OCD is an obsessive-compulsive disorder. Symptoms, treatment, causes. Obsessive-compulsive personality disorder (OCD)

Every person at least once in his life has experienced a “visit” of unpleasant thoughts that frightened him, leading him to a terrible state. Fortunately, for the most part, a person can not concentrate his attention on them and, easily brushing them aside, move on with his life, enjoying life. But, unfortunately, there are people who cannot do this. They cannot let go of an unpleasant thought, but begin to dig around and look for the reason for the appearance of such thoughts and fears. Such people come up with specific actions for themselves, performing which they can calm down for a while. This phenomenon is called OCD.

And in today’s article we will talk about such a personality disorder as OCD (Obsessive-Compulsive Disorder).

Expanding the term we get to the essence

Obsessions are thoughts, images and even impulses that frighten the patient and do not let him go. Compulsions are specific actions that a person performs in order to eliminate these thoughts and calm down.

In a patient, this condition may progress, and in this case the person has to commit more compulsions in order to calm down.

OCD itself can be chronic or episodic. More importantly, this condition causes real inconvenience to a person, affecting all areas of his life.

Top common obsessive thoughts

A lot of research has been conducted on this issue, which has helped to identify which obsessive thoughts are most often found in people.

Of course, in reality there are a lot of obsessions, different people Those suffering from this disorder are visited by a variety of thoughts and fears. But above we have listed the most common ones today.

How does the disease manifest itself?

The most characteristic symptoms of this disease are the following:

When a thought appears in the patient, he is perceived not as the voice of another from the outside, but as his own.
The patient himself understands that this is not normal and makes efforts to resist them: he fights these thoughts, tries to switch his attention to other things, but all to no avail.
A person constantly experiences feelings of guilt and fear because his fantasies and thoughts can come true.
Obsessions are permanent and can be repeated very often.
After all, this tension leads a person to loss of strength, and subsequently the person becomes inactive and fearful, closing off from the outside world.

Unfortunately, not knowing or not fully understanding the complexity of this disorder, others do not understand that the person has a real problem. For many people who do not know about obsessive-compulsive disorder, these symptoms can only cause laughter or misunderstanding. However, OCD is a serious personality disorder that affects all areas of a person's life.

Pure OCD

In this disorder, there is a predominance of either compulsion or obsession. However, pure OCD can also occur. In this case, the person understands that he has this disorder. Understands that there are intrusive thoughts that do not correspond to one’s values and beliefs. But they are confident that they do not have compulsive manifestations, in other words, they do not perform any rituals to free themselves from frightening thoughts.

In fact, this is not entirely true, because in this version of OCD a person may not knock on wood, may not pull pens and all that, but at the same time he can for a long time, sometimes spend hours convincing yourself that you don’t need to pay attention to these thoughts or fears.

And they themselves do certain actions. These actions may not be visible to others, but still, even in this type of obsessive-compulsive disorder, a person gets rid of emotional stress thanks to certain actions: this could be a quiet prayer, counting to 10, shaking the head, stepping from one foot to the other and the like.

All this may go unnoticed by others, and even by the patients themselves. However, no matter what the type of OCD, it is still accompanied by some kind of compulsions: it does not matter whether these actions are conscious or unconscious.

What causes OCD?

Just like any other problem, disease or disorder. and OCD has reasons for its manifestation. And to understand the full picture of the problems, you need to start by studying exactly the cause.

To date, researchers of this problem have come to the conclusion that obsessive-compulsive disorder is caused by a combination of three factors: social, psychological and biological.

Thanks to the latest technologies Scientists can already study the anatomy and physiology of the human brain. And studies of the brains of OCD patients have shown that there are some significant differences in the way the brains work in these people. Basically, there are differences in different regions, such as the anterior frontal lobe, thalamus and striatum of the anterior cingulate cortex.

Research has also shown that patients have certain abnormalities that are associated with nerve impulses between neuron synapses.

In addition, a mutation of genes that are responsible for the transfer of serotonin and glutamate was identified. All these anomalies lead to the fact that a person processes neurotransmitters before he is able to transmit an impulse to the next neuron.

Most scientists, when talking about the causes of OCD, insist on genetics. Since more than 90% of patients with this disorder also have sick relatives. Although this may be controversial, since in these cases the child, living with a mother who has OCD, may simply take this disorder for granted and apply it in his life.

Group A streptococcal infection can also be cited as a cause.

As for the psychological reasons, experts in this field assure that people who are predisposed to OCD have a peculiarity in their thinking:

Overcontrol - such people believe that they have the power to control everything, including their own thoughts.
Super-responsibility - such people are confident that every person is responsible not only for their actions, but also for their thoughts.
Materiality of thoughts - the entire psychology of such people is built on the belief that thought is material. They firmly believe that if a person can imagine something, then it will happen. It is for this reason that they believe that they are capable of bringing trouble upon themselves.
Perfectionists - those with OCD - are the most ardent representatives of perfectionism; they are confident that a person should not make mistakes and should be perfect in everything.

This disorder is often found in those people who were raised in strict families, where parents controlled all the child’s steps and set high standards and goals. And the child wants in vain to meet these requirements.

And in this case: that is, if a person has peculiarities of thinking (mentioned above) and supercontrol of parents in childhood, the appearance of obsessive-compulsive disorder is only a matter of time. And just one, the slightest push, a stressful situation (divorce, death of a loved one, moving, job loss, etc.), fatigue, prolonged stress or use large quantities psychotropic substances can cause OCD.

Nature of the disorder

This disorder is mostly cyclical in nature, and the patient’s actions themselves occur in cycles. At first, a person has a thought that frightens him. Then, as this thought grows, he begins to feel shame, guilt, and anxiety. Afterwards, the person, not wanting this, concentrates his attention more and more on the thought that frightens him. And all this time, tension, anxiety and a feeling of fear are growing.

