washing hands frequently, "correct" arrangement of books, double-checking turned off electrical appliances or closed taps, 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, and 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 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 will help to stop the further development of the syndrome and save the child from 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.

The following methods help to get rid of this ailment:

• 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, the 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 pathology and try to establish a trusting relationship with patients. 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, since 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. The residual effects of the pathology are expressed in a mild form and do not interfere with the normal life of 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 consists in the prevention of stress, conflict situations, the creation of a favorable environment in the family, the exclusion of 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. With a preventive purpose, phototherapy is carried out, since light contributes to 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 lighter 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

Obsessive-compulsive mental disorder (also called obsessive-compulsive disorder) can significantly worsen the quality of life. Despite this, many of those who notice anxiety symptoms in themselves do not rush to the doctor, explaining this by prejudices, a sense of false shame, and other reasons.

Obsessive-compulsive disorder: what is it in simple words

Obsessive-compulsive disorder (OCD) is a neurotic pathology, which is characterized by the appearance of restless thoughts that provoke the performance of actions that have the significance of a ritual for the patient. Thus, a person manages to reduce the level of anxiety for some time.

The symptoms of OCD appear as:

• obsessions - obsessive thoughts, images or urges to act, which the patient receives in the form of stereotypes;
• compulsions - repetitive actions caused by experiences and fears. They perform the role of "magic" rituals that can protect from trouble or prevent an undesirable event.

A striking example of OCD psychologists consider:

• nosophobia - a pathological fear of incurable conditions;
• a mania for constantly washing hands for fear of catching an infection.

Notably, people with OCD tend to be highly intelligent, punctual, conscientious, and tidy.

Causes

The reasons for the development of OCD have not been precisely established, but there are various hypotheses about this.

Symptoms and Treatment of Bipolar Affective Disorder:

1. Biological. As causal factors, she considers:
   • brain pathologies, including those that were the result of birth trauma;
   • functional and anatomical anomalies;
   • features of the work of the autonomic department of the central nervous system;
   • hormonal disorders.
2. Genetic, which does not exclude the development of OCD in the presence of a hereditary predisposition.
3. Psychological theories, including:
   • psychoanalytic, explaining obsessive-compulsive states by the fact that they are a tool for reducing anxiety in cases where it, together with aggression, is directed at another person;
   • exogenous-psychotraumatic, which puts forward a theory about the impact of strong stressful situations related to family, work, various types of sexual relations as a reason.
4. Sociological theories explaining OCD by the fact that it is a pathological reaction of the body to psycho-traumatic situations.

The mechanism of the formation of the disease

As mentioned above, there are different explanations for the formation of obsessive-compulsive disorder. Currently, the neurotransmitter theory, which is part of the biological one, is considered a priority. Its essence is that the cause of OCD lies in incorrect communications between the individual parts of the cerebral cortex and the complex of subcortical neural nodes.

The interaction of these structures provides serotonin. Scientists have come to the conclusion that in obsessive-compulsive disorder there is a deficiency of this hormone, caused by increased reuptake, which interferes with the transmission of an impulse to the next neuron.

Summing up, it can be stated that the pathogenesis of OCD is quite complex and has not been sufficiently studied.

OCD in men, women and children - differences in manifestation

Obsessive-compulsive disorder affects a lot of people, while the number of men and women is about the same. In terms of age, it is believed that symptoms appear more often in adults, but there is information that up to 4% of children and adolescents suffer from OCD to one degree or another. Among the elderly, there are also a considerable number of those who suffer from obsessive-compulsive disorders. The given statistics contain information on the number of people who applied for help.

Manifestations of pathology in men and women have much in common, in particular:

• always manifested first by obsessive thoughts;
• a restless stream of consciousness breeds anxiety;
• against the background of fears, actions are born that relieve nervous tension and, according to the patient, are able to prevent terrible consequences.

For men, the source of anxiety is:

• labor activity;
• career and business development;
• the desire to preserve and increase acquired.

For example, a man is worried that he may be fired from his job and left without a livelihood. Against the background of anxiety, anxiety is born, in connection with which a person begins to compulse: pray or perform other rituals (actions), which, as it seems to him, will miraculously help to avoid trouble.

Women's anxieties are more due to:

• concern for the health of family members;
• fear of the possibility of divorce;
• pathological fear of loneliness.

There is a special - postpartum OCD, when the mother is so worried about the health and life of the newborn baby that it takes on the character of a pathology. She is tormented by thoughts that he can:

• suddenly fall ill and die;
• fall and get injured
• stop breathing in your sleep.

