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

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

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

Obsessive thoughts fill his entire being, giving rise to anxiety and fear. This happens because some object, a person, becomes important and valuable to him. At the same time, the environment appears too dangerous.

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

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

The obsession and compulsion component form an OCD attack. In principle, we can talk about the cyclical nature of pathology: the appearance of an obsessive thought leads to filling it with meaning and the emergence of fear, which, in turn, causes certain defensive actions. After completing these movements, a period of calm begins. After some time, the cycle starts again.

When obsessive thoughts and ideas are predominantly present, they speak of intellectual obsessive-compulsive disorder. The predominance of obsessive movements indicates motor pathology. Emotional disorder is associated with the presence of constant fears that turn into phobias. ABOUT mixed syndrome spoken when obsessive movements, thoughts or fears are detected. Although all three components are part of the disorder, categorizing the predominance of one has implications for treatment decisions.

The frequency of symptoms makes it possible to distinguish a pathology with an attack that occurred only once, regularly occurring incidents and a constant course. In the latter case, it is impossible to distinguish between periods of health and pathology.

The nature of obsession affects the characteristics of the disease:

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

Causes

Today there is no clear and unambiguous reason why obsessive-compulsive disorders develop. Hypotheses are identified, most of which seem logical and reasonable. They are divided into groups: biological, psychological and social.

Biological

One of the well-known theories is the neurotransmitter theory. The basic idea is that in obsessive-compulsive disorder, too much serotonin is taken up into the neuron. The latter is a neurotransmitter. It is involved in the transmission of nerve impulses. As a result, the impulse cannot reach the next cell. This hypothesis is proven by the fact that when taking antidepressants, the patient feels better.

Another neurotransmitter hypothesis relates to dopamine excess and dependence. Being able to resolve a situation related to an obsessive thought or emotion leads to “pleasure” and increased production dopamine.

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

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

Psychological

The nature of obsessive-compulsive disorder has been examined by psychologists of various directions. Thus, S. Freud associated it mainly with the unsuccessful passage of the anal stage of development. Feces at that moment were considered something valuable, which ultimately led to a passion for accumulation, neatness and pedantry. He connected obsession directly with the system of prohibitions, rituals and the “omnipotence of thought.” Compulsion, from his point of view, is associated with a return to the experienced trauma.

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

Cognitive psychology emphasizes mental activity and the fear of making up meaning. It arises due to a feeling of hyper-responsibility, a tendency to overestimate danger, perfectionism and the belief that thoughts can come true.

Social

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

Symptoms

The following symptoms indicate obsessive-compulsive disorder:

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

Adults in some cases realize the groundlessness of their fears, thoughts, and the meaninglessness of their actions, but they cannot help themselves. The patient loses control over his thoughts and actions.

In children, the disorder is extremely rare. It most often appears after 10 years. Associated with the fear of losing something. A child, afraid of losing his family, tends to constantly clarify whether his mother or father loves him. He is afraid of getting lost himself, so he holds his parents’ hands tightly. The loss of any item at school or the fear of it forces the child to double-check the contents of his backpack and wake up at night.

Obsessive-compulsive disorder may be accompanied by nightmares, tearfulness, moodiness, dejection, and loss of appetite.

Diagnostics

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

Testing is based on the Yale-Brown obsessive-compulsive scale. Half of its items assess how severe obsessions are, the other half helps analyze the severity of actions. The scale is completed during the interview based on the manifestation of symptoms for last week. The level of psychological discomfort, the duration of symptoms during the day, the impact on the patient’s life, the ability to resist symptoms and exercise control over them are analyzed.

The test determines 5 various degrees disorders - from subclinical to extremely severe.

The disease is differentiated from depressive disorders. If you have symptoms of schizophrenia, organic disorders, neurological syndromes obsession is considered part of these diseases.

Treatment

The main methods of treating obsessive-compulsive disorder are psychotherapy, the use of medications, and physical therapy.

Psychotherapy

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

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

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

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

Within the framework of psychoanalysis, the doctor and the patient discover the causes of experiences and rituals, and work out ways to free themselves from them.

