Frequent hand washing. Obsessive Compulsive Disorder: Causes. OCD and social conditions, including family life. Gender studies

Obsessive-compulsive disorder, also abbreviated (OCD), refers to complexes of symptoms that are combined into a group and are derived from the combined Latin terminology obsessio and compulsio.

Obsession itself, translated from Latin, means siege, imposition, blockade, and compulsions, translated from Latin, means I force.

For obsessive drives, varieties of obsessive phenomena (obsessions) are characterized by unbearable and very irresistible drives that arise in the head in defiance of reason, will and feelings. Very often they are accepted by the patient as unacceptable and act contradictory in relation to his moral and ethical principles and never, compared with impulsive drives, compulsions are realized. All these inclinations are recognized by the patients themselves as wrong and are very hard for them to experience. The very emergence of these drives, by the nature of its incomprehensibility, very often contributes to the emergence of a feeling of fear in the patient.

The very term compulsions is often used to refer to obsessions in the realm of movement, as well as obsessive rituals.

If we turn to domestic psychiatry, we will find that obsessive states are understood as psychopathological phenomena, which are characterized by the appearance in the mind of the patient of phenomena of a certain content, accompanied by a painful feeling of coercion. Obsessive states are characterized by the emergence of involuntary, against the will itself, obsessive desires with a clear awareness. But these obsessions are alien in themselves, superfluous in the psyche of the patient, but the patient himself cannot get rid of them. The patient has a close relationship with emotionality, as well as depressive reactions and a feeling of unbearable anxiety. When the above symptoms occur, it is found that they do not affect the intellectual activity and in general, are alien to his thinking, and also do not lower his level, but worsen his working capacity and productivity itself mental activity. For the entire period of illness, a critical attitude is maintained towards the ideas of obsession. Obsessive states are preliminarily subdivided into intellectual-affective obsessions (phobias), as well as motor obsessions (compulsions). In most cases, several types of obsessions are combined in the very structure of the disease of obsessions. The allocation of obsessions that are abstract, or indifferent in their content (affectively indifferent), for example, arrhythmomania, is often unjustified. When analyzing the psychogenesis of neurosis, it is realistic to see at the basis

Obsessive Compulsive Disorder - Causes

The causes of obsessive-compulsive disorder are the genetic factors of a psychasthenic personality, as well as family problems.

With elementary obsessions, in parallel with psychogeny, there are cryptogenic causes, in which the very cause of the occurrence of experiences is hidden. Obsessive states are observed mainly in people with a psychasthenic character, and fears are especially important here. intrusive nature, as well as these n.s. occur during neurosis-like states at the time of sluggish schizophrenia, epilepsy, after traumatic brain injuries and somatic diseases, with hypochondriacal-phobic or nosophobic syndrome. Some researchers believe that mental trauma plays an important role in the clinical picture of the genesis of obsessive-compulsive disorder, as well as conditioned reflex stimuli that have become pathogenic due to their coincidence with other stimuli that previously caused a feeling of fear. Situations that have become psychogenic due to the confrontation of opposing tendencies play an important role as well. But it should be noted that these same experts note that obsessive states occur in the presence of various features character, but still more often in psychasthenic personalities.

To date, all these obsessive states are described and included in the International Classification of Diseases under the names of "obsessive-compulsive disorder".

OCD is very common with a high percentage of morbidity and needs urgent involvement of psychiatrists in the problem. Currently, the understanding of the etiology of the disease has expanded. And it is very important that the treatment of obsessive-compulsive disorder is directed towards serotonergic neurotransmission. This discovery made it possible in the prospects to be cured by millions around the world who fell ill with obsessive-compulsive disorder. How to replenish the body with Serotonin? Tryptophan, an amino acid found in the only source- food. And already in the body Tryptophan is converted into Serotonin. With this transformation, mental relaxation occurs, as well as a feeling of emotional well-being. Further, Serotonin acts as a precursor to melatonin, which regulates the biological clock.

This discovery of intense serotonin reuptake inhibition (SSRI) holds the key to the most effective treatment for obsessive-compulsive disorder and was the very first stage of the revolution in clinical research, where the effectiveness of such selective inhibitors was noticed

Obsessive Compulsive Disorder - History

The obsessive-compulsive disorder clinic has attracted the attention of researchers since the 17th century.

They were first talked about in 1617, and in 1621 E. Barton described an obsessive fear of death. Studies in the field of obsession are described by F. Pinel (1829), and I. Balinsky introduced the term "obsessive ideas", which entered the Russian psychiatric literature. Since 1871, Westphal has introduced the term "agoraphobia", which refers to the fear of being in public places.

In 1875, M. Legrand de Sol, analyzing the characteristics of the dynamics of the course of obsessive-compulsive disorder in the forms of insanity of doubt, along with the delusion of touch, found out that the gradually becoming more complex clinical picture, in which obsessive doubts are replaced by fear of touching objects in environment, as well as motor rituals that govern the life of the sick

Obsessive Compulsive Disorder in Children

But only in the XIX-XX centuries. the researchers were able to more clearly characterize the clinical picture and give an explanation of the syndromes of obsessive-compulsive disorders. Obsessive-compulsive disorder itself in children often falls on adolescence or adolescence. The maximum of clinically identified manifestations of OCD itself stands out in the interval of 10-25 years.

