Compulsive disorder, or obsessive-compulsive disorder (OCD), affects 1 to 3% of people. Predisposition to the disease is largely determined by hereditary factors, but in young children, symptoms are practically not manifested. In most cases, OCD is first diagnosed between the ages of 10 and 30.
Today we will talk about those signs that may indicate that a person has an obsessive-compulsive disorder syndrome.
People with OCD often have an exaggerated fear of infection. The consequence of a phobia becomes too frequent washing hands At the same time, the process is associated with a number of strange actions. For example, a person lathers his palms a strictly defined number of times or rubs each finger from all sides, always in the same order. As a result, a routine hygiene procedure turns into a strictly regulated ritual. The inability to perform all actions in the usual order causes anxiety and irritation in the patient.
Exaggeration of the risk of infection in OCD is manifested by an obsessive desire to clean the premises as often as possible. The patient constantly experiences discomfort: all the surrounding objects seem to him not clean enough. If a person washes floors several times a day, is eager to check all surfaces for dust, unnecessarily uses strong disinfectants- is a wake-up call.
In some people with obsessive-compulsive disorder, the morbid desire for cleanliness is manifested by the fear of touching various objects (for example, the patient refuses to press the buttons in the elevator or opens the doors with his elbows so as not to touch them with his hands). Sometimes patients are not able to do their usual activities, seeing the dishes left on the table or crumpled napkins.
Each of us at least once found ourselves in a situation where, after leaving the house, he could not remember whether he locked the front door. This usually happens when we think and get distracted from the actions performed automatically. This kind of distraction is the norm. You can talk about pathology if a person ceases to trust himself and is afraid of the consequences of losing control over a familiar situation.
People with OCD experience this kind of anxiety all the time. To protect themselves and calm down, they form numerous rituals related to rechecking their own actions. When leaving the house, a person can count out loud the number of turns of the key, pull the locked door the “necessary” number of times, go around the apartment along a strictly defined route, checking that there are no electrical appliances turned on, etc.
The obsessive-compulsive disorder syndrome can manifest itself as a pathological tendency to count. The patient constantly counts the objects around him: steps in the entrance, steps that he takes on the usual path, cars of a certain color or brand. At the same time, the action itself often has a ritual character or is associated with irrational hopes and fears. For example, a person gains unreasonable confidence in the future good luck if the account "converged", or begins to fear the harmful consequences of not having time to count some objects.
The OCD patient organizes around him a strictly regulated order. This is especially noticeable in everyday life. A sign of pathology is not so much the habit of arranging everything necessary items in a certain way, how inadequately sharp, painful reaction to any violation of the once and for all worked out layout.
If your relative or friend refuses to sit down at the table after noticing that the fork is at an angle to the plate, throws a rowdy tantrum over shoes placed a few inches further from the sofa than usual, or cuts an apple into perfectly even slices every time, he should seek medical advice.
Life's troubles do not please anyone, but usually people solve problems in order of arrival. The OCD sufferer is overly anxious about troubles that may happen in the future. At the same time, his behavior is dominated not by the desire to take real steps in advance that can prevent the onset of an unpleasant situation, but by irrational fear. He prefers ritual actions that are in no way connected with the essence of the problem, but supposedly capable of influencing the development of events (arrangement of objects in the "correct" order, "happy" counts, etc.).
A sign of pathology is also a specific reaction to the attempts of others to calm the patient by analyzing the situation and giving advice on preventing trouble. As a rule, sympathy and a desire to help cause mistrust and rejection.
A patient with OCD may be haunted by sexual fantasies of a perverse nature, often directed at people with whom the patient is in constant contact (relatives, colleagues). At the same time, a person feels shame, considers himself "unclean", but cannot get rid of fantasies. Thoughts of obscene or cruel behavior are not realized in practice, but become the cause of internal discomfort, the desire for isolation, refusal to communicate with loved ones.
The syndrome of obsessive states changes the patient's idea of the meaning of contacts with others. He tends to overly meticulously analyze every conversation or action, suspect other people of hidden thoughts and intentions, evaluate his own and other people's words as stupid, harsh or offensive. It is very difficult to communicate with a person suffering from OCD: he constantly considers himself either offended or an offender, without having any real reason for that.
The tendency to overreact to events that have not yet occurred is manifested in the OCD patient by constant attempts to rehearse their future actions or conversations. At the same time, he imagines all possible and impossible complications, multiplying his own fears many times over. Actions that normally help a person prepare for future difficulties and develop an optimal behavior model only provoke increased anxiety in an OCD patient.
People with obsessive-compulsive disorder often seek support from family and friends. Anxiety should not be caused by an ordinary request for help, but by repeated appeals with the same problem (usually voiced in the same terms) to all acquaintances in a row - while completely ignoring their reaction and advice.
Patients with OCD often suffer from body dysmorphic disorder. This violation is manifested by an acute obsessive dissatisfaction with one's own appearance (in whole or in separate details). The internal discomfort that a person experiences has nothing to do with unsuccessful attempts to improve his figure, get rid of excess weight. The patient is simply sure that his nose (eyes, hair, etc.) is ugly and disgusts those around him. Moreover, the person completely ignores the fact that no one except him notices the “defects” of his appearance.
In the presence of a syndrome of obsessive states, the patient is not able to adequately assess reality. He is haunted by numerous imaginary dangers (obsessions). To reduce anxiety, he performs protective actions (compulsions), which serve as a kind of barrier between him and the aggressive outside world.
A characteristic feature of OCD is the stereotyping of obsessions and compulsions. This means that imaginary threats disturb the patient constantly, and protective actions are of a ritual nature: repetitions of the same type of actions are noticeable, a tendency to superstition, irritation when it is impossible to complete the usual actions.
Obsessions and compulsions have diagnostic value in the case when they appear stably for two weeks in a row. Imaginary fears should cause distinct discomfort, and protective actions - temporary relief. It should be borne in mind that only a psychiatrist can confirm the diagnosis of OCD.
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Compulsive disorder or obsessive-compulsive disorder (OCD), occurs in different age groups of people. A mental disorder characterized by the appearance of obsessive thoughts and the desire to perform actions against the will of a person is diagnosed in 2-5% of the population. The development of OCD neurosis is possible in people of both sexes. Children also experience this type of disorder. In the treatment of obsessive-compulsive disorder, a complex is used medications and methods of psychotherapy.
Obsessive-compulsive disorder is a neurotic (not mental) disorder in which a person has:
Repetitive obsessive thoughts and actions are often aggressive in nature. A person with obsessive-compulsive disorder requires constant and close attention from others. This is due to the fact that the patient is not able to suppress the obsessive state by willpower.
This psychological disorder causes chronic stress, in which the patient cannot switch to other thoughts and concentrate on solving everyday problems.
The first signs of a pathological condition are usually diagnosed in patients aged 10-30 years, less often OCD is diagnosed in children under 10 years of age. Moreover, patients are more likely to seek medical assistance 7-8 years after the onset of symptoms of a neurotic disorder.
The risk zone for developing obsessive-compulsive disorder includes people with the following characteristics:
It is important to note that all people experience anxiety and fear. The occurrence of these feelings is considered a normal reaction of the body and does not indicate the development of obsessive-compulsive disorder.
The true causes of the development of obsessive-compulsive disorder have not been established. At the same time, researchers have identified several factors that can cause neurological damage.
Neurological neurosis often develops due to mental disorders:
Obsessive-compulsive disorder often develops who grew up in a strict religious family. In addition, a neurological disorder occurs in people whose parents instilled a desire for perfectionism, cleanliness, and also did not teach them how to adequately respond to difficult life situations.
In addition to social and psychological factors, neurosis can be caused by biological causes that determine work. internal organs and systems:
Among the factors that can provoke the development of neurosis include:
In addition to dysfunction of internal organs and toxic damage to the central nervous system, these pathologies make a person anxious and suspicious.
A distinctive feature of obsessive-compulsive disorder is the occurrence of such a pathological condition more often under the influence of biological factors. The remaining neuroses mainly appear against the background of mental disorders.
OCD is often accompanied by depression. This is due to the fact that the development of both disorders occurs due to overvoltage (excitation) separate parts brain. Such foci cannot be eliminated by willpower, so patients are not able to get rid of obsession on their own.
Obsessive-compulsive disorder is characterized by three main features:
These manifestations of obsessive-compulsive disorder in most patients follow each other. After the completion of the last stage, the patient experiences temporary relief. However, after some time, the process is repeated.
Allocate the following forms neurosis:
In addition to obsessive thoughts and actions, a neurological attack causes physiological disorders, manifested in the form of:
In the absence of treatment, on average, in 70% of patients, obsessive-compulsive disorder becomes chronic. Moreover, in people in such circumstances, the neurological disorder progresses. In advanced cases of obsessive-compulsive disorder, patients may repeat certain activities for hours on end.
The appearance of the first symptoms of obsessive-compulsive disorder is accompanied by a person's desire to get rid of the anxiety state. To suppress fears, the patient performs certain actions that play the role of a ritual:
An important feature of the obsessive-compulsive disorder syndrome is that these actions are of the same type and are repeated at the moment when the patient is experiencing anxiety. After performing the ritual, the person calms down for a while.
These actions are mandatory. That is, the patient is unable to resist own will put things in a certain order right now, and not some time later. Moreover, the person is aware that he is performing absurd and inappropriate actions.
In the neurosis of obsessive thoughts, adults have ideas and thoughts of the following nature:
It is not certain factors that lead to the appearance of obsessions, but internal attitudes, own thoughts.
Such an impact on the psyche leads to the fact that a person becomes unsure of himself. The patient constantly experiences anxiety, as a result of which his personality is gradually destroyed.
With the development of obsessive-compulsive disorder nervosa, the symptoms of the pathological condition also manifest themselves in the form of unreasonable fears. Moreover, the latter have the widest variation. A common form of phobia that occurs in many patients with psychosis includes:
An obsessive-compulsive disorder appears if the patient is faced with a situation to which he cannot adapt: the need to speak in front of an audience, work in someone's presence, and other factors.