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

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

Medicines

Treatment of severe obsessive-compulsive disorder is recommended using medicines. They complement, but do not replace, psychotherapy methods. The following groups of drugs are used:

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

Physiotherapy

It is recommended to take various water procedures. These are warm baths with a cold compress on the head for 20 minutes. They are taken up to 3 times a week. It is useful to wipe with a towel soaked in cold water, dousing. It is recommended to swim in the sea or river.

Forecast

Obsessive-compulsive disorder is chronic pathology. Usually, the use of any treatment stops and softens its manifestations. Disease in the lungs and medium degree it is possible to cure, but in the future in some emotionally difficult situations exacerbation is possible.

The severe disorder is difficult to treat. Relapses are likely.

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

Prevention

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

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

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

Are you still carrying hand sanitizer? Is your wardrobe organized in every sense in your closet? Such habits may simply be a reflection of personality or beliefs, but sometimes they cross an invisible line and become obsessive-compulsive disorder (OCD), which affects almost 1% of Americans.

How to distinguish a habit from medical diagnosis requiring specialist help? The task is not easy, says Professor Jeff Zymanski. But some symptoms indicate a problem openly.

Frequent hand washing

Obsessive urges to wash hands or use hand sanitizer are common among OCD sufferers, so much so that they have even been identified as separate category"washers". The main reason for obsessive hand washing is the fear of bacteria, and less often, the desire to protect others from one’s own “uncleanness.”

When to ask for help: If you can't forget about germs even after washing your hands, are afraid that you didn't wash them thoroughly enough, or that you might have contracted AIDS from a supermarket cart, there's a good chance you're one of the "washers." Another a clear sign- rituality of washing: you think that you should soap and rinse your hands five times, while soaping each individual nail.

Obsession with cleaning

People with OCD and a passion for handwashing often go to another extreme: they become obsessed with cleaning the house. The reason for this obsessive state is also germophobia or the feeling of “uncleanness”. Although cleaning relieves germ anxiety, the effects don't last long and the urge to clean again becomes stronger than before.

When to ask for help: If you spend several hours every day cleaning your home, there's a good chance you have obsessive-compulsive disorder. If satisfaction from cleaning occurs within 1 hour, it will be more difficult to make a diagnosis.

Obsessive checking of actions

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

When to ask for help: It's perfectly reasonable to double check something important. But if obsessive checking interferes with your life (you start being late for work, for example) or takes on a ritual form that you cannot break, you may be a victim of OCD.

An inexplicable desire to count

Some people with obsessive-compulsive disorder attach great importance to counting and count everything that catches their eye: the number of steps, the number of red cars passed, etc. Often the reason for counting is superstition, fear of failure if some action is not performed a certain “magic” number of times.

When to ask for help:“It all depends on the context,” explains Rzymanski. - Does this behavior make sense for you? Counting steps from the door to the car, for example, can be done out of boredom. But if you can’t get rid of the numbers in your head and the constant counting, it’s time to turn to a specialist.”

Total organization

People with obsessive-compulsive disorder are capable of perfecting the art of organization. Things on the table should lie smoothly, clearly and symmetrically. Always.

When to ask for help: If you want your desk to be clean, neat and organized, it may be easier for you to work this way, and you are doing this out of a completely normal need for order. People with OCD may not need this, but still organize the surrounding reality, which otherwise begins to frighten them.

Fear of trouble

Everyone has anxious thoughts about a possible unpleasant incident or violence. And the harder we try not to think about them, the more persistently they appear in our heads, but for people with OCD, fear goes to the extreme, and the troubles that happen cause too strong a reaction.

When to ask for help: It is important to set the line between periodic unpleasant thoughts and fears and excessive worries. OCD is possible if you avoid, for example, walking in the park for fear of being robbed, or calling several times a day dear person to inquire about his safety.

Obsessive thoughts of a sexual nature

Just like thoughts of violence, obsessive-compulsive disorder often involves intrusive thoughts about inappropriate behavior or taboo desires. Those suffering from OCD may, against their will, imagine themselves harassing co-workers or strangers, or begin to doubt their sexual orientation.