Naturally, in such conditions, the human psyche cannot remain in a helpless state for long, and ultimately he finds how to calm down: by doing certain actions and rituals. After performing stereotypical actions, a person feels relief for some time.

But this is only for a short time, since the person understands that something is wrong with him and these sensations force him to return to strange and frightening thoughts again and again. And then the whole cycle begins to repeat itself again.

Many people naively believe that these ritual actions of patients are harmless, but in fact, over time, the patient begins to become dependent on these actions. It's like drugs, the more you try, the harder it is to quit. In fact, ritual actions increasingly perpetuate this disorder and lead the person to avoid certain situations that cause obsession.

As a result, it turns out that a person avoids dangerous moments and begins to convince himself that he has no problems. And this leads to the fact that he does not take measures for treatment, which ultimately worsens the situation even more.

Meanwhile, the problem is getting worse, since the patient hears reproaches from his relatives, they take him for a madman and begin to forbid him to do the rituals that are familiar and soothing to the patient. In these cases, the patient cannot calm down and all this leads the person to various difficult situations.

Although, in some cases, it also happens that relatives encourage these rituals, which ultimately leads to the patient beginning to believe in their necessity.

How to diagnose and treat this disease?

Diagnosing OCD in a person is a difficult task for a specialist, since its symptoms are very similar to those of schizophrenia.

It is for this reason that in most cases a differential diagnosis is made (especially in cases where the patient’s obsessive thoughts are too unusual, and the manifestations of compulsion are clearly eccentric).
For diagnosis, it is also important to understand how the patient perceives incoming thoughts: as his own or as imposed from the outside.

One more thing to remember important nuance: Depression itself is often accompanied by OCD.
And in order for a specialist to be able to determine the level of severity of this disorder, an OCD test or the Yale-Brown scale is used. The scale has two parts, each with 5 questions. The first part of the questions helps to understand the frequency of occurrence of obsessive thoughts and determines whether they correspond to OCD, and the second part of the questions makes it possible to analyze the patient’s compulsions.

In cases where this disorder is not so severe, a person is able to cope with the disease himself. To do this, it will be enough not to get hung up on these thoughts and turn your attention to other things. You can, for example, start reading, or watch a good and interesting film, call a friend, etc.

If you have a desire or need to perform a ritual action, try to delay performing it for 5 minutes, and then gradually increase the time and reduce the performance of these actions more and more. This will make it possible to understand that you yourself can calm down without any stereotypical actions.

And in cases where a person has this disorder of moderate severity or higher, then the help of a specialist is needed: a psychiatrist, psychologist or psychotherapist.

In the most severe cases, the psychiatrist prescribes medication. But, unfortunately, medications do not always help treat this disorder, and their effect is not permanent. So, after the course of drugs ends, the disorder returns again.

It is for this reason that psychotherapy has become widespread. Thanks to her, about 75% of OCD patients have recovered to date. The psychotherapist’s tools can be very different: cognitive behavioral psychotherapy, exposure or hypnosis. What is more important is that they all have good help and help achieve good results.

The best results are obtained using the exposure technique. Its essence is that the patient is “forced” to face his fears in situations where he controls the situation. For example, a person who is afraid of germs is “forced” to poke the elevator button with his finger and not immediately run to wash his hands. And so the requirements become more complicated each time, and as a result the person understands that it is not so dangerous and it becomes habitual for him to do things that previously frightened him.

One last thing

It is important to understand and accept the fact that OCD is as serious a personality disorder as any other disorder. That is why the attitude and understanding of family and friends is very important for patients. Otherwise, hearing ridicule, curses and not receiving understanding, a person may close down even more, and this will lead to an increase in tension, which will bring a bunch of new problems.

To do this, we recommend that you do not seek help from a psychologist alone. Family therapy will help family members understand not only the patient, but also understand the causes of the disease. Thanks to this therapy, relatives will understand how to behave correctly with the patient and how to help them.

It is also important for every person to understand that in order to prevent obsessive compulsive disorder You need to follow simple preventative tips:

Don't get overtired:
Don't forget about rest;
Apply techniques to combat stress;
Resolve intrapersonal conflicts in a timely manner.

Remember, OCD is not a mental illness, but a neurotic disorder and does not lead a person to personal changes. The most important thing is that it is reversible and with the right approach you can easily overcome OCD. Be healthy and enjoy life.

What is obsessive-compulsive disorder? We will discuss the causes, diagnosis and treatment methods in the article by Dr. E. V. Bachilo, a psychiatrist with 9 years of experience.

Definition of disease. Causes of the disease

Obsessive-compulsive disorder (OCD)- a mental disorder, which is characterized by the presence in the clinical picture of obsessive thoughts (obsessions) and obsessive actions (compulsions).

Data regarding the prevalence of OCD are highly inconsistent. According to some data, the prevalence varies between 1-3%. There is no exact data regarding the causes of obsessive-compulsive disorder. At the same time, several groups of hypotheses of etiological factors are distinguished.

Symptoms of obsessive-compulsive disorder

As noted above, the main symptoms of the disease manifest themselves in the form of obsessive thoughts and compulsive actions. These obsessions are perceived by patients as something psychologically incomprehensible, alien, irrational.

Obsessive thoughts- these are painful ideas, images or desires that arise regardless of the will. They constantly come to a person’s mind in a stereotypical form, and he tries to resist them. Recurrent obsessions are unfinished, endlessly considered alternatives that are associated with an inability to make any ordinary decision necessary in everyday life.

Compulsive actions- these are stereotypical, repetitive actions, which sometimes take on the character of rituals that perform a protective function and relieve excessive anxious tension. A significant part of compulsions is associated with cleaning from contamination (in a number of cases, compulsive hand washing), as well as repeated checks in order to obtain assurance that a potentially dangerous situation will not arise. Let us note that this behavior is usually based on the fear of danger that is “expected” by the person himself or that he can cause to another.