Comorbidity is a combination of several chronic pathologies. This concept is used in cases of neurological disorders, when the symptoms of the following diseases complement the main signs of the obsessive-compulsive disorder syndrome:
Obsessive compulsive disorder can be diagnosed in the presence of the following clinical phenomena:
Obsessive Compulsive Disorder is diagnosed if: indicated symptoms repeated for two or more weeks. The Yale-Brown test is used to determine the severity of neurological impairment. The patient is asked to answer 10 questions, each of which is evaluated on a 10-point scale. The test results allow you to evaluate:
Differential diagnosis of obsessive-compulsive disorder is carried out with anankastic depression and schizophrenia.
The tactics of treating neurological disorders are selected on an individual basis. The therapy scheme is developed with the participation of psychotherapists, neurologists, psychiatrists and doctors of other specialties.
In the treatment of obsessive-compulsive disorder, drugs are used as an adjunct to psychotherapeutic treatment. Medications are used to relieve the symptoms of a neurological disorder: headaches, insomnia, and other symptoms. Compulsive neurosis and obsessions are treated by:
Duration drug treatment and dosage of drugs are determined taking into account the severity of neurosis. It is highly recommended not to self-medicate with medications. Medications temporarily stop the symptoms of a neurological disorder. After discontinuation of drugs, clinical phenomena again begin to disturb the patient.
In addition to drug therapy, it is recommended to take herbal medicines that calm the nervous system: valerian, motherwort, peony. To normalize brain activity, preparations of omega-3 fatty acids (Omacor, Tecom) are prescribed. Neurosis can be treated with acupressure, or acupressure.
Since it is necessary to treat obsessive-compulsive disorder, based on the characteristics of the patient and the nature of the development of a neurological disorder, various methods are used in the treatment of the disorder:
Obsessive-compulsive disorder can be cured if it is possible to identify a traumatic factor. To do this, apply the methods of psychoanalysis.
Situations or thoughts that arose in the past and do not correspond to the internal attitudes of a person are eventually replaced by obsessive ideas and actions. Methods of psychoanalysis allow to establish the relationship between these circumstances and obsessions, phobias, compulsions.
This approach has been successfully applied in treatment of OCD. Psychoanalysis sessions are held 2-3 times a week for 6-12 months.
Cognitive behavioral therapy is used to change a person's attitude towards obsessive thoughts. In case of successful treatment, the patient ceases to respond to such triggers.
With this approach, a person is forced to face their fears. For example, the psychotherapist forces the patient to touch the doorknob, suppressing his urge to immediately wash his hands. Such procedures are constantly repeated until a person learns to cope with an irresistible desire to perform the same type of action.
Cognitive behavioral therapy has also been successfully used in the treatment obsessive neurosis. With the right approach, the results become noticeable after a few weeks. However, the success of the procedures directly depends on the will and self-discipline of the patient.
Hypnosuggestive therapy is a method that involves introducing a person into a hypnotic state in order to instill in him other attitudes and behaviors. The effectiveness of this approach is extremely high. In the course of hypnosuggestive therapy, it is possible to correct the patient's behavior at an unconscious level.
Group therapy is used to raise self-esteem. In addition, this treatment tactic allows the patient to learn how to manage stress. During each group therapy session, the therapist plays out a situation in which the patient experiences fear or anxiety. Next, the patient must independently find a solution.
On initial stage development of neuroses, you can get rid of obsessive thoughts by self-hypnosis. To do this, you need to go through several stages:
The main goal of the treatment of obsessive-compulsive syndrome is that the patient learns to repress non-essential events or episodes that provoke compulsions.
obsessive states (synonym:, anancasm, obsession)
involuntary emergence of irresistible thoughts alien to the patient (usually unpleasant), ideas, memories, doubts, fears, aspirations, drives, actions while maintaining a critical attitude towards them and attempts to fight them. They are observed in one of the main forms of neurosis - obsessive-compulsive disorder, as well as in neurotic development (see Pathological Personality Development) ,
psychopathies (Psychopathies) (more often psychasthenia), neurosis-like schizophrenia (Schizophrenia) ,
manic-depressive psychosis (Manic-depressive psychosis) (especially with cyclothymia), epilepsy (Epilepsy) and other organic diseases of the brain. A large role in the occurrence of N.s. play psychogenic factors, incl. iatrogenic (see Iatrogenic diseases) .
Distinguish abstract (abstract) N.s. and figurative (sensual) with pronounced affective (emotional) disorders. To the abstract N.s. include obsessive account (), obsessive thoughts. With obsessive counting, he counts the windows of houses, floors, buttons on the clothes of passers-by, steps, steps, adds car numbers, sometimes mentally adds and subtracts various numbers or keeps them in memory. Counting operations tire and irritate the patient, but he cannot get rid of this. With obsessive memories, the patient constantly strives to recall the details of past events, the names of classmates, terms, etc. Obsessive thoughts are manifested primarily in fruitless or painful sophistication (“mental chewing gum”). With this type of N.s. the patient thinks all the time about all sorts of problems, often of no practical importance (for example, why the Earth is round, if it were of a different shape, how it would move, how day and night would change). In other cases, ordinary situations are subjected to “mental chewing gum”: the patient seems to lose upcoming events or already past, but not satisfying it. To the figurative N.s. include various phobias, obsessive drives (compulsion), blasphemous thoughts, doubts, actions. - strong irresistible, covering the patient, despite the fact that he understands his groundlessness and tries to cope with it. The most common nosophobia is the fear of getting a serious illness, such as cancer (), myocardial infarction (), syphilis (), (speedophobia). Cancerophobia occurs more often psychogenic. After the death of a loved one from cancer or as a result of a careless word of a doctor during an examination, the patient may have the idea that he has cancer. Such a patient turns to various doctors, analyzes his feelings, feels and examines himself, finding confirmation of his fears, insists on conducting various examinations. Upon learning that he did not have a disease, he short period calms down, and then the fear begins to overcome him again. Often the thought arises that doctors do not give him the correct diagnosis, because. he turned to them too late, and he could no longer be helped. Patients who have expressed fears and depressed mood need urgent consultation at the psychiatrist. Cardiophobia can also appear under the influence of mental. The patient has autonomic disorders(, increased, discomfort in the region of the heart), which are accompanied by anxiety, fear, the thought that he has developed, from which he will die. The doctor's dissuasion helps for a short time, then fear and vegetative disorders increase again, confirming the patient's fears. Such a patient believes that he cannot stay at home alone, go out into the street, because. in these cases there will be no one to help him. At the height of fear, a critical attitude towards one's condition may be lost. Agoraphobia is the fear of open spaces. afraid to cross wide streets and squares, preferring to go around them in public transport. He can easily overcome this fear if someone accompanies him, even small children. Claustrophobia is the fear of closed spaces. Patients experience fear in public transport, especially in, they cannot visit cinemas and theaters, and if they come, they tend to take a seat near the entrance in order to be able to quickly exit. Obsessive ideas arise involuntarily, despite the patient's desire to get rid of them, for example, he is persistently haunted by the memory of an unseemly, shameful act committed earlier, or of a tragic event that he witnessed, or of an alleged tragic event in a situation of expectation. So, a mother, waiting for her son from a party, presents pictures of bandits attacking him, murders, etc. Obsessive doubts - uncertainty about the correctness of the action: whether the door is locked, whether the electrical appliance remains on, whether the documents are correctly executed or the address is written. The patient is forced to repeatedly check his actions, return home, double-check documents, but doubts, accompanied by anxiety and fear, remain. The patient, having made sure that everything is in order at home, leaves reassured, but soon doubts seize him again: “That time it was locked, but I unlocked the door, perhaps I didn’t lock it” Obsessive doubts appear when choosing one or another action (go to or to acquaintances, make this or that purchase). At the same time, the patient cannot make a decision for hours. Treatment of patients with N. with. conducted by psychiatrists and psychotherapists. With pronounced obsessions with impaired social adaptation and disability, it is indicated in a hospital, in departments for patients with borderline forms of mental illness. After discharge from the hospital, patients should be under the supervision of a psychotherapist, receive supportive therapy and attend psychotherapeutic classes. Tranquilizers are prescribed to alleviate autonomic symptoms. ;
anxious anticipation, fears, low mood are stopped by antidepressants (Antidepressants) in combination with antipsychotics (Neuroleptics) in small doses (preferably haloperidol drops). With complex rituals that determine the picture of the disease, more active antipsychotics are indicated. A big place in the treatment of N. s. occupy various types of psychotherapy (Psychotherapy) :
rational, explanatory, functional training, autogenic therapy. The prognosis depends on the underlying disease. With schizophrenia, the complication and expansion of the symptoms of obsessive-compulsive disorders is possible. More favorable in obsessive-compulsive disorder than in pathological development personality. Bibliography Karvasarsky B.D. , With. 34, 38, M., 1980; Lakosina N.D., Pankova O.F. and Bezzubova E.B. Clinical features acute phobias with somatovegetative disorders in neuroses and low-progressive schizophrenia, Zhurn. neuropath, and psychiatrist. vol. 86, no. 11, p. 1684, 1986; Ozeretskovsky D.S. , M., 1950, bibliography; Smulevich A.B. Maloprogredient and borderline states, M., 1987; Ushakov G.K. Borderline neuropsychiatric disorders, p. 153, M., 1987.
1. Small medical encyclopedia. - M.: Medical Encyclopedia. 1991-96 2. First aid. - M.: Great Russian Encyclopedia. 1994 3. encyclopedic Dictionary medical terms. - M.: Soviet Encyclopedia. - 1982-1984.