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

Unhealthy relationship analysis

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

When to ask for help: Breaking up with a loved one may get stuck in your head, which is normal, but if these thoughts snowball over time, developing into a complete erosion of self-confidence and negative attitude to yourself - it’s worth asking for help.

Finding support

Those suffering from obsessive-compulsive disorder often try to relieve their pain with support from friends and family. If, for example, they are afraid of messing up at a party, then they ask their friends to “rehearse” in advance possible situation, and more than once.

When to ask for help: Asking friends for help is a completely normal part of friendship, but if you find yourself regularly asking the same question - or friends telling you so - it could be a sign of OCD. Worse, receiving approval and support from loved ones can worsen the manifestation of this obsessive state. It's time to turn to professionals.

Dissatisfaction with your appearance

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

When to ask for help: It's completely normal to not be excited about some part of your body. It’s another matter when you spend hours in front of the mirror, looking at and criticizing this place.

Obsessive-compulsive disorder is a syndrome whose causes are rarely obvious. It is characterized by the presence of obsessive thoughts (obsessions), to which a person responds with certain actions (compulsions).

Obsession (lat. obsessio - “siege”) is a thought or desire that constantly pops up in the mind. This thought is difficult to control or get rid of, and it causes a lot of stress.

Common obsessions in OCD are:

• fear of contamination (from dirt, viruses, germs, body fluids, excrement or chemicals);
• concerns about possible dangers(external, for example, fear of being robbed and internal, for example, fear of losing control and harming someone close to you);
• excessive concern about precision, order, or symmetry;
• sexual thoughts or images.

Almost everyone has experienced these intrusive thoughts. However, for a person with OCD, the level of anxiety from such thoughts is off the charts. And in order to avoid too much anxiety, a person is often forced to resort to some “protective” actions - compulsions (Latin compello - “to force”).

Compulsions in OCD are somewhat reminiscent of rituals. These are actions that a person repeats over and over again in response to an obsession in order to reduce the risk of harm. The compulsion can be physical (like repeatedly checking to see if a door is locked) or mental (like saying a certain phrase in your head). For example, this could be uttering a special phrase to “protect relatives from death” (this is called “neutralization”).

Common in OCD syndrome are compulsions in the form of endless checks (for example, gas taps), mental rituals (special words or prayers repeated in a prescribed order), and counting.

The most common is fear of germs combined with compulsive washing and cleaning. Because of the fear of getting infected, people go to great lengths: they do not touch door handles, toilet seats, and avoid shaking hands. Typically, with OCD syndrome, a person stops washing his hands not when they are clean, but when he finally feels “relief” or “right.”

Avoidance behavior is a central part of OCD and includes:

1. desire to avoid situations evoking feelings anxiety;
2. the need to perform compulsive actions.

Obsessive-compulsive disorder can cause many problems and is usually accompanied by shame, guilt and depression. The disease creates chaos in human relationships and affects performance. According to WHO, OCD is one of the ten diseases leading to disability. People with OCD syndrome don't apply for professional help, because they are embarrassed, afraid or do not know that their illness can be treated, incl. non-medicinal.

What Causes OCD

Despite many studies on OCD, it is still impossible to say for sure what is the main cause of the disorder. Physiological factors may be responsible for this condition (disturbance of the chemical balance in nerve cells), and psychological. Let's look at them in detail.

Genetics

Research has shown that OCD can be passed down through generations to close relatives, in the form of a greater tendency to develop painful obsessive states.

A study of adult twins showed that the disorder is moderately hereditary, but no single gene has been identified as causing the condition. However special attention deserve genes that could play a role in the development of OCD: hSERT and SLC1A1.

The task of the hSERT gene is to collect “waste” serotonin in nerve fibers. Recall that the neurotransmitter serotonin is necessary for the transmission of impulses in neurons. There are studies that support unusual hSERT mutations in some obsessive-compulsive disorder patients. As a result of these mutations, the gene begins to work too quickly, collecting all the serotonin before the next nerve “hears” the signal.