To the most common manifestations of OCD include:

mysophobia (when there is an obsessive fear of pollution with the ensuing consequences and human behavior);
“gathering” (in the case when people are afraid to throw something away, experiencing anxiety and fear that it may be needed in the future);
obsessive thoughts of a religious nature;
obsessive doubts (when a person constantly doubts whether he has turned off the iron, gas, light, or whether the water taps are closed);
obsessive counting or anything related to numbers (adding numbers, repeating numbers a certain number of times, etc.);
obsessive thoughts regarding “symmetry” (can manifest itself in clothing, arrangement of interior items, etc.).

Let us note that the manifestations described above are permanent and painful for a given person.

Pathogenesis of obsessive-compulsive disorder

As noted above, there are different approaches to an explanation of obsessive-compulsive disorder. Today, the neurotransmitter theory is the most widespread and accepted. The essence of this theory is that there is a connection between obsessive-compulsive disorder and impaired communication between certain areas of the cerebral cortex and the basal ganglia.

The designated structures interact through serotonin. Thus, scientists believe that in OCD there is an insufficient level of serotonin due to increased reuptake (by neurons), which prevents the transmission of impulses to the next neuron. In general, it must be said that the pathogenesis of this disorder is quite complex and not fully understood.

Classification and stages of development of obsessive-compulsive disorder

Obsessive thoughts (obsessions) can be expressed in different ways: arrhythmomania, obsessive reproduction, onomatonia.

"Mental Chewing Gum" is expressed in the irresistible desire of patients to pose and think about questions that have no solution.
Arrhythmomania or, in other words, obsessive counting, is expressed in the counting of objects that, as a rule, fall into a person’s field of vision.
Obsessive reproductions manifest themselves in the fact that the patient develops a painful need to remember something that, in general, does not have any personal meaning at the moment.
Onomamania- an obsessive desire to remember names, terms, titles and any other words.

Within obsessive-compulsive disorders, various types of compulsions can be found. They can be in the form of simple symbolic actions. The latter is expressed in the fact that patients form certain “prohibitions” (taboos) on performing any actions. For example, the patient counts steps in order to find out whether failure or success awaits him. Or should the patient only walk on right side streets and open the door only right hand. Another option may be stereotypical acts of self-harm: pulling out hair on one's own body, pulling out hair and eating it, plucking one's own eyelashes for painful reasons. However, it is worth noting that in a number of cases (as, for example, in the last one), a clear and deep differential diagnosis with other mental disorders, which is carried out by a doctor, is necessary. There may also be obsessive desires that arise episodically, are not motivated in any way and frighten patients and which are usually not realized because they encounter active resistance from the person. Obsessive drives arise suddenly, unexpectedly, in situations where adequate impulses may arise.

Complications of obsessive-compulsive disorder

Complications of obsessive-compulsive disorder are associated with the addition of other mental disorders. For example, with long-term obsessions that cannot be corrected, depressive disorders, anxiety disorders, and suicidal thoughts may occur. This is due to the fact that a person cannot get rid of OCD. There are also frequent cases of abuse of tranquilizers, alcohol, and other psychoactive substances, which will certainly aggravate the course. One cannot help but mention the low quality of life of patients with severe obsessions. They interfere with normal social functioning, reduce performance, and impair communication functions.

Diagnosis of obsessive-compulsive disorder

The diagnosis of OCD is currently based on the International Classification of Diseases, 10th revision (ICD-10). Below we will consider what signs are characteristic and necessary for making a diagnosis of obsessive-compulsive disorder.

ICD-10 has the following diagnoses for the disorder we are considering:

OCD. Predominantly intrusive thoughts or ruminations;
OCD. Predominantly compulsive actions;
OCD. Mixed obsessive thoughts and actions;
Other obsessive-compulsive disorders;
Obsessive-compulsive disorder, unspecified.

General diagnostic criteria for making a diagnosis are:

presence of obsessive thoughts and/or actions;
they must be observed most days over a period of at least two weeks;
obsessions/compulsions must be a source of distress for the person;
the thought of implementing an action should be unpleasant for a person;
thoughts, ideas and impulses must be unpleasantly repetitive;
compulsive actions do not necessarily have to correspond to specific thoughts or concerns, but should be aimed at relieving the person of spontaneously arising feelings of tension, anxiety and/or internal discomfort.

So, the diagnosis is “OCD. Predominantly intrusive thoughts or ruminations” is scored if only the indicated thoughts are present; thoughts must take the form of ideas, mental images or impulses to action, almost always unpleasant for a particular subject.

Diagnosis of OCD. Predominantly compulsive actions” is set in case of predominance of compulsions; behavior is based on fear, and the compulsive action (in fact, a ritual) is a symbolic and fruitless attempt to prevent danger, and it can take a lot of time, several hours a day.

The mixed form is indicated when obsessions and compulsions are expressed equally.

The diagnoses discussed above are made based on an in-depth clinical interview, examination of the patient, and medical history. It should be noted that scientifically proven laboratory tests aimed exclusively at identifying OCD do not exist in routine practice today. One of the valid psychodiagnostic tools for identifying obsessive states is the Yale-Brown scale. This is a professional tool that is used by specialists to determine the severity of symptoms, regardless of the form of obsessive thoughts or actions.

Treatment of obsessive-compulsive disorder

In terms of treatment of obsessive-compulsive disorders, we will proceed from the principles of evidence-based medicine. Treatment based on these principles is the most proven, effective and safe. In general, treatment of the disorders in question is carried out with antidepressant drugs. If the diagnosis is made for the first time, it is most advisable to use monotherapy with antidepressants. If this option turns out to be ineffective, you can resort to drugs from other groups. In any case, therapy should be carried out under close medical supervision. Treatment is usually carried out on an outpatient basis, in complicated cases - in a hospital.