OBSESSIVE STATES- OBSESSIVE CONDITIONS, psychopathological. phenomena characterized by the fact that certain contents repeatedly appear in the mind of the patient, accompanied by a painful feeling of subjective coercion. The patient is fully aware of ... ... Big Medical Encyclopedia
obsessive states- involuntary, suddenly appearing in the mind, painful thoughts, ideas or urges to action, perceived by a person as alien, emotionally unpleasant. The term was introduced by the German psychiatrist R. Kraft Ebing (1868). Although the patient often ... ... Great Psychological Encyclopedia
Mental contents, personally uncontrolled reproduction of which leads to disruption of activity. They can manifest themselves in the form of constant thoughts, memories, doubts, drives, external actions. Often associated with painful ... ... Psychological Dictionary
- (obsessions, obsessions), involuntary thoughts, memories, doubts, phobias, aspirations, movements and actions, accompanied by a consciousness of their pain and a painful feeling of insurmountability ... Modern Encyclopedia
- (obsessions) involuntary thoughts, memories, doubts, phobias, etc., accompanied by the consciousness of their pain and a painful feeling of insurmountability ... Big Encyclopedic Dictionary
English obsession; German Zwangszustande. A symptom of neurosis and psychosis, diseases, expressed in the fact that irresistible thoughts, memories, fears, and desires arise in the mind of a person against his will. see COMPULSIVITY. Antinazi. Encyclopedia ... Encyclopedia of Sociology
obsessive states- (obsessions, obsessions), involuntary thoughts, memories, doubts, phobias, aspirations, movements and actions, accompanied by a consciousness of their pain and a painful feeling of insurmountability. … Illustrated Encyclopedic Dictionary
obsessive states- - inadequate or even absurd and subjectively painful thoughts, ideas, impulses, fears and actions that arise in addition to or against the will of patients, while a significant part of them are aware of their painful nature and often try to ... Encyclopedic Dictionary of Psychology and Pedagogy
obsessive states- - thoughts, doubts, fears, inclinations, actions that arise in a person against his will. Separate unstable obsessive states can appear in perfectly healthy people. Persistent and irresistible obsessions are a sign of ... ... Social Work Dictionary
Obsessive compulsive disorder usually occurs in individuals with a special personality type. Everything manifests itself in the form of self-doubt, as well as constant doubts, anxiety and suspiciousness. Such a state is typical for people who are suspicious, fearful, too conscientious. Isolated obsessions can occur even in healthy people. IN this case we are talking about the fear of the dark, heights, animals and insects.
Obsessive-compulsive disorder according to microbial 10 is characterized as F40. Anxiety-phobic disorders”, “F41. Other anxiety disorders", "F42. Obsessive Compulsive Disorders". The main reasons may be conflict situations between desires and aspirations. Sometimes this is provoked by the needs of the individual and the impossibility of their implementation. Often moral or other considerations become a barrier.
During this process, a certain focus of excitation is formed in the cerebral cortex. This usually happens after one episode when the person forgets something important. So, in this case, we are talking about the fear of not turning off the gas, not closing the door, etc. It is enough just to transfer the feeling of fear so that the focus of excitation is formed.
All varieties of these states can be characterized by feelings of fear, fear and phobia. Both certain objects and situations can act as “things” provoking negative emotions. Neurosis usually begins by the mechanism conditioned reflex. Over time, phobias can expand. As a result, they put pressure on the social and professional life of a person.
F48 Other neurotic disorders
Ordinary overwork can serve as the cause of obsessive-compulsive disorder. Most often, neuroses appear against the background of existing mental disorders. A person is plagued by obsessive thoughts, ideas. He can't deal with this on his own.
There are other reasons for the development of pathology. A special role in this case is assigned to previous injuries. They can affect the human condition. Traumatic brain injuries are especially difficult to tolerate. Neurosis can occur against the background of mental disorders. Brain injuries can affect the problem. Infectious diseases make a special contribution, which in a certain way affected the body and led to its intoxication.
It is not so easy to prevent neurosis. Modern life requires quick decision-making and constant movement. People are often under stress, which is why the nervous system suffers. Taking sedatives and healthy sleep will reduce the risk of developing neurosis.
At the moment it is difficult to say what exactly causes the development of obsessive-compulsive disorder. Experts put forward a connection between the orbito-frontal cortex of the brain and the basal ganglia. These brain structures use the neurotransmitter serotonin to communicate.
It is believed that the problem is caused by an insufficient amount of serotonin produced. More precisely, it has been established that these two states are directly related to each other. The process of information transfer is regulated by neurons. With regard to reuptake, the neurotransmitters are partially returned to the emitting neuron. It is here that the elimination of monoamine oxidase occurs. Its level is monitored at the synapse.
There is speculation that the condition is associated with increased reuptake. In connection with it, the impulse simply does not have time to reach the next neuron. Many are in favor of this theory. At the moment, the pathological process is associated with overactivation of the 5-HT1B receptor. The mechanism of work is associated with dopamine.
For the most part, everything happens spontaneously. A person begins to visit various doubts, fears, thoughts, memories, desires and movements. Obsessive-compulsive disorder is characterized by a state of suspiciousness, anxiety and self-doubt. For example, a person does not know how to act in this or that situation. When leaving the house, gas, water, electricity are constantly checked. One has only to move away from the door, as the person returns and checks everything again. In such states, he can bring himself to exhaustion.
In addition to suspiciousness and anxiety, a person is constantly in a state of fear. He may be excruciatingly afraid of something, especially performing some important action. For such a patient, performing on stage is simply torture. Moreover, people with such a deviation cannot even have sexual intercourse.
Over time, intrusive thoughts begin to appear. The patient tries to remember someone's names, surnames, poems. But usually it doesn't do any good. Intrusive thoughts can be depressing. Patients are able to talk for hours on topics that are not of interest to them at all, even more than that, they are absurd.
Fear is another symptom of obsessive-compulsive disorder. A person is afraid of getting sick, he is afraid to be in the dark, at a height. It frightens open space, wide areas, or, on the contrary, enclosed spaces. All these states are capable of moving into the action stage. A person unnecessarily considers all objects that are in his field of vision. In addition, there is a need to perform some kind of obsessive movement. It can be licking lips, winking, fixing hair, etc. Finally, there are special representations. A person very clearly "sees" and "hears" the memories, sounds, phrases that he is trying so hard to forget.
The main symptom of this condition is the presence of thinking and behavior that are obsessive. The patient begins to suffer from the influx of thoughts, images, they do not go away, but more and more pressure. Obsession is often accompanied by severe anxiety and phobia. Such people most often have their own rituals. It refers to the performance of certain actions. They supposedly protect from some kind of misfortune or tragedy. For example, so that nothing bad happens to the relatives of the patient, he needs to spit over his left shoulder three times every hour, otherwise trouble cannot be avoided.
There are several basic signs of obsessive-compulsive disorder. A person is pestered by thoughts and images that do not recede. In addition, there is fear, phobia. There is a repetition of some rituals.
Quite often a neurosis is confused with a condition similar to it. The latter are most often associated with brain lesions. Diagnosing the condition will take a long time. Because you need to determine the true cause and put correct diagnosis.
This condition is not very common. The favorites in this matter are neurasthenia and hysteria. The disease is characterized by the presence of obsessive symptoms. As a rule, everything has a pronounced course. It should be noted that in this case, obsessive formations are a source of decompensation. In obsessive-compulsive disorder, the symptoms are most clearly presented. Consciousness does not notice any changes at all, and over time they are strongly expressed. Patients are able to show increased activity in order not to notice their own obsessive states.
This pathology, together with depression, is especially dangerous. After all, a person can think about something without stopping and just torment himself with thoughts. Often the problem is characterized by obsessive memories, thoughts, doubts. A person simply torments himself in this way, but he cannot do anything about it. The worst thing about all this is the performance of rituals. Each person performs a series of specific actions to prevent a certain cataclysm or misfortune. All this is done contrary to reason.
Extra thoughts in the head prevent a person from focusing on really important things. He does not get enough sleep, concentration is lost, and excessive fatigue appears. As a rule, the mood decreases sharply, obsessive fears appear. Often the nervous system becomes too excited. A person performs certain actions, his hands are trembling.
The pathological process in children it manifests itself in the form of obsessive fears, movements, thoughts and tics. So, a child is able to constantly wind his hair around his finger, suck his finger, strands, move his hands intensively, etc. This needs to be watched carefully.
The main causes of obsessive-compulsive disorder lie in sudden mental trauma. At the same time, an adult is not even able to assess what happened. More precisely, a certain situation may not be so serious, but the child has this moment for long time imprinted in memory. Other psycho-emotional factors include the appearance of obsessive movements in children. This can develop due to a dysfunctional situation in the family. That is why children should not swear, quarrel and create conflict situations. For an adult, this is a solution to a common everyday problem, and for a child, it can become a severe mental trauma. Changes in life and routine can affect the baby. Most often this leads to children's neuroses. It is not excluded the development of tics and certain movements. The risk group includes children who have previously suffered a traumatic brain injury, infectious diseases and chronic pathologies of internal organs. These diseases can deplete the central nervous system.
It is necessary to treat neurosis under the supervision of a physician. It is important that the child is constantly observed and follows certain recommendations. The recovery process takes a long time. It is desirable to be observed by one specialist throughout the entire period of treatment.
This condition can occur even in a healthy teenager. It can be provoked by the weakening of the body, as well as the nervous system. This occurs against the background of a previously transferred infectious disease, as well as a traumatic brain injury. Most often, the problem occurs in adolescents with a weak nervous system. You can determine this in childhood. The kid is strongly clamped, cowardly, suspicious. Under influence negative events the situation is gradually evolving. Excessive demands on the child, alcoholism in the family, quarrels, disagreement between parents, etc. can provoke development. After acute injury, obsessive compulsive disorder manifests itself with lightning speed.
The obsession that arose in adolescence, is characterized by its diversity and is somewhat different from such a state, but already in a more mature person. There are several types of manifestation of pathology: memories, expectations, doubts, fears, drives, ideas, movements and actions. Most often, they are pestered by thoughts, fears, which, in fact, are ridiculous. Intrusive memories are haunting, they are simply impossible to forget. They constantly remind of themselves and do not allow the teenager to exist normally. There is a painful condition and even painful. All this leads to self-doubt.
Doubts often arise in healthy people. True, after a couple of checks, a person, as a rule, calms down. The victim, on the contrary, exhausts himself to the point of exhaustion. Fear in its manifestation resembles doubt. The child is very afraid of forgetting something important at the blackboard, embarrassing himself at a speech, etc. He is constantly on the lookout for failure.
The main consequence is reduced performance. A person suffers from a decrease in concentration, mental activity worsens, nothing can be remembered. This causes certain difficulties in performing standard work. In order to eliminate the likelihood of such a scenario developing, you need a sufficient amount of time to rest. Healthy sleep and non-exhausting labor will not harm the nervous system.
Often, neuroses lead to the appearance of diseases of the internal organs. This happens due to the existing decompensation of diseases. Neuroses are capable of capturing not only the nervous system, but also the somatic sphere. This leads to a deterioration in the adaptive states of a person.
The nervous state and the inability to control what is happening lead to problems in the family. Anxiety, tearfulness, resentment appear. All these symptoms are direct companions of neuroses. They are what give rise to conflict situations, scandals and misunderstandings.