SLC1A1 is another gene that may be involved in obsessive-compulsive disorder. This gene is similar to hSERT, but its responsibilities include transporting another neurotransmitter - glutamate.

Autoimmune reaction

Some cases of rapid onset of OCD in children can be a consequence of Group A streptococcal infection, which causes inflammation and dysfunction of the basal ganglia. These cases are grouped into clinical conditions, which are called PANDAS (pediatric autoimmune neuropsychiatric disorders associated with streptococcal infections).

Another study suggested that the episodic occurrence of OCD is not due to streptococcal infection, but rather to prophylactic antibiotics that are prescribed to treat infections. OCD conditions may also be associated with immunological reactions to other pathogens.

Neurological problems

Brain imaging techniques have allowed researchers to study the activity of specific areas of the brain. Some parts of the brain have been shown to have unusual activity in OCD sufferers. OCD symptoms involved are:

• orbitofrontal cortex;
• anterior cingulate gyrus;
• striatum;
• thalamus;
• caudate nucleus;
• basal ganglia.

The circuit involving the above areas regulates primitive behavioral aspects such as aggression, sexuality and bodily secretions. Activation of the circuit triggers appropriate behavior, such as washing hands thoroughly after touching something unpleasant. Normally, after the necessary act, the desire decreases, that is, the person stops washing his hands and moves on to another activity.

However, in patients diagnosed with OCD, the brain has some difficulty turning off and ignoring the urges from the circuit, which creates communication problems in these areas of the brain. Obsessions and compulsions continue, leading to repetition of certain behaviors.

The nature of this problem is not yet clear, but it is most likely associated with a violation of brain biochemistry, which we talked about earlier (reduced activity of serotonin and glutamate).

Causes of OCD from the point of view of behavioral psychology

According to one of the fundamental laws of behavioral psychology, repetition of a particular behavioral act makes it easier to reproduce it in the future.

All people with OCD do is try to avoid things that can trigger fear, “fight” thoughts, or perform “rituals” to reduce anxiety. Such actions temporarily reduce fear, but paradoxically, according to the law stated above, they increase the likelihood of obsessive behavior occurring in the future.

It turns out that avoidance is the cause of obsessive-compulsive disorder. Avoiding the object of fear instead of enduring it can lead to dire consequences.

People most susceptible to developing pathology are those who are in under stress: begin new job, end relationships, suffer from overwork. For example, a person who has always calmly used public restrooms suddenly, in a state of stress, begins to “wind up” himself, saying that the toilet seat is dirty and there is a danger of contracting an illness... Further, by association, fear can spread to other similar objects: public sinks, showers, etc.

If a person avoids public toilets or begins to perform complex cleansing rituals (cleaning seats, door handles, followed by a thorough hand washing procedure) instead of coping with fear, this may result in the development of a real phobia.

Cognitive Causes of OCD

The behavioral theory described above explains the occurrence of pathology with “wrong” behavior, while the cognitive theory explains the occurrence of OCD with the inability to correctly interpret one’s thoughts.

Most people experience unwanted or intrusive thoughts several times a day, but all sufferers greatly exaggerate the importance of these thoughts.

For example, against the background of fatigue, a woman who is raising a child may periodically have thoughts about harming her baby. The majority, of course, brushes aside such obsessions and ignores them. People suffering from OCD exaggerate the importance of thoughts and react to them as a threat: “What if I’m really capable of this?!”

The woman begins to think that she could become a threat to the child, and this causes her anxiety and other negative emotions, such as disgust, guilt and shame.

Fear of one's own thoughts may lead to attempts to neutralize the negative feelings arising from obsessions, for example, by avoiding situations that trigger the corresponding thoughts, or by participating in "rituals" of excessive self-purification or prayer.

As we noted earlier, repeated avoidance behavior can become “stuck” and tend to repeat itself. It turns out that the cause of obsessive-compulsive disorder is the interpretation of intrusive thoughts as catastrophic and true.