We also note that one of the methods of therapy is psychotherapy. Currently, cognitive behavioral therapy and its various directions have proven effectiveness. To date, it has been proven that cognitive psychotherapy is comparable in effectiveness to medicines and superior to placebo for mild obsessive-compulsive disorder. It has also been noted that psychotherapy can be used to enhance the effects of drug therapy, especially in cases of difficult-to-treat disorders. In the treatment of OCD it is used as customized forms work and group work, as well as family psychotherapy. It should be said that therapy for the disorder in question should be carried out long-term, for at least 1 year. Despite the fact that improvement occurs much earlier (within 8-12 weeks or earlier), it is absolutely impossible to stop therapy.

Therapy for OCD in children and adolescents generally follows treatment algorithms for adults. Non-pharmacological methods are mainly based on psychosocial interventions, the use of family psychoeducation and psychotherapy. Cognitive behavioral therapy, including exposure and response prevention, is used and is considered the most effective methods. The latter consists in the purposeful and consistent contact of a person with OCD with the stimuli he is avoiding and the conscious slowing down of the occurrence of pathological reactions.

Forecast. Prevention

As mentioned above, the most characteristic feature of obsessive-compulsive disorder is the chronicity of the process. It is worth noting that a number of people with this disorder may have a long-term stable state, this is especially true for patients who have one type of obsession (for example, arithmomania). IN in this case They note a mitigation of symptoms, as well as good social adaptation.

Mild manifestations of OCD usually occur on an outpatient basis. In most cases, improvement occurs around the end of the first year. Severe cases of obsessive-compulsive disorder, which have in their structure numerous obsessions, rituals, complications with phobias, can be quite persistent, resistant to therapy, and may also show a tendency to relapse. This can be facilitated by the repetition or occurrence of new psychotraumatic situations, overwork, general weakening of the body, insufficient sleep, and mental overload.

There is no specific prevention for OCD, since the exact cause of its occurrence has not been established. Therefore, recommendations for prevention are sufficient general character. Prevention of OCD is divided into primary and secondary.

TO primary prevention These include activities aimed at preventing the development of OCD symptoms. To do this, it is recommended to prevent psychotraumatic situations in family conditions and at work, and to pay special attention to raising the child.

Secondary prevention is aimed specifically at preventing the recurrence of symptoms of obsessive-compulsive disorder. A number of methods are used for this:

Of particular note is the quality preventative measure periodic consultations and/or examination by a doctor. This could be a preventive examination, which children undergo annually from adolescence to monitor their mental state. It also includes periodic consultations with a doctor for people who have previously suffered from obsessive-compulsive disorder. The doctor will help to promptly identify abnormalities, if any, and prescribe therapy, which will help more effectively cope with the disorder and prevent its occurrence in the future.

Bibliography

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Obsessive-compulsive disorder (OCD) is one of the common syndromes of psychological illness. A severe disorder is characterized by a person having anxious thoughts(obsessions), provoking the appearance of constantly repeating certain ritual actions (compulsions).

Obsessive thoughts conflict with the patient’s subconscious, causing him depression and anxiety. And manipulative rituals designed to relieve anxiety do not bring the expected effect. Is it possible to help a patient, why does this condition develop, turning a person’s life into a painful nightmare?

Obsessive-compulsive disorder causes suspiciousness and phobias in people

Every person has encountered this type of syndrome in their life. People call this an “obsession.” Such ideas-states are divided into three general groups:

Emotional. Or pathological fears that develop into a phobia.
Intelligent. Some thoughts, fantastic ideas. This includes intrusive disturbing memories.
Motor. This type of OCD manifests itself in the unconscious repetition of certain movements (wiping the nose, earlobes, frequent washing of the body, hands).

Doctors classify this disorder as a neurosis. The name of the disease “obsessive-compulsive disorder” is of English origin. Translated, it sounds like “obsession with an idea under duress.” The translation very accurately defines the essence of the disease.

OCD negatively affects a person's standard of living. In many countries, a person with such a diagnosis is even considered disabled.

OCD is "obsession with an idea under duress"

People encountered obsessive-compulsive disorder back in the dark Middle Ages (at that time this condition was called obsession), and in the 4th century it was classified as melancholy. OCD was periodically recorded as paranoia, schizophrenia, manic psychosis, and psychopathy. Modern doctors classify pathology as neurotic conditions.

Obsessive-compulsive disorder is amazing and unpredictable. It is quite common (statistically, it affects up to 3% of people). Representatives of all ages are susceptible to it, regardless of gender and level of social status. Studying the features of this disorder for a long time, scientists made interesting conclusions:

It has been noted that people suffering from OCD have suspiciousness and increased anxiety;
obsessive states and attempts to get rid of them with the help of ritual actions can occur periodically or torment the patient for whole days;
the disease has a bad effect on a person’s ability to work and perceive new information (according to observations, only 25-30% of patients with OCD can work productively);
Patients’ personal lives also suffer: half of people diagnosed with obsessive-compulsive disorder do not create families, and in the case of illness, every second couple breaks up;
OCD more often attacks people who do not have a higher education, but representatives of the intelligentsia and people with a high level of intelligence are extremely rare with this pathology.

How to recognize the syndrome

How to understand that a person suffers from OCD and is not subject to ordinary fears or is not depressed and protracted? To understand that a person is sick and needs help, pay attention to the typical symptoms of obsessive-compulsive disorder:

Intrusive thoughts. Anxious thoughts that constantly follow the patient often concern fear of illness, germs, death, possible injuries, and loss of money. From such thoughts, an OCD patient becomes panicked, unable to cope with them.

Components of obsessive-compulsive disorder

Constant anxiety. Being caught up in obsessive thoughts, people with obsessive-compulsive disorder experience an internal struggle with their own condition. Subconscious “eternal” anxieties give rise to a chronic feeling that something terrible is about to happen. It is difficult to remove such patients from a state of anxiety.