The appearance of fears, thoughts and memories can worsen the normal life of a person. Therefore, people simply simply avoid traumatic situations.
Complications in neurosis can lead to really grave consequences. So, severe damage to the psyche, as well as physical development, is not ruled out. This issue is especially acute for the younger generation. Problems need to be addressed at the initial stage, so that the situation does not get out of control and does not worsen.
If treatment is started on time, then there can be no complications in a person. People with a similar diagnosis should be under the supervision of specialists. Do not try to fix the problem yourself, nothing good will come of it. As soon as the disease recedes, it will be necessary to come to the doctor every year for examination. This will avoid re-neurosis.
Getting rid of the problem is not as difficult as it might seem at first glance. But, nevertheless, everything must be carried out in full accordance with the recommendations set. A significant role is played by the desire of a person to get rid of his condition. In this case, the treatment will really show a positive result.
Certain factors play a special role in diagnosing pathology. So, the first step is to collect all the data about the patient. It's about history. It is important to find out at what stage deviations began to appear in a person, what could provoke them. It is worth indicating information regarding the presence of mental disorders in one of the relatives. A special role is given to circumstances that could precede the onset of the disease. This can be provoked by alcoholic excesses, as well as changes in residence or work.
Diagnosis can be made in certain cases. So, if the symptoms are painful for the patient himself. That is why they are perceived as unacceptable and alien. Attention is drawn to more serious deviations. Thus, a person cannot be in society. At the same time, its deviation has a progressive character and it is quite easy to distinguish it from stress.
A special role in the diagnosis is given to the dynamics of pathological sensations. So, in some cases, they can intensify, and the person simply does not control the situation. There is a clear dependence of actions on negative emotions. The patient's condition may worsen alone or when visiting a doctor, while watching any TV shows that cause excitement.
For an accurate diagnosis, the patient must undergo a series of specific studies. The first step is a general blood test, it allows you to evaluate the quantitative and qualitative indicators blood. It refers to the primary non-specific diagnosis. Then a general urine test is given. Thanks to him, the physico-chemical characteristics of urine are evaluated.
A special role is given biochemical analysis blood. It allows to obtain qualitative and quantitative indicators of functional diagnostics of kidney activity. The level of lipid and carbohydrate metabolism is determined, and latent anemia is diagnosed. It is necessary to take a blood test to determine the level of catecholamines. This procedure is carried out three times. This will allow diagnosing and identifying lesions in the adrenal glands.
To make an accurate diagnosis, it is necessary to conduct a number of specific studies. Often an electrocardiogram is indicated. This procedure allows you to evaluate the structure and functional activity of all metabolic processes taking place in the heart muscle. The composition of the human body, as well as the basal level of metabolism, is being changed.
Uzi plays important role throughout the study. It allows you to evaluate the state thyroid gland, liver, kidneys and biliary system. After all, neurosis often occurs against the background of the presence of an infectious disease.
Color triplex scanning of extracranial vessels of the head is widely used. This procedure is an ultrasound examination. Its main purpose is to obtain objective information regarding the characteristics of blood flow in the arteries and veins. Plain radiography of the chest organs in one projection may be prescribed.
The symptoms of obsessive-compulsive disorder can be recognized by specific melancholic disturbances of impulses. However, despite this, a misdiagnosis can be made. At the beginning of the schizophrenic process, obsessions may appear, but this has nothing to do with neurosis. Therefore, doubts begin to arise diagnostic measures Oh. All this gradually fades away with time. It is fundamentally important to learn to distinguish delirium from obsession. This will allow a correct diagnosis to be made.
The main diagnostic measures include the delivery of blood and urine tests. The first step is to collect an anamnesis, then on its basis indications for further examination are given. The analyzes will help identify possible deviations in organs and systems. Making a diagnosis based on differential diagnosis alone is foolish. It is worth comparing the results obtained with instrumental methods research. Thus, it is possible to get a complete picture of what is happening, to identify the true causes of the onset of neurosis and to prescribe quality treatment.
This issue is resolved in several steps. The first step is a course of psychotherapy. The basis of the technique is the patient's awareness of the presence of a problem and step-by-step resistance to its main manifestations. The method of exposure and warning has proven itself the most well. Thus, exposure consists in placing the patient in a situation that can cause him visible discomfort. At the same moment, the victim is given instructions that he must follow in a stressful situation. Thus, it is possible to develop in a person a persistent "immunity" to strong mental stress.
Psychoanalytic psychotherapy allows you to cope with some aspects of the disorder. Thus, many psychiatrists believe that this technique is useless for eliminating the problem. But if used in conjunction with by special means, the result will not keep you waiting. Therapy with psychotropic drugs is widely used. These include selective serotonin reuptake inhibitors. For treatment, drugs such as Risperidone and Quetiapine are used. They are classified as atypical antipsychotics. In the presence of anxiety, it is recommended to give preference to benzodiazepine tranquilizers. It can be Clonazepam and Phenazepam.
Physiotherapy has a beneficial effect on a person. You can use warm baths, lasting at least 20 minutes, make a cool compress on the head, apply rubdowns and douches. Bathing in river and sea water will be useful.
Medications are the mainstay of any treatment. In this case, they can reduce obsessive-compulsive states and lead to complete stabilization of the pathology. Medicines can be prescribed only by the attending physician in a certain dosage. The most commonly used are Risperidone, Quetiapine, Clonazepam and Phenazepam.
The dosage is prescribed by the attending physician. The agent is used for one and a half months, 250-500 mg, 2-3 times a day. The dosage may be adjusted. If necessary, the dose may be increased. Despite positive reviews and effectiveness, the drug has contraindications. So, it can not be used in the presence of hypersensitivity to its main components. In this case, we are talking about phenibut. Some restrictions are available for pregnant women, women during breastfeeding. In no case should children under 2 years of age take the remedy.
Concerning side effects, there are a lot of them. Possible drowsiness, nausea, vomiting, allergic reactions, apathy, excessive fatigue. All this requires dose adjustment. Do not use this remedy with drugs that have a similar effect. This can cause a high concentration of certain substances in the body and lead to an increase in symptoms.
Alternative treatment can help in solving many problems. Most importantly, you can use improvised means. So, it is enough to take 100 grams of red wine, one raw egg and half a teaspoon of sugar. All ingredients are thoroughly mixed together. It is necessary to take the resulting remedy 2 times a day, preferably in the morning and in the evening. After that, a break is made for 3 days, then everything is used again for 2 days. Such a course of treatment will get rid of neurosis. In the end, you can just rub yourself with red wine.
With mental disorders, onion on an empty stomach has a good effect. Garlic has the same effect. It is able to increase the action of the vitamin and form a special substance that promotes the dissolution of fats. These folk remedies can save a person from unnecessary nervousness.
There is one grandmother's method. It is necessary to take half a kilogram of lemons and 12 apricot kernels. The nucleoli should be finely chopped and the lemons grated. The resulting ingredients are mixed together. You can add honey for taste. Such a composition is taken for a month in a tablespoon in the morning and at night.
Herbs can have a positive effect on a person. But at the same time, you definitely need to know which plants can be used and which cannot. After all, many of them are poisonous.
Timely elimination of neurosis is the key to peace and peace of mind. Constant anxiety, mood swings and insomnia negatively affect a person. Against their background, the standard of living decreases, there is a decrease in working capacity. You can get out of this situation, even by means of homeopathy.
Homeopathy is a sure way to get rid of obsessive conditions once and for all. Neurosis is one of the most common reasons for visiting a homeopath. The drugs prescribed by the specialist are based on plants. It must be understood that they are not able to help all people. After all, a person may have hypersensitivity to certain components.
Treatment must be approached comprehensively. Usually it is based on the use of mono drugs. Today they are in great demand. The use of knowledge, as well as experience, allows homeopaths to prescribe a truly high-quality treatment. You can get acquainted with all the drugs used directly during the consultation. The names of the tools are not listed for security reasons. It is not recommended to use them just like that, a clear dosage is necessary.
In fact, neuroses are not cured by surgical intervention. But, it all depends on the reason for which it was called. If the problem lies in the infection in the body, surgical treatment is not excluded. Infections are different and in some cases they can affect healthy tissues and organs. It requires not only medical, but also surgical elimination of the problem.
In most cases, the operation does not make sense. The patient is simply under the supervision of a psychiatrist and fulfills all the recommendations set by him. This will result in a positive short term. Surgical intervention is possible when the cause lies in the presence of serious changes in the body.
In any case, the decision to have surgery or conservative treatment hosted by a leading specialist. This is done after all diagnostic studies. Only in this way can the true cause of obsessive-compulsive disorder be identified and corrected.
Competent preventive methods can exclude the development of mental disorders. First of all, they consist in the implementation of simple rules. It is important to practice daily, giving this procedure only 20 minutes a day. It is good to exercise while being outdoors.
What is most interesting, the prevention of neurosis lies in color, human environment. It has been proven that the more aggressive the shades of the room and other elements, the more negative emotions it causes. It is better to give preference to warm and soothing colors. If a person is constantly affected by depression, black and blue shades should be excluded. It is desirable that the interior of the apartment was in soothing pastel colors. Suitable beige, orange, green and yellow.
Well-chosen music can calm a person. It is important that it matches the mood of the person. It is advisable to change the style of music after listening to several compositions. It has been proven that it has a positive effect on a person.
Proper nutrition also contributes. It is necessary to exclude the products caused by nervous overexcitation. Enough to eat chocolate in order to suppress Bad mood. Chicken, fish and low-fat beef have similar properties. Invigorating coffee should be excluded, it can lead to the development of depression.
Neuroses are in the nature of functional diseases, in most cases they proceed favorably and end in recovery. However, if there is a pronounced accentuation of character, an insufficient level of maturity of the individual and aggravating injuries, treatment can be difficult. Moreover, in some cases it is protracted and does not always lead to a favorable prognosis. Neurotic development of personality is not ruled out.
That is why, with insufficient maturity, in most cases, difficulties are found in assessing the state of a person. Because rigidity is observed, as well as the complete impossibility of creating a new life dominant. If pathocharacterological symptoms begin to develop, then the chances of a full recovery are significantly reduced.
The development of signs in the future occurs with abnormal development of the personality. This is influenced by the complication of the relationship between the patient and the psychotraumatic environment. This includes not only the main traumatic situation, which is gradually aggravated, but also the body's reaction to its own condition. This can hinder treatment and rehabilitation. The forecast is favorable, but you have to try hard.