Researchers theorize that OCD sufferers attach exaggerated importance to thoughts due to false beliefs learned in childhood. Among them:

• exaggerated responsibility: the belief that a person bears overall responsibility for the safety of others or harm caused to them;
• belief in the materiality of thoughts: the belief that negative thoughts can “come true” or influence other people and must be controlled;
• exaggerated sense of danger: tendency to overestimate the likelihood of danger;
• exaggerated perfectionism: the belief that everything must be perfect and mistakes are unacceptable.

Environment, distress

Stress and psychological trauma can trigger the process of OCD in people who are prone to developing this condition. Studies of adult twins have shown that obsessive-compulsive neurosis in 53-73% of cases arose due to adverse environmental influences.

Statistics confirm the fact that most people with OCD symptoms experienced a stressful or traumatic life event just before the onset of the disease. Such events may also cause existing symptoms of the disorder to worsen. Here is a list of the most traumatic environmental factors:

• abuse and violence;
• change of housing;
• disease;
• death of a family member or friend;
• changes or problems at school or work;
• relationship problems.

What contributes to the progression of OCD?

For effective treatment Obsessive-compulsive disorder, knowledge of the reasons that caused the pathology is not so important. It is much more important to understand the mechanisms that support OCD. This is the key to overcoming the problem.

Avoidance and compulsive rituals

Obsessive-compulsive disorder is perpetuated by a vicious cycle of compulsion, anxiety, and response to the anxiety.

Whenever a person avoids a situation or action, the behavior becomes “hardwired” into a corresponding neural circuit in the brain. The next time in a similar situation, he will act in the same way, which means he will again miss the chance to reduce the intensity of his neurosis.

Compulsions are also reinforced. A person feels less anxious after checking that the lights are off. Therefore, it will act the same way in the future.

Avoidance and impulsive actions “work” at first: the patient thinks that he has prevented harm, and this stops the feeling of anxiety. But in the long run they will create even more anxiety and fear because they feed the obsession.

Exaggerating your capabilities and “magical” thinking

A person with OCD over-exaggerates their capabilities and ability to influence the world. He believes in his power to cause or prevent bad events with the power of thought. "Magical" thinking involves the belief that the fulfillment of certain special actions, rituals, will prevent something unwanted (similar to superstition).

This allows a person to feel the illusion of comfort, as if he has more influence over events and control over what is happening. As a rule, the patient, wanting to feel calmer, performs rituals more and more often, which leads to the progression of neurosis.

Excessive concentration on thoughts

This refers to the degree of importance a person places on intrusive thoughts or images. It is important to understand here that obsessive thoughts and doubts - often absurd and opposite to what a person wants or does - appear in everyone! In the 1970s, researchers conducted experiments in which they asked people with and without OCD to list their intrusive thoughts. There was no difference between the thoughts recorded by both groups of subjects - with and without the disease.

The actual content of intrusive thoughts comes from a person's values: the things that matter most to him. Thoughts represent a person's deepest fears. So, for example, any mother always worries about the health of her child, because he is the greatest value in her life, and she will be in despair if something bad happens to him. This is why obsessive thoughts about harming the child are so common among mothers.

The difference is that people with obsessive-compulsive disorder experience distressing thoughts more often than others. But this happens due to too much significance that patients attribute to these thoughts. It's no secret: the more attention you pay to your obsessive thoughts, the worse they seem. Healthy people They can simply ignore obsessions and not concentrate their attention on them.

Overestimation of danger and intolerance of uncertainty

Another important aspect is overestimating the danger of the situation and underestimating your ability to cope with it. Many OCD sufferers believe that they need to know for sure that bad things won't happen. For them, OCD is a kind of absolute insurance policy. They think that if they try harder and do more rituals and better insurance, they will get more certainty. In reality, trying harder only leads to more doubt and a greater sense of uncertainty.

Perfectionism

Some forms of OCD involve the belief that there is always a perfect solution, that everything should be done perfectly, and that the slightest mistake will have consequences. serious consequences. This is common in people with OCD who seek order, and is especially common in those with anorexia nervosa.