This leads to the fact that a significant part of the time is devoted to experiences and behavior dictated by OCD.

Obsessional-compulsive disorder in older people is associated with such phenomena as:

• loneliness, without prospects to change anything;
• inactive lifestyle;
• worries about the health and well-being of younger relatives;
• deterioration in the quality of life;
• the development of ailments leading to physical limitations.

Elderly people stop sleeping at night, often begin to call their grandchildren and children to make sure that they are alive and well. Inexplicable rituals are born on the go - in order for everything to be fine, it is necessary:

• take a dip;
• shift things in the closet;
• swap flowers on the windowsill;
• perform other actions.

In children, it occurs, for the most part, due to genetic reasons or due to problems at school, at home, in the circle of friends. Children often suffer from:

• poor performance;
• quarrels and loneliness;
• violent actions of a physical and psychological nature.

Like adults, against the background of increased anxiety, they begin to perform certain rituals.

Types and types of obsessive-compulsive disorder and their distinguishing features

It has been observed that OCD can occur in a chronic, progressive, or episodic form:

1. A chronic condition indicates that the disorder is permanent, stable, and unchanging.
2. A progressive condition means that the patient is going through a chronic process, the symptoms of which are getting worse, which is dangerous.
3. The episodic character is characterized by the fact that the symptoms appear from time to time. There are cyclic, conditional and mixed varieties of the episodic form of the disorder, while:
   • cyclic states depend on the biorhythms of the body;
   • conditional ones are manifested under the influence of traumatic circumstances, which include a sharp change in the usual way of life, the impact of psycho-emotional stress, various pathologies of the body;
   • mixed represent a combination of biorhythmic and conditional factors.

Depending on the degree of prevalence of the main symptoms, several types of OCD are classified:

1. Mixed, including both compulsions and obsessions;
2. "Pure" types - obsessive and compulsive.

It is noteworthy that in single-component types, upon closer examination, one way or another, the influence of the pair component is traced.

For example, a person who slowly arranges objects on a table in a certain order (compulsion). He performs these actions in order to suppress the feeling of anxiety (obsession) that inevitably arises from the contemplation of disorder.

Compulsions can be expressed:

• external actions (counting stripes on trousers, shifting small items, washing hands frequently, and so on);

Obsessions are present in the form:

• annoying thoughts (for example, about your own professional incompetence);
• groundless fears;
• doubts about the impeccability of their own actions and reasoning;
• obsessive anxiety about personal relationships;
• moving memories of the distant past;
• pathological fear of doing something wrong or discovering in oneself signs (character, appearance, lifestyle) that are condemned and ridiculed in society;
• an obsessive feeling of physical discomfort.
• feeling of anxiety that arises suddenly and prompts to perform a certain action.

Signs and symptoms

The symptoms of obsessive-compulsive disorder are as follows:

• a person worries about order, small, insignificant details, imaginary dangers so much that many truly important moments of life fade into the background;
• perfectionism does not allow you to complete the work you have begun due to endless rework, due to doubts and worries about insufficient quality;
• all the time and attention is devoted to work in the name of high results. At the same time, a person sacrifices rest, friendship, interesting leisure, although objectively “the game is not worth the candle”, that is, the sacrifices are not comparable with remuneration for the results of labor;
• OCD sufferers are distinguished by a pathologically high level of consciousness and responsibility, are meticulous and completely inflexible in matters of morality and ethics;
• a person experiences real suffering when it is required to throw away spoiled and unnecessary things;
• difficulties arise whenever it comes to the need to share at least a small part of their powers with other people. If this happens, then only on the condition that the work will be carried out according to already existing rules;
• People with OCD are tough and stubborn. In addition, they are extremely economical and reluctant to spend money, because in the future difficulties, tragedies and disasters are possible that will require financial costs,

If someone has found in themselves or a loved one 4 or more of the signs listed above, there is a possibility that these are symptoms of the development of obsessive-compulsive personality disorder.

Methods of treatment

Therapy for obsessive-compulsive disorder includes medication and psychotherapy as mandatory elements.