Obsessive-compulsive disorder, or abbreviated as OCD, and scientifically - obsessive-compulsive disorder, is characterized by the appearance of unpleasant obsessive thoughts, and after them - compulsive actions, peculiar rituals that help the patient temporarily relieve anxiety and excitement.
Among mental illnesses, various kinds of syndromes can be distinguished into a special group, which are combined under one “tag” - obsessive-compulsive disorders (or briefly OCD), which got its name from the Latin words that mean “siege, blockade” (obsession) and “ coercion" (compello).
If you “dig into” the terminology, then two points are of great importance for OCD:
1. Obsessive desires and thoughts. And it is characteristic of OCD that such drives arise without human control (against feelings, will, reason). Often such drives are unacceptable to the patient and contrary to his principles. Unlike impulsive drives, compulsive ones may not be realized in life. Obsession is hard experienced by the patient, remains deep inside, giving rise to a feeling of fear, disgust and irritation.
2) Compulsions that accompany bad thoughts. Compulsiveness also has an extended term, when the patient experiences any obsessions, and even obsessive rituals. As a rule, the main features of this type of disorder are repetitive thoughts with compulsive actions that the patient repeats over and over again (ritual creation). But in an expanded sense, the "core" of the disorder is the obsessive-compulsive syndrome, which in the clinical picture manifests itself in the form of a predominance of feelings, emotions, fears and memories that manifest themselves without the control of the patient's mind. And often, patients realize that this is not natural and illogical, but they cannot do anything about obsessive-impulsive disorder.
Moreover, this mental disorder is conditionally divided into two types:
Moreover, the prevalence of obsessive-compulsive disorders in modern society is really high. According to some studies, about 1.5% of the population of developed countries suffer from OCD. And 2-3% - have relapses that are observed throughout life. Patients who suffer from compulsive disorders make up about 1% of all patients treated in psychiatric institutions.
Moreover, OCD does not have certain risk groups - both men and women are equally affected.
Currently, all varieties of obsessive-compulsive disorders that are known to psychology are combined in the International Classification of Diseases under a single term - "obsessive-compulsive disorders".
For a long time in Russian psychiatry, OCD meant “psychopathological phenomena that are characterized by the fact that patients experience a repeated feeling of burden and coercion.” In addition, the patient experiences involuntary and uncontrollable volitional decision the emergence of obsessive thoughts in the mind. Although these pathological conditions are alien to the patient, it is very difficult, almost impossible for a person suffering from a disorder to get rid of them.
In general, obsessive-compulsive disorders do not affect the patient's intellectual potential, and do not interfere with human activity in general. But they lead to a decrease in the level of performance. During the course of the disease, the patient is critical of OCD and denial, substitution occurs.
Obsessive states are conditionally divided into such states in the intellectual-affective and motor spheres. But most often, obsessive states are "delivered" to the patient in a complex. Moreover, psychoanalysis of the human condition often shows a pronounced, depressive “foundation” at the basis of obsession. And along with this form of obsession, there are also “cryptogenic” ones, the cause of which is very difficult to find even for a professional psychoanalyst.
Most often, obsessive-compulsive disorder occurs in patients with a psychasthenic character. In addition, disturbing fears are clearly distinguished here, and such sensations are found within the framework of neurosis-like states. Some researchers believe that the cause of obsessive-compulsive disorders is a special nervosa, which is characterized by the fact that memories prevail in the clinical picture, reminding a person of an emotional and mental trauma suffered in a certain period of life. In addition to this, the emergence of neurosis is facilitated by conditioned reflex stimuli that caused a strong and unconscious feeling of fear, as well as situations that became psychogenic due to the struggle with internal experiences.
Understanding anxiety disorder and OKR has been rethought over the last fifteen years. Researchers have completely changed their view of the epidemiological and clinical significance obsessive-compulsive disorders. If previously it was thought that OCD was a rare disease, now it is diagnosed in a large number of people; and the incidence rate is quite high. And this calls for the urgent attention of psychiatrists around the world.
In addition, practitioners and theorists in psychology have expanded their understanding of the root causes of the disease: the fuzzy definition obtained with the help of the psychoanalysis of neurosis has been replaced by a clear picture with an understanding of neurochemical processes where neurotransmitter connections are disrupted, which in most cases is the “foundation” for the development of OCD .
And most importantly, a correct understanding of the root causes of neurosis helped the doctor to treat OCD more effectively. Thanks to this, pharmacological intervention became possible, which became targeted, and helped millions of patients to recover.
The discovery that intense serotonin reuptake inhibition (SSRI for short) is one of the most powerful treatments for OCD was the first step in a therapy revolution. And also stimulated subsequent research, which shows effectiveness in modifications of treatment with modern means.
What are the common signs that you have obsessive-compulsive disorder?
The patient is obsessed with washing hands, constantly applying antiseptics. And this happens in a fairly large group of people suffering from OCD, for whom they came up with the designation - "washers". The main reason for this "ritual" is that the patient experiences an overwhelming fear of bacteria. Less often - an obsessive desire to isolate oneself from "impurities" in the society surrounding a person.
When is help needed? If you cannot suppress and overcome the constant desire to wash your hands; If you are afraid that you are not washing thoroughly enough, or after going to the supermarket you are visited by thoughts that you caught the AIDS virus from the handles of a cart, then there is a high probability that you suffer from OCD. Another sign that you are a "washer" is washing your hands at least five times, thoroughly washing off the soap. We lather each nail separately.
“Hand washers” often go to the other extreme as well – they are obsessed with cleaning. The reason for this phenomenon is that they experience a constant feeling of "impurity". Although cleaning reduces the feeling of anxiety, the effect of this is short-lived, and the patient starts a new cleaning.
When should you seek help? If you spend several hours every day just cleaning your house, then most likely you suffer from OCD. If the satisfaction of cleaning lasts more than an hour, then the therapist will have to "sweat" to diagnose you.
Obsessive-compulsive disorder is one of the most common disorders (about 30% of patients suffer from this type of OCD from total of all patients), when a person checks the action performed 3-20 times: whether the stove is turned off, whether the door is closed, and so on. Such repeated checks arise from a constant feeling of anxiety and fear for one's life. New mothers suffering from postpartum depression often notice symptoms of obsessive OCD in themselves, only such anxiety appears in relation to the child. A mother can change her baby's clothes many times, shift his pillow, trying to convince herself that she did everything right and the baby is comfortable, warm and not hot.
When should you seek help? It is perfectly reasonable to double-check the performed action. But if obsessive thoughts and actions prevent you from living (constantly being late for work, for example) or have already acquired the form of a “ritual” that cannot be broken, then be sure to make an appointment with a psychotherapist.
Some OCD patients have an obsessive craving to count everything all the time - the number of stairs that cars of a certain color have passed, and so on. Often, the root cause of such a disorder is some kind of superstition, fear of failure, and other actions that have a "magical" character for the patient.
When should you seek help? If you cannot get rid of the numbers in your head, and the calculations occur against your will, then be sure to make an appointment with a specialist.
Another common phenomenon in the field of obsessive-compulsive disorders - a person brings the art of self-organization to perfection: things are always in a certain order, clearly and symmetrically.
When should you seek help? If you need your desk to be clean, organized, and tidy to make your job easier, then there is no sign of OCD. People with obsessive-compulsive disorder often organize the space around them unconsciously. Otherwise, the slightest "chaos" begins to frighten them in a panic.
Every person at least once in his life has thoughts about an unpleasant incident, violence. And the more we try not to think about them, the more they manifest themselves in the mind in addition to control from the person himself. In people with obsessive-compulsive disorder, this feeling goes to extremes, and the troubles that have happened (even the most insignificant ones) cause a panic state, fear, and anxiety. Young girls with this type of OCD are afraid that they might be raped, although there is no apparent reason for this. Young people have a fear of being in a fight, that someone might hit them or even kill them.
When should you seek help? It is important to clearly understand that in periodic fears and thoughts of "getting stuck in an unpleasant story" - there are no signs of the development of the disorder. And when, because of these disturbing thoughts, the patient avoids any action (I don’t walk in the park, as they can be robbed there), then you should seek help from a specialist.
Intrusive thoughts of harm are one of the most common types of OCD. The patient suffers from obsessive thoughts, the center of which is his children, other family members, close friends or work colleagues. postpartum depression in new mothers often contributes to the occurrence of such OCD. As a rule, it is directed at one's own child, less often - at a husband or other close people.
Such fear begins because of great love for the child, a sense of incredible responsibility, which often increases stress. A mother suffering from depression begins to blame herself for being a bad mother, eventually negative thoughts on themselves and presenting themselves as a source of danger. Unfortunately, parents suffer a lot because of their OCD, they do not tell anyone about it, for fear of being misunderstood.
Sexual stress disorders, obsessive fears, and obscene sexual desires are one of the most frustrating types of OCD. As well as thoughts of violence, obsessive thoughts about obscene behavior or taboo desires often visit a person with OCD. Patients suffering from disorders can unwillingly imagine themselves with other partners, imagine that they are cheating on their wife, how they are pestering work colleagues, which they absolutely do not want to do in reality.
If this type of OCD occurs in a child and adolescent, then often the parents become the object of forbidden thoughts. A teenager begins to be afraid of his thoughts, because thinking and imagining various obscenities about his parents is not normal, they say.
Many young people are familiar with homosexual OCD, or HOCD. Such an obsessive-compulsive disorder consists in the fact that a person begins to doubt his own sexual orientation. A kind of “trigger” for such obsessive thoughts can be an article in a newspaper, a television program, or simply an excess of information about sexual minorities. Suspicious and sensitive young people immediately begin to look for signs of homosexuality in themselves. Compulsions in this case are, for example, viewing photographs of men (for women with this type of OCD - photographs of women) in order to find out whether they are excited by representatives of their own sex. Many homo-OCD sufferers may even feel arousal, although any psychiatrist will tell you that this feeling of arousal is false, it is the body's response to stress. The person with OCD expects this reaction to be confirmed to his obsessive thoughts, and, as a result, he receives it.
It is not uncommon for new parents to face one of the most frustrating OCDs - the fear of becoming a pedophile. Most often, this type of contrasting obsessions manifests itself in mothers, but fathers also suffer from this type of OCD. Fearing that such thoughts may be realized, parents begin to avoid their own children. Bathing, changing diapers, and just spending time with your own child is torture for a mother or father with OCD.