Repeating movements. One of the most striking manifestations of the syndrome is the constant repetition of certain movements (compulsions). Obsessive actions come in a wide variety. The patient can:

count all the steps of the ladder;
scratching and twitching certain parts of the body;
constantly wash your hands for fear of contracting the disease;
synchronously arrange/lay out objects and things in the closet;
come back many times to once again check whether household appliances, lights are turned off, and whether the front door is closed.

Often, impulsive-compulsive disorder requires patients to create their own system of checks, some kind of individual ritual of leaving the house, going to bed, and eating. Such a system can sometimes be very complex and confusing. If something in it is violated, a person begins to carry it out again over and over again.

The entire ritual is carried out deliberately slowly, as if the patient is delaying time in fear that his system will not help, and internal fears will remain.

Attacks of the disease are more likely to occur when a person finds himself in the middle of a large crowd. He immediately awakens with disgust, fear of illness and nervousness from the feeling of danger. Therefore, such people deliberately avoid communication and walking in crowded places.

Causes of pathology

The first causes of obsessive-compulsive disorder usually appear between the ages of 10 and 30. By the age of 35-40, the syndrome is already fully formed and the patient has a pronounced clinical picture of the disease.

Frequently encountered pairs (thought-ritual) in OCD

But why does obsessive neurosis not come to all people? What must happen for the syndrome to develop? According to experts, the most common culprit of OCD is an individual characteristic of a person’s mental make-up.

Doctors divided provoking factors (a kind of trigger) into two levels.

Biological provocateurs

The main biological factor causing obsessive-compulsive disorder is stress. A stressful situation never goes away without leaving a trace, especially for people prone to OCD.

In susceptible individuals, obsessive-compulsive disorder can even cause overwork at work and frequent conflicts with relatives and colleagues. Other common biological causes include:

heredity;
traumatic brain injuries;
alcohol and drug addiction;
disturbance of brain activity;
diseases and disorders of the central nervous system;
difficult birth, trauma (for the child);
complications after severe infections affecting the brain (after meningitis, encephalitis);
metabolic disorder, accompanied by a drop in the levels of the hormones dopamine and serotonin.

Social and psychological reasons

family serious tragedies;
severe psychological trauma from childhood;
parental long-term overprotection of the child;
long work accompanied by nervous overload;
strict puritanical, religious education, based on prohibitions and taboos.

The psychological state of the parents themselves also plays an important role. When a child constantly observes their manifestations of fear, phobias, and complexes, he himself becomes like them. The problems of loved ones seem to be “drawn in” by the baby.

When to see a doctor

Many people suffering from OCD often do not even understand or perceive existing problem. And even if they notice strange behavior, they do not appreciate the seriousness of the situation.

According to psychologists, a person suffering from OCD must undergo a full diagnosis and begin treatment. Especially when obsessive states begin to interfere with the lives of both the individual and those around him.

It is imperative to normalize the condition, because OCD has a strong and negative impact on the well-being and condition of the patient, causing:

depression;
alcoholism;
isolation;
thoughts of suicide;
rapid fatigue;
mood swings;
decline in quality of life;
growing conflict;
gastrointestinal disorder;
constant irritability;
difficulty making decisions;
loss of concentration;
abuse of sleeping pills.

Diagnosis of the disorder

To confirm or refute the mental disorder OCD, a person should consult a psychiatrist. After a psychodiagnostic conversation, the physician will differentiate the presence of pathology from similar mental disorders.

Diagnosis of obsessive-compulsive disorder

The psychiatrist takes into account the presence and duration of compulsions and obsessions:

Obsessive states (obsessions) acquire a medical basis when they are stable, regularly repeated and intrusive. Such thoughts are accompanied by feelings of anxiety and fear.
Compulsions (obsessive actions) arouse the interest of a psychiatrist if, at the end of them, a person experiences a feeling of weakness and fatigue.

Attacks of obsessive-compulsive disorder should last for an hour, accompanied by difficulty communicating with others. To accurately identify the syndrome, doctors use a special Yale-Brown scale.

Treatment of obsessive-compulsive disorder

Doctors are unanimously inclined to believe that it is impossible to cope with obsessive-compulsive disorder on your own. Any attempts to take control of your own consciousness and defeat OCD lead to a worsening of the condition. And the pathology is “driven” into the crust of the subconscious, destroying the patient’s psyche even more.

Mild form of the disease

Treatment of OCD in the initial and mild stages requires constant outpatient monitoring. During the course of psychotherapy, the doctor identifies the causes that provoked obsessive-compulsive neurosis.

The main goal of treatment consists of establishing a trusting relationship between the sick person and his close circle (relatives, friends).

Treatment of OCD, including combinations of psychological correction methods, may vary depending on the effectiveness of the sessions.

Treatment of complicated OCD

If the syndrome occurs in more complex stages, accompanied by the patient’s obsessive phobia of the possibility of contracting diseases, fears of certain objects, treatment becomes more complicated. Specific medications (in addition to psychological correction sessions) enter the fight for health.

Clinical therapy for OCD

Medicines are selected strictly individually, taking into account the state of health and concomitant diseases of the person. The following groups of medications are used in treatment:

anxiolytics (tranquilizers that relieve anxiety, stress, panic);
MAO inhibitors (psychoenergizing and antidepressant medications);
atypical antipsychotics (antipsychotics, new class drugs that relieve symptoms of depression);
serotonergic antidepressants (psychotropic drugs used in the treatment of severe depression);
antidepressants of the SSRI category (modern third-generation antidepressants that block the production of the hormone serotonin);
beta blockers (medicines whose action is aimed at normalizing cardiac activity, problems with which are observed during attacks of acute respiratory syndrome).