Psychotherapy

It involves the use of such treatment methods as:

1. Cognitive-behavioral correction, which was developed by the American psychiatrist D. Schwartz. The technique gives the patient the opportunity to resist the influence of the disorder by changing the order of ritual actions, simplifying them in order to gradually minimize them. The method is based on a conscious attitude of a person to his mental problem and gradual resistance to its signs.
2. "4 steps" - another technique developed by the same specialist in the field of psychiatry. Its action is based on what the doctor explains to the patient:
   • which of his fears are justified, and which are provoked by the effects of OCD, and therefore do not make sense;
   • how, having got into this or that situation, a healthy person would act;
   • how to stop intrusive thoughts.
3. Exposure and prevention is one of the most effective forms of behavioral intervention for OCD sufferers. In this case, the exposure consists in immersing the patient in conditions that provoke discomfort due to obsessions. The therapist instructs how to resist the urge to perform compulsive actions, forming a warning of a pathological response. According to statistics, the vast majority of those who have undergone such treatment achieve a stable improvement in their condition. The effect of psychotherapy can last for many months.

In the treatment of OCD, other types of psychocorrection are also used:

• group and family
• rational and aversive:
• other types.

Medical therapy with psychotropic drugs

Antidepressants have been shown to be most effective in OCD. With an increase in anxiety in the first stages of treatment, they are supplemented with tranquilizers. In chronic cases of OCD, when antidepressants of the serotonin reuptake inhibitor series are ineffective, atypical antipsychotic drugs are increasingly being prescribed.

It is impossible and unacceptable to treat the disease at home.

How to live with OCD and is it possible to get rid of it completely

There is no universal answer to this question, since everything depends on:

• the severity of the disorder;
• characteristics of a particular person;
• motivation to overcome the problem.

The latter is extremely important, since it would be wrong to come to terms with the situation and adapt to the standards of the disorder. In order for life to be long, happy, eventful and interesting, one should realize the problem and take measures to solve it. Of course, it is better to immediately consult a doctor. Many people try to cope with the disease on their own, but in the absence of special knowledge and skills, this can lead to time being wasted, and symptoms will increase.

To change life for the better, it is important:

• get the maximum amount of information about obsessive-compulsive disorder. New knowledge will give an understanding of where obsessive states come from and how to manage them;
• be open to positive change, no matter how unrealistic it may seem;
• understand that the healing process takes time, perseverance and patience;
• communicate with other people with OCD. Similar communities exist on the Internet. They are useful not only as an opportunity to talk, but also as a chance to get new, useful information.

OCD that lasts for years is debilitating, takes a lot of energy and time, brings discomfort to life, but it has been successfully treated for a long time.

Obsessive-compulsive disorder is a mental illness of a person, otherwise called obsessive-compulsive disorder. For example, the pathological desire to wash hands two hundred times in one day due to thoughts of countless bacteria, or to count the pages of a book you are reading in an effort to know exactly how much time to spend on one sheet, or to repeatedly return home before work in doubt whether the iron is turned off. or gas.

That is, a person suffering from obsessive-compulsive disorder is tormented by obsessive thoughts that dictate the need for tedious, repetitive movements, which leads to stress and depression. This condition undoubtedly reduces the quality of life and requires treatment.

Description of the disease

The official medical term "obsessive-compulsive syndrome" is based on two Latin roots: "obsession", which means "embracing or siege by obsessive ideas", and "compulsion", that is, "compulsory action".

Sometimes there are disorders of a local nature:

• a purely obsessive disorder, experienced only emotionally, and not physically;
• apart from compulsive disorder, when restless actions are not caused by clear fears.

Obsessive compulsive disorder occurs in about three out of a hundred cases in adults and about two out of five hundred in children. The pathology of the psyche can manifest itself in different ways:

• occur sporadically;
• progress from year to year;
• be chronic.

The first signs are usually observed no earlier than 10 years and rarely necessitate immediate treatment. The initial obsessive-compulsive neurosis is presented in the form of various phobias and strange obsessive states, the irrationality of which a person is able to understand independently.

By the age of 30, the patient may already have a pronounced clinical picture, with a refusal to perceive their fears adequately. In advanced cases, a person, as a rule, has to be hospitalized and treated with more effective methods than conventional psychotherapeutic sessions.

Causes

To date, the exact etiological factors for the occurrence of obsessive-compulsive syndrome are unknown. There are only a few theories and assumptions.

Among the biological causes, the following factors are considered possible:

• pathology of the autonomic nervous system;
• feature of the transmission of electronic impulses in the brain;
• violation of the metabolism of serotonin or other substances necessary for the normal functioning of neurons;
• previous traumatic brain injury;
• infectious diseases with complications;
• genetic inheritance.