Does this type of OCD have compulsions? Many of them do not manifest themselves in the form of any obsessive movements, however, compulsive thoughts are present in the head of people with neurosis. For example, a person who is afraid of becoming gay or a pedophile will constantly repeat to himself that he is normal, trying to convince himself that he is not a pervert. People who have obsessive thoughts about their children may keep revisiting the same situation over and over again, trying to find out if they did everything right, if they harmed their child. Such compulsions are called "mental chewing gum", they are very tiring for a person with obsessive-compulsive disorder and do not bring relief.
When should you seek help? If most people who do not suffer from OCD will convince themselves that such thoughts are just fiction and do not reflect their personality at all, then a person with a mental disorder will think that such thoughts are disgusting, they do not occur to anyone else, so he is probably a pervert, and what will they think of him now? From such an obsessive state, the patient's behavior changes; Depending on the type of OCD and who is the object of obscene thoughts and urges, the sufferer begins to avoid familiar people, their own children, or gay people.
Another type of OCD that cannot be ignored. Usually such a feeling of guilt is imposed and a similar obsessive-compulsive disorder arises against a background of depression. Guilt affects people with low self-esteem, prone to hypochondria. Often the cause of guilt is an unpleasant event that the OCD patient could well have been responsible for. However, people who do not suffer from obsessions will learn from this lesson and move on. A person with OCD, on the other hand, will get "stuck" at this stage, and the feeling of guilt will arise again and again.
It also happens that a sense of guilt is imposed on a person, and is not his own conclusion regarding any situation. For example, an overbearing partner may blame the person for something they didn't do. Aggressive attitudes and domestic violence play a significant role in the emergence of neurosis. "You are a bad mother", "You are a worthless wife" - such accusations will first cause resentment and a healthy desire to protect oneself in a person. Constant attacks will sooner or later lead a person to depression, especially when one of the partners in the family is materially or spiritually dependent on the aggressor.
Intrusive memories are of the "mental chewing gum" type. A person focuses on some event from the past, carefully trying to remember every detail, or something very important to him. Often such memories are accompanied by an obsessive sense of guilt. The plots of such memories can be very different. For example, an OCD sufferer struggles to remember if he made any mistake, did something bad or immoral in the past (hit someone in a car, accidentally killed in a fight and forgot, etc.).
Thinking about it over and over again, a person is afraid that he has missed something. In a panic, he tries to "think out" in order to fully understand and feel the situation. Because of this, their own memories are often mixed with fantasies about this event, since a person with obsessive-compulsive disorder tends to think only about the bad and invent the most negative scenario for the development of events. As a result, the neurosis intensifies even more, since the OCD patient is no longer able to make out where his real memories are and where are his fictions.
People who suffer from obsessive-compulsive disorder are also known for constantly analyzing relationships with other individuals. For example, they may worry for a long time because of an incorrectly understood phrase, which will cause parting with a loved one, for example. This state can increase the sense of responsibility to the limit, as well as complicate the correct perception of unclear situations.
When should you seek help? “Breaking off relations with a loved one” - such a thought can turn into a cycle in a person’s mind. Over time, in people suffering from OCD, such thoughts turn into a "snowball", acquiring anxiety, panic and a drop in self-esteem.
Patients who experience obsessive-compulsive disorder often seek support from family and friends. If they are afraid of embarrassing themselves at a public event, they often ask their friends to “rehearse” all the actions several times.
When should you seek help? Asking for help from friends and loved ones is normal. But if you catch yourself thinking that you are asking the same question, or friends are telling you about it, then you should make an appointment with a psychotherapist. This may be the cause of obsessive-compulsive disorder. Particular attention should be paid to your own condition after the support has been received. Usually, people with OCD have a mental, emotional condition only gets worse.
This is not a whim at all: often insecurity and even self-hatred arises on the basis of obsessive-compulsive disorder neurosis. Often OCD is accompanied by body dysmorphia - the belief that there is some kind of flaw in appearance, which causes people to constantly evaluate parts of the body that seem "ugly" to them - the nose, ears, skin, hair, and so on.
When should you seek help? It is quite normal not to be delighted with some part of the body. But for people with OCD, it looks different - a person spends hours in front of a mirror, looking at and criticizing their "flaw" in appearance.
Already in the 17th century, researchers drew attention to the existence of obsessive-compulsive disorders in some people. They were first described by Platter in 1617. A few years later (1621) Barton described the obsessive fear of death in psychiatry. Mentions about the existence of such states of the human psyche are found in the later works of F. Pinel (the end of the first decade of the 19th century). Researcher I. Balinsky put forward the designation of the term "obsessive ideas", which is rooted in Russian psychiatric literature.
At the end of the 19th century, Westphal introduces the term "agoraphobia", which, in his opinion, meant the fear of being in the company of other people. At about the same time, Legrand de Sol suggests that a feature of the dynamics of obsessions occurs in the form of "doubt insanity with delusions of touch". Along with this, he also points to a gradually progressive clinical picture - obsessional doubts are replaced by absurd fears such as "fear of contact" with any object. And besides, the patient begins to perform "protective rituals" that significantly "spoil" his life.
But it is noteworthy that only at the turn of the 19th-20th century, researchers came to a more or less unified view of the clinical picture of the disease, and gave a description of the "syndrome" of OCD diseases. In their opinion, the onset of the disease occurs in adolescence, adolescence. Maximum clinical manifestations researchers found in patients aged 10-25 years.
Let's analyze in detail the clinical picture of this disease. From a medical reference book, the term "obsessional thoughts" means painful thoughts, ideas, images and beliefs that arise against the will of the patient. As a rule, it is incredibly difficult, if not impossible, for the patient to “drive away” such thoughts. And such thoughts can take the form of both individual phrases and even poems. Such images can be blasphemous and unpleasant for the very person who experiences them.
Whereas obsessional images are nothing more than "vivid scenes" with elements of violence, sex, perversion. Obsessional impulses are a severe form of the disease, when the patient, against his will, wants to perform some action that is destructive, dangerous for the person himself. For example, jump out on the road in front of the car, injure a child, yell obscene words in society.
The "rituals" that people with OCD perform include: mental activity and repetitive actions. For example, mental counting without end or washing hands 5-10 times in a row. Some of them combine mental and physical activities (washing hands is associated with a fear of infection with germs). However, there are other "rituals" that do not have such a connection (folding clothes before putting them on). Most patients want to repeat the action several times. And if this does not work out (do it in a row, without stopping), then people will repeat the action from the beginning. Both obsessive thoughts and rituals complicate a person's life in society.
Obsessive rumination, what psychiatrists call mental chewing gum, is an internal debate with “oneself” that considers arguments for and against, even in the simplest actions. Moreover, some obsessive thoughts are directly related to the action taken earlier - did I turn off the stove, did I close the apartment, and so on. Other considerations also apply to complete strangers - I'm driving and I can knock down a cyclist and so on. Often, doubts are also associated with a possible violation of religious canons, which are accompanied by strong remorse.
All these heavy thoughts accompany compulsive actions - the patient repeats stereotyped actions that take the form of "rituals". By the way, such rituals for the patient mean "protection, amulet" from possible troubles that are dangerous for the patient or his relatives.
In addition to the disorders described above, there are still a number of outlined symptoms and complexes, among which there are phobias, contrasting obsessions and doubts.
It happens that obsessive neuroses and compulsive rituals begin to intensify in certain cases: for example, while holding a knife, an OCD patient begins to experience an increased impulse to “stab” a loved one with it, and so on. On top of that, anxiety is a common companion of OCD sufferers. Some rituals alleviate the feeling of anxiety somewhat, but in other cases it can be quite the opposite. In some patients, this occurs in a "scripted" psychologically motivated response to a stimulus and symptom of OCD, but in other cases, patients have episodes of relapses of depression that occur independently of each other.
Obsessions (or obsessions, in simple terms) are divided into figurative (sensual) and obsessions of a completely neutral content. The first type of obsession includes:
Now let's go through each of the types of sensory obsessions.
Obsessive doubts are intrusively arising, contrary to the mind and will of the patient, insecurities that are accompanied during decision-making and the performance of any actions. The contents of doubts are varied, ranging from household fears (whether the door is closed, whether water, gas and electricity are turned off, etc.) and ending with doubts that are related to work (whether the report was correctly calculated, whether the signature was on the last document, etc.). Despite the fact that a person with OCD checks the action several times, the obsession does not go away.
Psychologists refer to obsessive memories as those that have a stubborn, painful character. Sad, shameful events for the patient, which were accompanied by feelings of guilt and shame, have such an effect. Coping with such thoughts is not easy - a patient with OCD cannot suppress them in himself simply by an effort of will.
Obsessions are urges that “require” a person to perform some dangerous, terrible, terrible actions. Often, the patient cannot get rid of such a desire. For example, the patient is seized by the desire to kill a person, or to throw himself under a train. This desire intensifies when a stimulus is detected (a weapon, an approaching train, etc.).
Manifestations of "obsessive ideas" are varied:
An obsessive feeling of antipathy (and also “blasphemous, blasphemous” thoughts) is an unjustified, alien to the consciousness of the patient, aversion to a certain (usually close) person. It can also be cynical thoughts, ideas about loved ones.
Obsessions are when patients do things that were against their will, despite their best efforts to "not do it." Obsessive thoughts pull a person to do a fantasy until it is realized. And some of them are simply not noticed by a person. Obsessive actions are incredibly painful, especially in those cases when the people around them see their result.
To obsessive fears (phobias), experts rank the following: fear of heights, too wide streets; the onset of sudden death. It also happens that people are afraid to be in confined / open spaces. And even more common cases - a phobia to get sick with an incurable disease.
And, in addition, some patients experience fear of the occurrence of any fear (phobophobia). And now a few lines about what classifications of phobias are.
Hypochondriacal - a person experiences an obsessive fear of getting sick with a difficult to treat (or generally incurable) virus. For example, AIDS, heart disease, various forms of tumors and other symptoms that accompany suspicious person. At the peak of anxiety, patients "lose their heads", stop doubting their "morbidity" and begin to go through doctors of the appropriate authorities. The emergence of hypochondriacal phobias occurs both in "pair" with somatogenic, mental provocations, and independently of them. Usually, the result of a phobia is the development of hypochondriacal neurosis, which is accompanied by frequent medical examinations and senseless medication.