Prognosis of the disorder

OCD is a chronic disease. This syndrome is not characterized by complete recovery, and the success of therapy depends on the timely and early start of treatment:

In mild forms of the syndrome, recession (relief of manifestations) is observed 6-12 months after the start of therapy. Patients may remain with some symptoms of the disorder. They are expressed in a mild form and do not interfere with everyday life.
In more severe cases, improvement becomes noticeable 1-5 years after the start of treatment. In 70% of cases, obsessive-compulsive disorder is clinically curable (the main symptoms of the pathology are relieved).

OCD in severe, advanced stages is difficult to treat and is prone to relapse. Aggravation of the syndrome occurs after discontinuation of medications, against the background of new stress and chronic fatigue. Cases of complete recovery of OCD are very rare, but they are diagnosed.

With adequate treatment, the patient is guaranteed stabilization of unpleasant symptoms and relief of severe manifestations of the syndrome. The main thing is not to be afraid to talk about the problem and start therapy as early as possible. Then the treatment of neurosis will have a much greater chance of complete success.

Obsessive psychological disorders have been known since time immemorial: in the 4th century BC. e. this disease was attributed to melancholia, and in the Middle Ages, the disease was considered an obsession.

The disease has been studied and tried to be systematized for a long time. It was periodically attributed to paranoia, psychopathy, manifestations of schizophrenia and manic-depressive psychosis. Currently obsessive-compulsive disorder (OCD) considered one of the types of psychosis.

Facts about obsessive-compulsive disorder:

Obsessiveness can be episodic or is observed throughout the day. In some patients, anxiety and suspiciousness are perceived as a specific character trait, while in others, unreasonable fears interfere with personal and social life, and also negatively affect loved ones.

CAUSES

The etiology of OCD is not clear; there are several hypotheses on this matter. The reasons may be biological, psychological or social in nature.

Biological reasons:

birth injuries;
pathologies of the autonomic nervous system;
features of signal transmission to the brain;
metabolic disorder with changes in the metabolism necessary for normal operation neurons (decreased serotonin levels, increased dopamine concentrations);
history of traumatic brain injury;
organic brain damage (after meningitis);
chronic alcoholism and drug addiction;
hereditary predisposition;
complicated infectious processes.

Social, social and psychological factors:

childhood psychological trauma;
psychological family trauma;
strict religious education;
excessive parental care;
professional activity under stress;
shock associated with a threat to life.

CLASSIFICATION

Classification of OCD according to the characteristics of its course:

a single attack (observed for a day, a week or longer than a year);
relapsing course with periods of absence of signs of the disease;
continuous progressive course of pathology.

Classification according to ICD-10:

mainly obsessions in the form of obsessive thoughts and ruminations;
predominantly compulsions - actions in the form of rituals;
mixed form;
other OCD.

SYMPTOMS of obsessive-compulsive disorder

The first signs of OCD appear between the ages of 10 and 30 years. As a rule, by the age of thirty, the patient develops a pronounced clinical picture of the disease.

Main symptoms of OCD:

The appearance of painful and obsessive thoughts. Usually they are in the nature of sexual perversion, blasphemy, thoughts of death, fear of reprisals, illness and loss of material wealth. A person with OCD becomes horrified by such thoughts, realizes their groundlessness, but is unable to overcome his fear.
Anxiety. A patient with OCD experiences a constant internal struggle, which is accompanied by a feeling of anxiety.
Repetitive movements and actions can manifest themselves in an endless recalculation of the steps of the ladder, frequent washing hands, arranging objects symmetrically to each other or in some order. Sometimes people with the disorder can come up with their own intricate system for storing personal belongings and constantly follow it. Compulsive checks are associated with repeated returns home in order to find that the lights and gas are not turned off, to check whether entrance doors. The patient performs a kind of ritual to prevent unlikely events and to get rid of obsessive thoughts, but they do not leave him. If the ritual cannot be completed, the person begins it again.
Obsessive slowness, in which a person performs daily activities extremely slowly.
Increased severity of the disorder in crowded places. The patient develops a fear of contracting infections, disgust, and nervousness for fear of losing his things. Because of this, people with obsessive-compulsive disorder try to avoid crowds whenever possible.
Decreased self-esteem. The disorder is especially susceptible to suspicious people who are used to keeping their lives under control, but are unable to cope with their fears.

DIAGNOSTICS

To establish a diagnosis, a psychodiagnostic conversation with a psychiatrist. A specialist can differentiate OCD from schizophrenia and Tourette syndrome. Special attention deserves an unusual combination of intrusive thoughts. For example, simultaneous obsessions of a sexual and religious nature, as well as eccentric rituals.

The doctor takes into account the presence of obsessions and compulsions. Obsessive thoughts have medical significance if they are repeated, persistent and intrusive. They should cause feelings of anxiety and distress. Compulsions are considered from a medical perspective if the patient experiences fatigue when performing them in response to obsessions.

Obsessive thoughts and movements should occupy at least one hour a day, and be accompanied by difficulties communicating with loved ones and others.

To determine the severity of the disease and its dynamics, in order to standardize data use the Yale-Brown scale.

TREATMENT

According to psychiatrists, a person needs to seek help medical care in the case when the disease interferes with his daily life and communication with others.

Treatment methods for OCD:

Cognitive behavioral psychotherapy allows the patient to resist obsessive thoughts by changing or simplifying rituals. When talking with a patient, the doctor clearly divides fears into justified and caused by the disease. At the same time, specific examples from the lives of healthy people, better than those who command respect from the patient and serve as an authority. Psychotherapy helps correct some symptoms of the disorder, but does not completely eliminate obsessive-compulsive disorder.
Drug treatment. Taking psychotropic medications is an effective and reliable method of treating obsessive-compulsive disorder. Treatment is selected strictly individually, taking into account the characteristics of the disease, the age and gender of the patient, as well as the presence of concomitant diseases.

Drug treatments for OCD:

serotonergic antidepressants;
anxiolytics;
beta blockers;
triazole benzodiazepines;
MAO inhibitors;
atypical antipsychotics;
antidepressants of the SSRI class.