Looping

As they say, fear has big eyes. There are typical ways to “wind up” yourself and increase anxiety with your own hands:

• “Everything is terrible!” ‒ means the tendency to describe something as “terrible”, “nightmarish” or “the end of the world”. It only makes the event seem more frightening.
• "Catastrophe!" - means expecting a catastrophe as the only possible outcome. The idea that something catastrophic will happen if it is not prevented.
• Low tolerance for disappointment - when any excitement is perceived as “unbearable” or “intolerable.”

In OCD, a person first involuntarily plunges himself into a state of extreme anxiety due to his obsessions, then tries to escape from them by suppressing them or performing compulsive actions. As we already know, it is precisely this behavior that increases the frequency of obsessions.

Treatment of OCD

Research shows that psychotherapy significantly helps 75% of patients with obsessive-compulsive disorder. There are two main ways to treat neurosis: medications and psychotherapy. They can also be used together.

Nevertheless, non-drug treatment preferable, since OCD can be easily corrected without medication. Psychotherapy does not provide side effects on the body and has a more sustainable effect. Medication may be recommended as treatment if the neurosis is severe, or as a short-term measure to relieve symptoms while you begin psychotherapy.

Cognitive behavioral psychotherapy (CBT), short-term strategic psychotherapy, and also are used to treat obsessive-compulsive disorder.

Exposure—the controlled confrontation with fear—is also used in the treatment of OCD.

The first effective psychological method The technique of confrontation with parallel suppression of the anxiety reaction has been recognized in the fight against OCD. Its essence lies in a carefully dosed confrontation with fears and obsessive thoughts, but without the usual reaction of avoidance. As a result, the patient gradually gets used to them, and fears begin to fade away.

However, not everyone feels able to undergo such treatment, so the technique has been refined through CBT, which focuses on changing the meaning of intrusive thoughts and urges (the cognitive part), as well as changing the response to the urge (the behavioral part).

Obsessive-compulsive disorder: causes

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Are you still carrying hand sanitizer? Is your wardrobe literally sorted into shelves? Such habits may be a reflection of a person's character or beliefs. Sometimes they cross an invisible line and become obsessive-compulsive disorders (OCD). Let's look at the main reasons for their appearance and the treatment methods offered by doctors.

Description of the disease

OCD is a mental disorder that affects a person's quality of life. Experts classify it as a phobia. If the latter include only obsessions, then compulsions are added to OCD.

The name of the disease comes from two English words: obsessio and compulsio. The first means "obsession with an idea", and the second can be interpreted as "compulsion". These two words were chosen successfully and succinctly, since they reflect the entire essence of the disease. People suffering from OCD are considered disabled in some countries. Most of them spend a lot of time mindlessly due to compulsions. Obsessions are often expressed as phobias, which also negatively affects the patient’s quality of life.

How does the disease begin?

According to medical statistics, obsessive-compulsive disorder develops between 10 and 30 years. Regardless of when exactly its first symptoms appeared, patients turn to the doctor between 27 and 35 years of age. This means that several years pass from the development of the disease to the start of treatment. Obsessive-compulsive personality disorder affects one in three adults. There are far fewer small children among the patients. This diagnosis is confirmed in every second child out of 500.

On initial stage symptoms of the disease manifest themselves in the form of obsessive states and various phobias. During this period, a person may still be aware of their irrationality. Over time, in the absence of medication and psychological assistance, the disorder worsens. The patient loses the ability to adequately evaluate his fears. IN advanced cases treatment involves hospitalization with the use of serious medications.

Main reasons

Scientists still cannot list the main factors contributing to the occurrence of mental illness. However, there are a large number of theories. According to one of them, among biological factors Obsessive-compulsive disorder has the following causes:

• metabolic disorder;
• head injuries and injuries;
• hereditary predisposition;
• complicated course of infectious diseases;
• deviations at the level of the autonomic nervous system.

IN separate group Doctors suggest introducing social causes of the disorder. Among them, the most common are the following:

• upbringing in a strict religious family;
• difficult relationships at work;
• frequent stress.