In addition to biological factors, obsessive-compulsive disorder can have many psychological or social causes:

• psychotraumatic family relationships;
• strictly religious education;
• work in stressful working conditions;
• experienced fear due to a real threat to life.

Panic fear can be rooted in personal experience or be imposed by society. For example, watching crime news provokes anxiety about being attacked by robbers on the street or fear of car theft.

A person tries to overcome the obsessions that have arisen by repeated “control” actions: looking over his shoulder every ten steps, pulling the car door handle several times, etc. But such compulsions give relief for a short time. If you do not start a fight with them in the form of psychotherapeutic treatment, obsessive-compulsive syndrome threatens to completely overwhelm the human psyche and turn into paranoia.

Symptoms in adults

Symptoms of obsessive-compulsive disorder in adults add up to approximately the same clinical picture:

1. First of all, neurosis manifests itself in obsessive painful thoughts:

• about perversions of a sexual nature;
• about death, physical harm or violence;
• blasphemous or sacrilegious ideas;
• fears of disease, virus infection;
• anxiety about the loss of material values, etc.

Such painful thoughts terrify a person with obsessive-compulsive disorder. He understands their groundlessness, but cannot cope with the irrational fear or superstition that all this will one day come true.

2. The syndrome in adults also has external symptoms, expressed in repetitive movements or actions:

• recalculation of the number of steps on the stairs;
• very frequent hand washing;
• rechecking several times in a row turned off taps and closed doors;
• restoring a symmetrical order on the table every half hour;
• arranging books on a shelf in a certain order, etc.

All these actions are a kind of ritual for "getting rid" of the obsessive state.

3. Obsessive-compulsive disorder tends to intensify in crowded places. In a crowd, the patient may experience periodic panic attacks:

• fear of infection due to the slightest someone else's sneeze;
• fear of touching the "dirty" clothes of other passers-by;
• nervousness due to "strange" smells, sounds, sights;
• fear of losing personal belongings or becoming a victim of pickpockets.

In connection with such obsessive disorders, a person with obsessive-compulsive neurosis tries to avoid crowded places.

4. Since obsessive-compulsive disorder is more susceptible to people who are suspicious and have the habit of controlling everything in their lives, the syndrome is often accompanied by a very strong decrease in self-esteem. This happens because a person understands the irrationality of the changes taking place with him and powerlessness in front of his own fears.

Symptoms in children

Obsessive-compulsive disorder is less common in children than in adults. But has a similar obsessive state:

• the fear of getting lost in the crowd makes the already grown-up children hold their parents by the hand and constantly check whether the hoop is tightly linked;
• the fear of being in an orphanage (if adults threatened at least once with such a “punishment”) makes the child want to very often ask his mother if he is loved;
• panic at school due to a lost notebook leads to a frantic recounting of all school subjects while folding a portfolio, and waking up in a cold sweat at night and again rushing to this lesson;
• obsessive complexes, which are intensified by the "persecution" of classmates because of dirty cuffs, can torment so much that the child completely refuses to go to school.

Obsessive-compulsive disorder in children is accompanied by sullenness, unsociableness, frequent nightmares and poor appetite. Contacting a child psychologist will help to get rid of the syndrome faster and prevent its development.

What to do

Obsessive-compulsive personality disorder can occur episodically in any person, even a completely mentally healthy person. It is very important to recognize the beginning symptoms at the very first stages and start treatment with a psychologist, or at least try to help yourself by analyzing your own behavior and developing a certain protection against the syndrome:

Step 1. Learn what obsessive-compulsive disorder is.

Read several times the causes, symptoms and treatments. Write down on a piece of paper the signs that you observe. Leave space next to each disorder for a detailed description and a plan describing how to get rid of it.

Step 2. Ask for an assessment from the outside.

If you suspect obsessive compulsive disorder, it is best, of course, to consult a specialist doctor who will help you start effective treatment. If it is very difficult to make the first visit, you can ask relatives or a friend to confirm the already discharged symptoms of the disorder or add some others that the person himself does not notice.

Step 3. Look your fears in the eye.

A person with obsessive-compulsive disorder is usually able to understand that all fears are just a figment of his imagination. If every time a new desire arises to wash hands or check a locked door, remind yourself of this fact and interrupt the next “ritual” with a simple effort of will, getting rid of an obsessive neurosis will become easier and easier.

Step 4 Praise yourself.

You need to celebrate the steps to success, even the smallest ones, and praise yourself for the work done. When a sufferer of the syndrome has felt at least once that he is stronger than his obsessive states, that he is able to control them, the treatment of neurosis will go faster.