Isolated phobias are obsessive states that occur only in certain conditions and situations - fear of heights, thunderstorms, dogs, dental treatment, and so on. Since "contact" with such situations causes intense anxiety in the patient, patients with such a phobia often avoid such events in their lives.
Obsessive fears that OCD sufferers experience are often accompanied by "rituals" that supposedly protect them from imaginary misfortune. For example, before starting any action, the patient will certainly repeat the same “spell” in order to avoid failure.
Such "protective" actions can be - snapping fingers, playing a melody, repeating certain words, and so on. In such cases, even relatives may not know that the patient is ill. Rituals take the form of an established system that has existed for years.
The next type of obsessions are affectively neutral. They are expressed in the form of memories of terms, formulations, neutral events; the formation of obsessive wisdom, counting and other things. Despite their "harmlessness", such obsessions disrupt the patient's usual rhythm of life and interfere with his mental activity.
Contrasting obsessions, or as they are also called "aggressive" obsessions, are blasphemous and blasphemous actions that carry the fear of harming others and oneself. Patients who experience contrast obsessions often complain of an irresistible urge to shout a curse in the company of other people, to add endings, to repeat after others, adding a touch of malice, irony, and so on. At the same time, people experience fear of losing control over themselves, and, as a result, the possible commission of terrible acts and ridiculous actions. At the same time, such an obsession is often combined with phobias of objects (for example, fear of knives and other cutting objects). The group of contrasting (aggressive) obsessions often includes obsessions of a sexual nature.
Obsessions of pollution. Experts in this group include:
In some cases, this type of obsession is never shown “outside”, remaining at the preclinical stage of development for many years, manifesting itself only in personal hygiene features (changing underwear or washing hands, refusing to touch doorknobs, etc.), or in the order of conduct household (careful processing of food before cooking, etc.).
Such phobias do not have a very strong effect (or do not affect at all) on the life of the patient, and also remain out of the attention of other people. But in the clinical picture, “mysophobia” is considered as a severe obsession, where the gradually becoming more complex “protective rites” come to the fore: sterility in the bathroom, perfect cleanliness in the apartment (floor washing several times a day, etc.).
Staying on the street of people who suffer from this type of disease is necessarily accompanied by the wearing of long, careful "protecting" the open integuments of the body, which must be "washed after the street." In the later stages of developing a severe obsession, people stop going outside, and even outside the "perfectly clean room". To avoid dangerous contacts with the "infected", the patient is protected from all other people. Misophobia is also considered the fear of getting sick with some kind of terrible disease that cannot be cured. And in the first "place" is the fear of what comes "from outside": the penetration of "bad" viruses into the body. Fearing infection, the OCD patient develops defensive reactions in the form of compulsions.
A notable place in the series of obsessions is occupied by obsessional actions, which have the appearance of specific movement disorders. Some of them are developing childhood- for example, tics, which, unlike natural deviations, are a much more complex motor "act" that has lost its meaning. Such actions are often perceived by others as exaggerated physiological movements - a caricature of certain actions, natural gestures for all.
Usually, patients who suffer from a tic may shake their heads for no reason (as if checking if they have a hat), make some senseless hand movements (check the time on a wristwatch without one), blink their eyes (as if in them rubbish fell).
Along with such obsessions, pathological actions develop, such as spitting, biting lips, grinding teeth, and so on. They differ from obsessions that arise for objective reasons in that they do not cause feelings of guilt, experiences that are alien, painful to a person. Neurotic states, which are characterized only by obsessive tics, as a rule, have a favorable outcome for the patient. Most often appearing in school age, tics go away by the end of puberty. True, there are such cases that they persist for many years.
Unfortunately, most often obsessive-compulsive disorder develops into chronic form. Moreover, cases of complete recovery of a patient suffering from OCD are extremely rare in our time. True, in many patients only one type of obsession persists, and long-term stabilization of a person's mental health is quite possible.
In such cases, there is a gradual (usually after thirty years) there is a tendency to reduce symptoms and social adaptation occurs. For example, patients who previously experienced fear public speaking or airplane travel eventually ceases to experience (or gets a relaxed form without anxiety) this obsession.
More severe, complex forms of OCD, such as infection phobias, fear of sharp objects, aggressive obsessions, and the numerous rituals that follow, on the contrary, can be very resistant to any treatment, go into a chronic form with frequent relapses. In this case, despite the fact that the patient is undergoing active therapy. Further worsening of these symptoms leads to the fact that the clinical picture of the disease becomes more and more difficult.
Many people with OCD are afraid to go to the doctor, believing that they will be mistaken for crazy or maniacs. This is especially true for people with sexual obsessions or intrusive thoughts of harm. However, it is important to know that OCD is treatable! Therefore, anyone who suffers from intrusive thoughts should consult an experienced psychotherapist who specializes in the treatment of OCD.
It should be understood that the symptoms of obsessive-compulsive disorder are similar to those of other mental illnesses. In some cases, OCD must be distinguished from schizophrenia (an experienced psychiatrist will be able to make a correct diagnosis). Moreover, during the development of sluggish schizophrenia, an increase in the complexity of rituals is observed - their persistence, antagonistic tendency in the human psyche (inconsistency of actions and thoughts), monotonous emotional manifestations.
The complex lingering obsessions that characterize OCD also need to be distinguished from schizophrenia. Unlike its manifestations, obsessions are usually accompanied by a growing sense of anxiety, significant systematization and expansion of the circle of obsessive associations, which acquire the character of "special significance". For example, events, random remarks, and objects that by their "presence" remind the patient of their biggest phobia, or unpleasant thoughts. As a result, things or events become dangerous in the imagination of a person with obsessive-compulsive disorder.
In such cases, the patient should definitely seek help from qualified specialists in order to exclude schizophrenia. Certain difficulties in making a differential diagnosis arise in Gilles de la Tourette's syndrome, in which generalized disorders predominate.
Nervous tics, in this case, are localized in the neck, face, jaws, and are accompanied by grimaces, tongue protrusion, etc. In such cases, the syndrome can be excluded based on the fact that it is characterized by roughness of movements, various movement disorders and more complex mental disorders.
Despite the fact that experts have conducted a lot of research on obsessive-compulsive disorders, they still have not revealed what is main reason occurrence of the disease. Physiological factors can be as important as psychological ones. Let's look at all this in more detail.
It is worth emphasizing that when OCD occurs, studies have shown that the neurotransmitter serotonin is of great importance. Moreover, it has been proven in many scientific works that an obsessive state can be transmitted from generation to generation in the form of a tendency to develop the disease.
The study of this problem in adult twins showed that this disorder is moderately hereditary. True, they could not identify the gene that is responsible for the occurrence of OCD. However, the most prerequisites for this are genes - hSERT and SLC1A1, which contribute to the development of the disease.
As a rule, the task of the hSERT gene is to collect “waste” substances in the nervous structures. And as we wrote above, a neurotransmitter is required for the transmission of impulses in neurons. There are studies that clearly state hSERT mutation among certain groups of OCD patients. As a result of such mutations, this gene begins to work too quickly, taking away even usable serotonin.
SLC1A1 - also affects the development of the disease, and possibly its appearance. This gene has a lot of similarities with the gene described above, but its task is to transfer another substance - the neurotransmitter glutamate.
What is the autoimmune response to obsessions? In addition, the occurrence of obsessive-compulsive disorder depends on autoimmune diseases. It is worth emphasizing that in childhood, OCD occurs as a consequence of infection with group A streptococcus, which causes dysfunction and inflammation of the basal ganglia. These cases are grouped into clinical conditions, which are called PANDAS.
Another study suggests that episodic manifestations of OCD disorders are not due to streptococcal infection, but as a result of taking prophylactic antibiotics that fight infection. Various forms of obsessive-compulsive disorder can also occur as a result of the reaction of the immune system to pathogens.
Which ones arise neurological problems? Thanks to modern development technology, and the ability to scan the brain, the researchers were able to study the activity various departments brain. They were able to prove that some parts of the brain in people with OCD have unusual activity. These departments are:
In the results of brain scans of OCD patients, it was found that the disease affects the functionality of the chain connection between departments. Such a circuit that regulates instinctive behavioral aspects (aggression, bodily secretions, sexuality); starts the corresponding behavior, in the normal state it can “turn off”. That is, a person once washing his hands, will not do it again, in the near future. And move on to something else. However, in patients who suffer from OCD, this circuit cannot "switch off" immediately, and the signals are ignored, which causes a breakdown in "communication" between departments. The obsessions and compulsions continue, triggering repetitions of the action.
At the moment, medicine has not found an answer to the nature of such actions. But without a doubt, this violation is associated with problems in the biochemistry of the brain.
According to the postulates of one of the laws of behavioral psychology: the repetition of the same action makes it easier to reproduce it in the future. But in the case of patients who suffer from obsessive-compulsive disorder, all they do is repeat the “same” action. And for them, it plays the role of a “protective ritual” in order to “drive away” obsessive thoughts / actions. Such activities temporarily reduce fear, anxiety, anger, and so on, but the paradox is that it is the “rituals” that lead to the appearance of obsession in the future.
In this case, it turns out that it is the “avoidance of fear” that becomes one of the fundamental reasons for the formation of an obsessive state. And this, alas, leads to an increase OCD symptoms. Most frequently affected pathological changes people who for a long time are in a state of great stress: for example, they start working in a new place, end an exhausted relationship, suffer from constant overwork. For example, if a person previously calmly used public toilets, then at “one fine moment” the patient may develop a phobia of “infection” from unclean toilet seats, because of which one can catch a “disease”. Further, a similar association may appear to other objects in social life- public sinks, cafes, restaurants and more.
Soon, a person who develops OCD begins to perform "protective rituals" - dusting door handles, trying to avoid public toilets, and much more. Instead of overcoming his fear, convincing himself of the illogicality of obsession, a person becomes more and more subject to a phobia.
In fact, the behavioral theory, as we described above, explains why pathologies with “wrong” behavior arise. In turn, cognitive theory can explain why patients with OCD are not taught to correctly interpret their thoughts and actions that occur under the influence of the disease.
Most people experience compulsions in thoughts and actions several times a day, much more than people with a healthy mind. And unlike the latter, patients with obsessive-compulsive disorder exaggerate the importance of the thoughts that come to their mind.