The inherent nature of this mental illness may be based on personal experience or imposed by society. A striking example The consequences of such a disorder is viewing crime news. A person tries to overcome emerging fears with actions that convince them of the opposite. He can double-check a locked machine or count banknotes several times. Such actions bring only short-term relief. It is unlikely that you will be able to get rid of it on your own. In this case, the help of a specialist is required. Otherwise, the disease will completely consume the human psyche.

Both adults and children are susceptible to this disease. However, children are less likely to suffer from its manifestations. Symptoms of the disorder may vary depending on the patient's age.

How does the disease manifest in adults?

Obsessive-compulsive disorder, the symptoms of which will be presented to your attention below, has approximately the same level in all adults. clinical picture. First of all, the disease manifests itself in the form of obsessive, painful thoughts. These may include fantasies about sexual violence or fatal outcome. A person is constantly haunted by the idea of ​​imminent death, loss of financial well-being. Such thoughts terrify the OCD sufferer. He clearly understands their groundlessness. However, he cannot independently cope with fears and superstitions that all his fantasies will one day come true.

The disorder also has external symptoms, which are expressed in the form of repetitive movements. For example, such a person can constantly count the steps and wash his hands several times a day. Manifestations of the disease are often noted by colleagues and co-workers. People suffering from OCD always have perfect order on their desks, with all objects arranged symmetrically. Books on the shelves are arranged either alphabetically or by color.

Obsessive-compulsive disorder is characterized by a tendency to worsen in crowded places. The patient may experience increased panic attacks even in a crowd. Most often, they are caused by the fear of catching a dangerous virus or losing personal belongings, becoming another victim of pickpockets. Therefore, such people tend to avoid public places.

Sometimes the syndrome is accompanied by a decrease in self-esteem. OCD is a disorder that is especially susceptible to suspicious individuals. They have a habit of controlling everything, from things at work to the diet of their pets. A decrease in self-esteem occurs due to awareness of the changes taking place and the inability to fight them.

Symptoms in children

OCD is less common in young patients than in adults. The symptoms of the disorder have many similarities. Let's look at a few examples.

1. Even old enough children are often haunted by the fear of getting lost among large quantity people on the street. He forces the children to hold their parents' hands tightly and periodically check whether their fingers are clasped tightly.
2. Many children are scared by older brothers and sisters of being sent to an orphanage. The fear of ending up in this institution forces the child to constantly ask whether his parents love him.
3. Almost all of us have lost personal belongings at least once in our lives. However, not everyone’s worries about this pass without leaving a trace. Panic over a lost notebook often leads to manic counting of school supplies. Teenagers may even wake up at night to double-check all their personal belongings.

Obsessive-compulsive disorder in children is often accompanied by bad mood, gloominess, and increased tearfulness. Some people lose their appetite, others are tormented by terrible nightmares at night. If within several weeks all attempts by parents to help their child are unsuccessful, a consultation with a child psychologist is needed.

Diagnostic methods

If you experience symptoms that indicate anxiety obsessive-compulsive disorder, you should seek help from a professional in the field. mental health. Often people with OCD are unaware of their problems. In this case, close relatives or friends should very carefully hint at this diagnosis. This disease does not go away on its own.

Its diagnosis can only be made by a psychiatrist who has the appropriate qualifications and experience in this field. Usually the doctor pays attention to three things:

1. The person has pronounced obsessive obsessions.
2. There is compulsive behavior that he wants to hide in any way.
3. OCD interferes with the usual rhythm of life, communication with friends and work.

To be medically significant, symptoms must recur on at least 50% of days within two weeks.

There are special rating scales (for example, Yale-Brown) to determine the severity of OCD. They are also used in practice to track the dynamics of therapy.

Based on the tests performed and a conversation with the patient, the doctor can confirm the final diagnosis. Typically, during a consultation, psychotherapists explain what obsessive-compulsive disorder is and what manifestations it has. Examples of patients with this disease from show business help to understand that the disease is not so dangerous, it needs to be fought. Also during the consultation, the doctor talks about treatment tactics and when to expect the first positive results.

Can a person help himself?