If it is difficult for a person to find sufficient strength in himself to get rid of obsessive-compulsive neurosis, he should turn to a psychologist.

Methods of psychotherapy

Treatment in the form of psychotherapeutic sessions for obsessive-compulsive syndrome is considered the most effective. Today, specialist psychologists have several effective methods in their medical arsenal to get rid of such obsessive-compulsive disorder:

1. Cognitive behavioral therapy for the disorder. Founded by psychiatrist Jeffrey Schwartz, the idea is to resist the syndrome by minimizing compulsions and then eliminating them completely. A step-by-step method of absolute awareness of one's disorder and its causes leads the patient to decisive steps that help to get rid of neurosis for good.

2. The technique of "stopping thoughts." Behavioral therapy theorist Joseph Wolp formalized the idea of ​​applying a "view from the outside." A person suffering from a neurosis is invited to recall one of the vivid situations when his obsessive states manifest themselves. At this point, the patient is told loudly “Stop!” and analyze the situation using a number of questions:

• Is there a high probability that this could happen?
• How much does thought interfere with living a normal life?
• How strong is the internal discomfort?
• Would life be easier and happier without this obsession and neurosis?

Questions may vary. There may be many more. Their main task in the treatment of obsessive-compulsive disorder is to "photograph" the situation, to consider it, as in a slow motion frame, to see it from all angles.

After such an exercise, it becomes easier for a person to face fears and control them. The next time the obsessive-compulsive disorder begins to haunt him outside the walls of the psychologist's office, the internal exclamation “Stop!” will work, and the situation will take on a completely different shape.

The above methods of psychotherapy are far from the only ones. The choice remains with the psychologist, after questioning the patient and determining the degree of obsessive-compulsive syndrome on the Yale-Brown scale, which was specially designed to identify the depth of neurosis.

Medication treatment

The treatment of some complex cases of obsessive-compulsive syndrome is not complete without medical intervention. Especially when metabolic disorders were discovered that are necessary for the work of neurons. The main drugs for the treatment of neurosis are SSRIs (serotonin reuptake inhibitors):

• fluvoxamine or escitalopram;
• tricyclic antidepressants;
• paroxetine, etc.

Modern scientific research in the field of neuroscience has found therapeutic potential in agents that release the neurotransmitter glutamate and help, if not get rid of neurosis, then significantly mitigate it:

• memantine or riluzole;
• lamotrigine or gabapentin;
• N-acetylcysteine, etc.

But conventional antidepressants are prescribed as a means of symptomatic effects, for example, to eliminate neurosis, stress arising from persistent obsessive-compulsive states or mental disorders.

Obsessive-compulsive disorder (OCD) is a mental illness characterized by obsessive thoughts, doubts, and constant double-checking of actions taken.

Obsessive-compulsive disorder is not as serious a pathology as schizophrenia or depression, but this mental disorder can significantly impair a person's quality of life, contribute to a decrease in self-esteem, and even worsen the patient's social status.

Causes

Obsessive-compulsive disorder can develop due to the interaction of a number of factors. First of all, it is a hereditary predisposition. Certain personality traits, a model of behavior in psychotraumatic conditions can be inherited by a person.

The development of this mental disorder can be caused by sudden mental trauma (a life-threatening situation, the death of a loved one, a natural disaster) or a long stay in stressful conditions when the human psyche is “exhausted”. Examples of such a situation are an uninteresting, hated job for a person, from which he cannot quit (he lives in a small village where another job cannot be found).

Symptoms of the disease

The first manifestations of obsessive-compulsive disorder appear in adolescence or early adulthood. At this time, obsessions arise, which are regarded by patients as something absurd, illogical.

The main obsessions characteristic of OCD are obsessive thoughts and compulsive actions.

Now let's take a closer look at each individual symptom.

obsessive thoughts

obsessive thoughts- painful thoughts, images and desires that arise against the will of a person, again and again come to his mind, and which he tries to resist. Such thoughts themselves “swarm” in the head, do not give a person peace of mind, he would be happy to switch to something else, but again and again obsessive thoughts arise in his mind.

We are all different, so each of us has our own obsessive thoughts. However, all obsessive thoughts can be divided into obsessive doubts, obsessive fears of contamination or contamination, and contrast obsessions. So, let's talk about each of these groups separately.

obsessive doubts

Obsessive doubts arose, probably, in each of us. Have I done everything? Did you make the right decision? Did I close the door? Did I turn off the gas? Did you write everything in the answer to the ticket during the entrance exam? Familiar thoughts, right?