How does obsession develop in young mothers? For example, against the background of fatigue, a woman who is raising a child may often have thoughts about harming her child. Most moms don't pay attention to stupid thoughts, attributing it to stress. But people who suffer from illness begin to exaggerate the importance of the thoughts and actions that come to their mind.
The woman begins to think, to realize that she is an "enemy" for the child. And this causes him fear, anxiety, and other negative thoughts. For the child, mommy begins to experience shame, mixed feelings of disgust and guilt. Fear of one's own thoughts leads to attempts to neutralize the "root causes". And more often than not, mothers begin to avoid situations during which they have such thoughts. For example, they stop feeding their baby, give him insufficient time, and develop their own "protective rituals."
And as we wrote above, the emergence of "rituals" help the violation in behavior to "get stuck" in the human psyche, to repeat this "ritual". It turns out that the cause of OCD is the perception of stupid thoughts as one’s own, along with the fear that they will certainly come true. Researchers also believe that people who suffer from obsessions received false beliefs as early as childhood. Among those:
It is worth emphasizing that stress and the state of the environment (both nature and the surrounding society) can trigger the harmful processes of obsession in people who are genetically susceptible to this disease. Studies have shown that neurosis in more than half of the cases occurs precisely because of the influence of the environment.
In addition, statistics show that patients who suffer from obsessions have experienced a traumatic event in their lives in the recent past. And such episodes can not only become a “prerequisite” for the appearance of the disease, but also for its development:
What helps obsessive-compulsive disorder get "stronger"? In order to cure OCD, knowing the exact causes of the disorder is not so important. The doctor needs to understand the underlying mechanisms that support the progress of the disease. Overcoming these will be the key to resolving the problem in the mental health of a person.
It is important to understand that obsessive-compulsive disorder is maintained by such a cycle - obsession, the emergence of fear / anxiety, and the response to the “irritant”. Every time a patient with neurosis avoids a situation/action that causes fear in him, the behavioral disorder is fixed in the neural circuit of the brain. The next time, the patient will act already on the “beaten path”, which means that the chance of a neurosis will increase.
Compulsions also become fixed over time. A person experiences discomfort and great anxiety if he has not checked “enough” the number of times whether the lights, stove, etc. are turned off. And as studies show, with a new “rule” in behavior fixed, a person will continue to do such operations in the future.
Avoidance and "protective rituals" initially work - a person reassures himself at the thought that if he hadn't checked, a catastrophe could have happened. But in the long run - such actions bring only a feeling of anxiety, which feeds the obsessive syndrome.
A person who suffers from obsessions overestimates his capabilities, his influence on the world. And as a result, he begins to believe that his bad thoughts can make a “catastrophe” in the world. Whereas if you turn "magic spells", "rituals" - this can be avoided. Thus, a patient with a developing mental disorder feels more comfortable. As if from the conducted "spells" there is control over what is happening. And bad things will not happen, a priori. But over time, the patient will perform such rituals more and more often, and this leads to an increase in stress and the progression of OCD.
It is important to understand that obsessions and doubts, which are often absurd and contrary to what a person really does and thinks, appear in every individual. The problem is that people who don't have OCD simply don't attach any importance to stupid thoughts, while a person with neurosis takes their thoughts too seriously.
In the 1970s, a number of experiments were conducted where healthy people and patients with OCD were asked to list their thoughts. And the researchers were surprised - the obsessive thoughts of both categories were practically the same!
Thoughts are the deepest fears of the individual. For example, any mother always worries that her child will get sick. The child is the greatest value for her, and she will be in despair if something happens to the child. That is why neuroses with obsessive thoughts about harming the child are especially widespread among young mothers.
The main difference between obsessions in healthy people and OCD sufferers is that painful thoughts occur much more often in the latter. And this is due to the fact that the patient attaches too much importance to obsession. It is no secret that the more often obsessive thoughts, images and actions are visited, the worse it affects the psychological balance of the patient. Healthy people often ignore them, do not attach importance to them.
Another important aspect The OCD patient overestimates the danger/underestimates their ability to cope with it. Most people with obsessions feel they need to be 100% sure that nothing bad will happen. For them, "protective rituals" are akin to insurance policy. And the more often they perform such magic spells, the more they will receive "security", certainty in the future. But in fact, such efforts only lead to the emergence of neurosis.
Some types of obsession make the patient think that everything must be done perfectly. But the slightest mistake will lead to catastrophic consequences. This occurs in patients who strive for order, suffer from anorexia nervosa.
As people say, "fear has big eyes." Here's how a person with OCD neurosis can "twist" themselves:
With obsession, a person "winds" himself to a state of anxiety, and then tries to suppress this feeling by performing obsessive actions.
Can obsessive-compulsive disorder be cured? In about 2/3 of OCD cases, improvements occur within a year. If the disease lasts more than a year, then during its course, doctors will be able to track fluctuations - when periods of exacerbation “change” with periods of improvement that last several months, and sometimes several years. The doctor can put a worse prognosis if there are severe symptoms of the disease, continuous stressful events in the life of a patient with a psychasthenic personality. Severe cases are incredibly persistent. Studies have shown that the symptoms in such cases can remain unchanged for 13-20 years!
How are obsessive thoughts and actions treated? Despite the fact that OCD is a complex psychological illness that includes a number of symptoms and forms, the principles of treatment for them are similar. The most reliable way to recover from OCD is considered drug therapy, which is determined individually for each patient, taking into account a lot of factors (age, gender, manifestations of obsessions, etc.). In this regard, we warn you - self-medication with medicines is strictly prohibited!
When symptoms appear that are similar to psychological disorders, it is necessary to contact the specialists of the psychoneurological dispensary or any other institutions of this profile to establish a competent diagnosis. And this, as you probably already guessed, is the key to effective treatment. At the same time, it is worth recalling that a visit to a psychiatrist does not have any negative consequences - for a long time there has been no “registration of the mentally ill”, which has been replaced by consultative and therapeutic assistance and observation.
During therapy, it should be remembered that OCD is often progressive in nature with "episodic" periods when worsening is followed by improvement. The pronounced suffering of a person with neurosis, it would seem, requires radical action, but remember that the course of the state is natural, and in many cases it should be excluded intensive care. It is important to remember that OCD, in most cases, is accompanied by depression. Therefore, the treatment of the latter will "erase" the symptoms of obsession, which makes it difficult to adequately treat.
Any therapy aimed at curing obsessions should begin with consultations, where the doctor proves to the patient that this is not “crazy”. Those suffering from this or that disorder often try to involve healthy family members in their “rituals”, so relatives should not make indulgences. But it’s also not worth it too harshly - this way you can aggravate the patient’s condition.
Currently, the following pharmacological drugs are used in OCD:
And now more about each of the groups of drugs.
Anxiolytic drugs give short-term therapeutic effect, reduces symptoms, but they should not be used for more than several weeks in a row. If treatment with the drug requires more time (1-2 months), then the patient is prescribed a small dosage of tricyclic antidepressants, as well as small antipsychotics. Atypical antipsychotics, such as risperidone, quetiapine, olanzapine and others, serve as the basis in therapy against the disease, where ritualized obsessions and negative symptoms are formative.
It is important to understand that any comorbid depression is treated with antidepressants at an acceptable dosage. There is evidence that, for example, the tricyclic antidepressant clomipramine has a specific effect on the symptoms of obsession. True, the test results showed that the effect of this drug is insignificant, and appears in patients with distinct signs of depression.
In cases where the symptoms of obsessive neurosis appear during diagnosed schizophrenia, intensive treatment in combination with pharmacotherapy and psychotherapy has the greatest effect. High doses of serotonergic antidepressants are prescribed here. But in some cases, traditional antipsychotics and benzodiazepine derivatives are involved.
What are the features of psychotherapy in the treatment of OCD? One of the fundamental tasks for effective treatment of the patient is to establish a fruitful contact between the patient and the doctor. It is necessary to instill in the patient faith in the possibility of recovery, to overcome all his prejudices and fears about the "harm" of psychotropic drugs. And also to "introduce" the confidence that regular visits, taking medications in prescribed doses, and following all the doctor's recommendations are the key to effective treatment. Moreover, the faith in recovery must be supported by the relatives of the patient.
If a patient suffering from OCD has formed "protective rituals", then the doctor needs to form for the patient the conditions under which he tries to perform such "spells". The study showed that improvement occurs in 2/3 of patients who suffer from moderate obsessions. If, as a result of such manipulation, the patient ceases to carry out such “rituals”, then obsessive thoughts, images and actions recede.
But it is worth remembering that behavioral therapy does not show effective results for correcting obsessive thoughts that are not accompanied by “rituals”. Some experts practice the "thought-stopping" method, but its effect has not been proven.
We have previously written about nervous breakdown has a fluctuating development, which is accompanied by an alternation of "improvement-deterioration". And regardless of what measures for treatment were taken by doctors. Until a pronounced recovery period, patients benefit from supportive conversations and providing hope for recovery. In addition, psychotherapy is aimed at helping the patient, correcting and getting rid of avoidant behavior, and in addition to this - reducing sensitivity to "fears".
We emphasize that family psychotherapy will help correct behavioral disorders, improve intra-family relationships. If marital problems cause the progression of OCD, then the spouses are shown joint therapy with a psychologist.
It should be emphasized that it is important to determine the correct timing of treatment and rehabilitation. So, first there is a long-term therapy (no more than two months) in a hospital, after which the patient is transferred to ambulatory treatment with continued therapy. And in addition to this - holding events that will help restore intra-family, social ties. Rehabilitation is a whole complex of programs for the education of patients with obsessive-compulsive disorders, which will help them think rationally in the society of other people.
Rehabilitation will help to set up the right interaction in society. Patients receive vocational training in the skills that are required in everyday life. Psychotherapy will help those patients who experience a sense of their own inferiority to feel better, treat themselves adequately, and gain confidence in their own strengths.
All these methods, if used in combination with drug therapy- will help improve the effectiveness of treatment. But, they cannot replace drugs in full. It is important to emphasize that the method of psychotherapy does not always bear fruit: in some patients with obsessions, deterioration is observed, since the “future treatment” makes them think about objects and things, which causes fear and anxiety. Often, obsessive-compulsive disorder can return again, even despite the positive result of past therapy.