OCD is a fairly common pathology. It can occur periodically in any person, including absolutely healthy mentally. It is very important to be able to recognize the first symptoms of the disorder and seek help. qualified assistance. If this is not possible, you should try to analyze the problem and choose a specific tactic to combat it. Doctors offer several options for self-treatment.

Step 1: Learn what obsessive-compulsive disorder is. Obsessive-compulsive disorder is described in detail in the specialized literature. Therefore, anyone can easily find out its main causes and symptoms. After studying the information, you need to write down all the symptoms that have recently caused concern. Opposite each disorder you need to leave a place for composing detailed plan how it can be overcome.

Step 2. Third party help. If you suspect OCD, it is better to contact qualified specialist. Sometimes the first visit to the doctor is difficult. In such a situation, you can ask a friend or relative to confirm the previously written symptoms or add others.

Step 3. Look your fears in the eye. People with obsessive-compulsive disorder usually understand that all fears are imaginary. Every time you feel the urge to double-check a locked door or wash your hands, you need to remind yourself of this fact.

Step 4. Reward yourself. Psychologists advise constantly marking steps on the path to success, even the most insignificant ones. You need to praise yourself for the changes you have made and the skills you have acquired.

Psychotherapy methods

OCD is not a death sentence. The disorder responds well to treatment through psychotherapeutic sessions. Modern psychology offers several effective techniques. Let's look at each of them in more detail.

1. The author of this technique belongs to Jeffrey Schwartz. Its essence boils down to resistance to neurosis. A person first realizes the presence of a disorder, and then gradually tries to fight it. Therapy involves acquiring skills that allow you to independently stop obsessions.
2. “Thought stopping” technique. It was developed by Joseph Volpe. The psychotherapist proposed treatment based on the patient's assessment of the situation. To do this, Wolpe recommends that the person remember one of the recent attacks of the disorder. Using leading questions, he helps the patient assess the significance of the symptoms and their impact on daily life. The psychotherapist gradually leads to the realization that fears are unrealistic. This technique allows you to completely overcome the disorder.

The given therapeutic techniques are not the only ones of their kind. However, they are considered the most effective.

Drug treatment

In advanced cases of obsessive-compulsive disorder, drug intervention is required. How to treat obsessive-compulsive disorder in this case? The main drugs to combat the disease are serotonin reuptake inhibitors:

• "Fluvoxamine."
• Tricyclic antidepressants.
• "Paroxetine."

Scientists from all over the world continue to actively study obsessive-compulsive disorders (OCD). Relatively recently, they were able to discover therapeutic opportunities in agents that are responsible for the release of the neurotransmitter glutamate. They can significantly mitigate the manifestations of neurosis, but do not help get rid of the problem forever. Fit this description the following drugs: Memantine (Riluzole), Lamotrigine (Gabapentin).

Everyone known antidepressants in this disorder they are used only as a means of using them to eliminate neurosis and stress that arise against the background of obsessive states.

It is worth noting that the medications listed in the article are dispensed from pharmacies only with a prescription. The choice of a specific medication for treatment is made by the doctor, taking into account the patient’s condition. The duration of the syndrome plays an important role in this matter. Therefore, the doctor must know how long ago the obsessive-compulsive disorder appeared.

Treatment at home

OCD belongs to the group mental illness. Therefore, it is unlikely that it will be possible to cure the disorder without outside support. However, therapy with folk remedies always helps to calm down. For this purpose, healers advise preparing herbal decoctions with sedative properties. These include the following plants: lemon balm, motherwort, valerian.

Method breathing exercises cannot be considered folk, but it can be successfully used at home. This treatment does not require a prescription or outside specialist support. Therapy by changing the force of breathing allows you to restore emotional condition. As a result, a person can soberly assess everything that happens in his life.

Rehabilitation

After the course of treatment, the patient needs social rehabilitation. Only in case of successful adaptation to society will the symptoms of the disorder not return again. Supportive therapeutic activities are aimed at teaching productive contact with society and relatives. At the rehabilitation stage, help from relatives and friends is of paramount importance.

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