Obsessive doubts can be related to everyday issues (is the door closed, is the gas turned off), with official activities (a bank employee will doubt whether he correctly indicated the account to which he transferred the money, the teacher - whether he gave the correct grade to the student). To make sure that everything is done, a person will again and again check gas, electricity, water, the number of the current account. And even if everything is done carefully, then after a while doubts may return again (what if the tap was not completely closed, and I didn’t see it; what if I still mixed up the numbers in the account number?)

If such thoughts sometimes arise - it's okay, it happens to almost everyone. But if you are forced to check many times whether the gas is turned off, the light is still not sure that everything is turned off, in this case it is better to visit a psychiatrist. You may have obsessive-compulsive personality disorder. By the way, here's a little anecdote on the subject.

The appearance of various obsessions, especially obsessive doubts, is characteristic of such a personality disorder as.

Contrasting obsessions

Contrasting obsessions can also occur with obsessive-compulsive disorder. These are vivid ideas that arise in the imagination of a person, unpleasant in meaning, blasphemous thoughts.

Contrasting obsessions include an absolutely groundless fear of harming oneself or others. It may also be a desire to continue someone's remark with an ironic, offensive statement. This group of obsessions can include obsessive representations of sexual content - obsessions by the type of forbidden representations of sexual acts with animals, representatives of the same sex.

Obsessions of pollution

Obsessions of pollution are also called mysophobia. They can be manifested by fear of getting dirty with earth, feces, urine, fear of penetration into the body of microorganisms, harmful substances.

Sometimes the fear of pollution is not very pronounced. At the same time, a person for many years only washes his hands too hard or washes the floor several times a day for no apparent reason. Such phobias do not significantly affect the quality of human life, and others are regarded only as increased cleanliness.

Much worse if pollution obsessions get more complicated. At the same time, various actions, rituals appear, aimed at preventing pollution. Such a person will avoid touching objects that may have been contaminated. He will go out into the street only in special clothes, supposedly protecting him from pollution. He will also wash his hands in a certain sequence and in no case violates it (otherwise he will consider that his hands were dirty). In the later stages of the disease, some people even refuse to go outside, so as not to get dirty there, not to pick up some kind of infection.

Another manifestation of mysophobia is the fear of contracting some kind of disease. Most often, patients are afraid that pathogens will enter their body from the outside in some unusual way (for example, due to contact with old things that once belonged to a sick person).

obsessive actions

Compulsive actions- stereotypically repetitive, obsessive behavior. In some cases, obsessive actions take the form of protective rituals: by performing certain actions under certain conditions, a person tries to protect himself from something. It is these compulsions that are most often found in OCD.

Among obsessive actions, especially in childhood and adolescence, tics predominate. They differ from tics in organic brain diseases in that they are much more complex movements that have lost their original meaning. For example, compulsive actions can include hand movements, as if throwing back long hair (although a person has been walking with a short haircut for a long time) or attempts to blink their eyes hard, as if a speck has got into the eye. The performance of these movements is accompanied by a painful sense of persistence, a person understands the meaninglessness of these movements, but performs them anyway.

Many of us have bad habits - someone bites his lips, someone twists the ring, someone else periodically spits. However, these actions are not accompanied by a sense of obsession.

If you diligently take care of yourself, you can get rid of such habits. Or if someone from outside pays attention that a person is biting his lips at that moment, then this person will stop doing it, and his mental state will not be disturbed.

In the presence of obsessive thoughts and actions that are becoming more and more absurd, it must be borne in mind that similar symptoms can also be observed with. It is also characterized by the progression of emotional impoverishment, the loss of habitual interests.

Treatment of the disorder

Antidepressants (anafranil, imipramine, amitriptyline, fluvoxamine) can be used to treat obsessive-compulsive disorder. With contrast obsessions, the antidepressant sertraline (Zoloft) has the best effect.

Tranquilizers (hydroxyzine, alprazolam, diazepam, clonazepam) may also be given for short-term treatment of OCD.

With an obsessive fear of pollution, accompanied by a complex system of protective rituals, neuroleptics (sonapax, truxal, ridazine) can be used.

In most cases, effective treatment of OCD is impossible without the use of psychotherapy. Its goal is to reduce a person’s self-control, to teach him to relax. One of the methods of psychotherapeutic treatment is the purposeful and consistent contact of a person with things that he avoids. This is done so that the patient learns to consciously control his emotions in such situations.