Cases of complete recovery are recorded quite rarely, but with the help of medications it is possible to reduce the severity of symptoms and stabilize the patient’s condition.

Many people suffering from this type of disorder do not notice their problem. And if they still guess about it, then they understand the meaninglessness and absurdity of their actions, but do not see a threat in this pathological condition. In addition, they are convinced that they can independently cope with this disease through sheer force of will.

The unanimous opinion of doctors is that it is impossible to cure OCD on your own. Any attempts to cope with such a disorder on your own only worsen the situation.

For the treatment of mild forms, outpatient observation is suitable; in this case, recession begins no earlier than a year after the start of therapy. More complex shapes obsessive-compulsive disorder associated with fear of infection, pollution, sharp objects, complex rituals and diverse ideas are particularly resistant to treatment.

The main goal of therapy should be establishing a trusting relationship with the patient, suppressing feelings of fear before taking psychotropic drugs, as well as instilling confidence in the possibility of recovery. The participation of loved ones and relatives significantly increases the likelihood of healing.

COMPLICATIONS

Possible complications of OCD:

depression;
anxiety;
isolation;
suicidal behavior;
abuse of tranquilizers and sleeping pills;
conflict in personal life and professional activities;
alcoholism;
eating disorders;
low quality of life.

PREVENTION

Primary prevention measures for OCD:

prevention of psychological trauma in personal life and professional activities;
proper upbringing of a child - from early childhood not to give reasons for thoughts about one’s own inferiority, superiority over others, not to provoke feelings of guilt and deep fear;
preventing conflicts within the family.

Methods of secondary prevention of OCD:

regular medical examination;
conversations with the aim of changing a person’s attitude towards situations that traumatize the psyche;
phototherapy, increasing room illumination ( Sun rays stimulates the production of serotonin);
general strengthening measures;
the diet provides for nutritious nutrition with a predominance of foods containing tryptophan (an amino acid for the synthesis of serotonin);
timely treatment of concomitant diseases;
prevention of any types of drug addiction.

PROGNOSIS FOR RECOVERY

Obsessive-compulsive disorder is chronic illness, for which complete recovery and episodicity are not characteristic or observed in rare cases.

When treating mild forms of the disease in an outpatient setting, the reverse development of symptoms is observed no earlier than 1-5 years after detection of the disease. Often the patient will still have some symptoms of the disease that do not interfere with their daily life.

More severe cases of the disease are resistant to treatment and are prone to recurrence. Aggravation of OCD occurs under the influence of overwork, lack of sleep and stress factors.

According to statistics, in 2/3 of patients improvement during treatment occurs within 6-12 months. In 60-80% of them it is accompanied by clinical recovery. Severe cases of obsessive-compulsive disorder are extremely resistant to treatment.

Improvement in the condition of some patients is associated with taking medications, so after stopping them, the likelihood of relapse increases significantly.

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Every person is visited by unpleasant or frightening thoughts, but while most can easily brush them aside, for some this is impossible.

Such people think about why such a thought occurred to them, returning to it again and again. They can only get rid of it by performing certain actions.

In psychiatry this is called obsessive-compulsive disorder (OCD) or, in foreign literature obsessive compulsive.

Obsessions are frightening thoughts, images or impulses that do not leave a person. Compulsions are certain actions that help temporarily eliminate obsessive thoughts and reduce anxiety. The condition can progress, causing the person to have more and more compulsions, and be chronic or episodic.

Frequent intrusive thoughts

The most common obsessions and corresponding compulsions:

Fear of contracting a disease or fear of germs. In order to prevent this, a person tries to wash his hands or take a shower as often as possible, wash his clothes, and thoroughly wash all surfaces with which he comes into contact. This can take many hours every day.
Fear of harming yourself or your loved ones. The patient tries not to be alone or with the person he believes could cause harm. Hides potentially dangerous things, such as knives, ropes, heavy objects.
Fear that the right thing won't be available. A person repeatedly checks his pockets and bags to see if he forgot to put documents, essential items or medicines.
Order and symmetry. It must be in a room where everything is in its place and subject to certain rules. They are very careful to ensure that even small objects melt into in a certain order, for example, arranged in height or symmetrically. And if someone touches or places a folder on the table incorrectly, the person experiences emotional stress.
Superstitions. A person may fear that he will have bad luck if he does not perform a certain ritual. Thus, an OCD patient, leaving the house, had to put on “lucky” shoes, look in the mirror twice and stick out his tongue at himself, and pull the door handle seventeen times. If something unpleasant happened to him, he increased the number of actions.
Thoughts that are prohibited by religion or morality. In order to drive away images or inappropriate thoughts, a person can read a prayer or take donations to the church, giving the last.
Thoughts of a sexual nature with elements of cruelty. A person tries to avoid intimacy out of fear of committing an unacceptable act towards a partner.

Clinical manifestations of OCD

Compulsive-obsessive disorder has characteristic symptoms:

thoughts should be perceived as your own, and not as a voice from above or another person;
the patient resists these thoughts and tries unsuccessfully to switch to others.
the thought that what is presented can happen frightens a person, makes him feel shame and guilt, causes tension and loss of activity;
the obsession is often repeated.

OCD in its purest form

OCD may be dominated by compulsions or obsessions, but so-called OCD in its pure form also occurs.

Sufferers admit that they have obsessive thoughts that conflict with their beliefs and values, but consider that they do not have compulsive behavior, i.e., no ritual actions. In order to get rid of thoughts that cause fear and shame, they can spend hours explaining to themselves why they should not pay attention to it.

When working through the problem, it turns out that they perform certain actions to get rid of tension. These actions are not obvious to others. This could be reciting a prayer or spell, counting, clicking joints, stepping from foot to foot, shaking your head.

Causes of the disorder

Impulsive compulsive disorder is thought to be caused by a combination of biological, social, and psychological factors.

Modern medicine is able to visualize the anatomy and physiology of the human brain. Research has shown that there are a number of significant differences in brain function in people with OCD.

There are differences in the connections of various parts, for example, the anterior part of the frontal lobe, the thalamus and striatum, and the anterior cingulate cortex.

Anomalies were also found in the transmission of nerve impulses between neuron synapses. Scientists have identified a mutation in the genes of serotonin and glutamate transporters. As a result of the anomaly, the neurotransmitter is processed even before it transmits an impulse to another neuron.

A quarter of people with the disorder have relatives with the same condition, suggesting genetics.

Group A streptococcal infection can cause OCD because it causes malfunction and inflammation of the basal ganglia.

Psychologists say that people who have developed obsessive-compulsive personality disorder have some thinking characteristics:

Confident that they can control everything, even your own thoughts. If a thought appeared, it means that it was in the subconscious and the brain had been thinking about it for a long time, and, accordingly, it is part of the personality.
Hyperresponsibility. A person is responsible not only for actions, but also for thoughts.
Belief in the materiality of thought. If a person imagines something terrible, then it will happen. He believes that he is capable of causing trouble.
Perfectionism. A person has no right to make a mistake. He must be perfect.

Compulsive personality disorder most often occurs in a person who was brought up in a family where parents controlled all areas of the child’s life, making excessive demands and demanding ideal behavior from him.

In the presence of the two components listed above, the impetus for the manifestation of the disorder can be a stressful situation, overwork, overexertion or abuse of psychotropic substances. Stress can be caused by moving, changing jobs, threats to life and health, divorce, or the death of a loved one.

The actions of a person with obsessive-compulsive disorder are cyclical.

First, a certain thought arises that frightens and makes you feel shame and guilt about it. Then there is a concentration on this thought against the will. The result is mental tension and increasing anxiety.

The human psyche finds a way to calm down by performing stereotypical actions that he thinks will save him. Thus, short-term relief occurs. But the feeling of his abnormality due to the thought that has arisen does not leave him and he returns to it again. The cycle takes on a new turn.

What influences the development of neurosis

The more often the patient resorts to ritual actions, the more dependent he becomes on them. It's like a drug.

Disorders are reinforced by avoidance of situations or actions that cause obsessions. A person, trying not to face a potentially dangerous situation, still thinks about it and becomes convinced of his abnormality.

The situation can be aggravated by the behavior of loved ones who call the person suffering from the disorder crazy or forbid them to perform the ritual.

After all, if he is crazy, then he really can carry out the actions that he is so afraid of. And imposing a ban on compulsions leads to an increase in anxiety. But the opposite situation also happens, when relatives are involved in the performance of the ritual, thereby confirming its necessity.

Diagnosis and treatment

The symptoms of obsessive-compulsive disorder are similar to those of schizophrenia. Therefore, a differential diagnosis needs to be made. Especially if the obsessive thoughts are unusual and the compulsions are eccentric. The important thing is whether thoughts are perceived as your own or as imposed.

Depression is also often accompanied by OCD. If they are equally strong, then it is recommended that depression be considered primary.

The obsessive compulsive disorder test or Yale-Brown scale is used to determine the severity of the symptoms of the disorder. It consists of two parts of five questions: the first part allows you to understand how often obsessive thoughts appear and whether they can be attributed to OCD; the second part analyzes the impact of compulsions on everyday life.

If obsessive and compulsive disorder is not very pronounced, then a person can try to cope on his own. To do this, you need to learn to switch your attention to other actions. For example, start reading a book.

Postpone the ritual for 15 minutes, and gradually increase the delay time and reduce the number of ritual actions. This way you will understand that you can calm down without performing stereotypical actions.

If the severity is moderate or higher, you need to seek help from any of the specialists: psychotherapist, psychologist, psychiatrist.

If the disorder is severe, the psychiatrist will make a diagnosis and prescribe medication. Medications are prescribed to alleviate the condition - serotonin reuptake antidepressants or selective serotonin reuptake inhibitors. Atypical ones are also used to control symptoms. They will help you calm down and reduce anxiety.

However, drug treatment for compulsive obsessive disorder does not have a permanent effect. After the end of the reception drugs OCD is back. The most effective way is psychotherapy. With its help, almost 75% of those who seek help recover.

A psychotherapist may offer: cognitive behavioral psychotherapy, exposure, hypnosis.

Exposure with response prevention techniques are effective for OCD. It lies in the fact that a person, faced with his experiences in a controlled situation, learns to cope with them without the usual reaction of avoidance.

So, to treat a person with a fear of germs, they may suggest touching a subway handrail or an elevator button and not washing your hands for as long as possible. The tasks are gradually becoming more complicated and they are asked to reduce the number of actions and the duration of the ritual. uh

Over time, the patient gets used to it and stops being afraid. However, not everyone can handle this technique. More than half of patients refuse it due to strong feelings.

Cognitive therapy helps the patient see the irrationality of his fears, dismantle his way of thinking and realize that it is wrong. Teaches effective ways switching attention and adequately responding to obsessive thoughts without the use of ritual.

Family therapy can help the patient. Thanks to it, family members will be able to better understand the causes of the disorder and learn how to behave correctly if obsessions begin. After all, close people can both help cope with the problem and cause harm with their behavior.

Group psychotherapy will provide support and approval, and reduce feelings of inferiority. The success of a fellow sufferer is highly motivating. And the person understands that he can cope with the problem.

May trouble pass everyone by

Obsessive compulsive disorder can and should be stopped at the approaches to mental and neurological health, for this it is necessary:

using techniques to combat stress;
timely rest, avoid overwork;
timely resolution of intrapersonal conflicts.

OCD is not a mental illness because it does not lead to personality changes; it is a neurotic disorder. It is reversible and with proper treatment disappears completely.