Obsessive Compulsive Disorder - Symptoms

The main features of obsessive-compulsive disorder are repetitive and very intrusive thoughts (obsessive) and compulsive actions (rituals).

Simply put, the core in OCD is the obsession syndrome, which is a combination of thoughts, feelings, fears, memories in the clinical picture, and all this occurs in addition to the desire of the patients, but still with the awareness of all the pain and a very critical attitude. When understanding the unnaturalness and all the illogicality of obsessive states, as well as ideas, patients are very powerless in trying to overcome them on their own. All obsessive urges, as well as ideas, are accepted as alien to the person and as if coming from within. In patients, compulsive actions are the performance of rituals that act as an alleviation of anxiety, (this may be washing hands, wearing a gauze bandage, frequent change laundry to prevent infection). All attempts to drive away uninvited thoughts, as well as urges, lead to severe internal struggle, which is accompanied by intense anxiety. These obsessive states are included in the group of neurotic disorders.

The prevalence among the population of OCD is very high. Those suffering from obsessive-compulsive disorder make up 1% of patients who are treated in psychiatric hospitals. It is believed that men, like women, get sick to the same extent.

Obsessive-compulsive disorder is characterized by the appearance of thoughts of an obsessive painful nature for independent reasons, but given out to patients as their personal beliefs, ideas, images. These thoughts forcibly penetrate into the consciousness of the patient in a stereotyped form, but at the same time he tries to resist them.

This combination of an internal feeling of compulsive belief, as well as efforts to resist it, indicates the presence of obsessive symptoms. Thoughts of an obsessive nature can also take the form of individual words, lines of poetry, and phrases. For the sufferer himself, they can be indecent, shocking, and also blasphemous.

The obsessional images themselves are very vividly presented scenes, often of a violent nature, as well as disgusting(sexual perversions).

obsessive impulses include urges to act that are usually destructive or dangerous, and that may also bring disgrace. For example, shout out obscene words in society, and also jump out abruptly in front of a moving car.

Obsessional rituals include repetitive activities such as counting, repeating certain words, repeating often meaningless actions such as washing hands up to twenty times, and some may develop obsessive thoughts about impending infection. Some of the rites of the sick include constant ordering in the laying out of clothes, taking into account a complex system. One part of the patients experiences an irresistible and wild impulse to carry out actions a certain number of times, and if this does not happen, then the sick are forced to repeat everything from the beginning. The patients themselves recognize the illogicality of their rituals and deliberately try to hide this fact. Sufferers experience and consider their symptoms as a sign of incipient madness. All these obsessive thoughts, as well as rituals, contribute to the appearance of problems in everyday life.

obsessive thoughts or simply mental chewing gum, akin to an internal debate in which all the arguments for and against are constantly reviewed, including very simple everyday actions. Some obsessive doubts refer to actions that could allegedly be incorrectly performed and also not completed, for example (turning off the gas stove faucet, as well as locking the door); and others refer to actions that could possibly harm other individuals (presumably driving past a cyclist in a car to knock him down.) Very often, doubts are caused by religious prescriptions and rituals, namely remorse.

As for compulsive actions, they are characterized by often repeated stereotyped actions that have acquired the character of protective rituals.

Along with this, obsessive-compulsive disorders distinguish a number of clear symptom complexes, including contrasting obsessions, obsessive doubts, and phobias (obsessive fears).

obsessive thoughts compulsive rituals themselves, as well as compulsive rituals, can intensify in some situations, namely, the nature of obsessive thoughts about harming other people is very often intensified in the kitchen or anywhere else where there are piercing objects. Patients themselves often try to avoid such situations and there may be similarities with an anxiety-phobic disorder. Anxiety itself is a significant component in obsessive-compulsive disorder. Some rituals weaken anxiety, and after other rituals it increases.

Obsessions tend to intensify within depression. In some patients, the symptoms resemble a psychologically understandable reaction to obsessive-compulsive symptoms, while in others recurring episodes occur. depressive disorders arising from independent causes.

obsessive states (obsessions) are divided into sensual or figurative, which are characterized by the development of a painful affect, as well as obsessive states of affectively neutral content.

To the obsessive states of the sensual plane gets obsessive feeling dislikes, actions, doubts, obsessive memories, ideas, desires, fears about habitual actions.

Under obsessive doubts falls uncertainty that has arisen in spite of sound logic, as well as reason. The patient begins to doubt the correctness decisions taken, as well as committed and committed actions. The very content of these doubts is different: fears about a locked door, closed taps, closed windows, electricity off, gas off; official doubts about a correctly written document, addresses on business papers, whether the numbers are accurate. And despite repeated verification of the perfect action, obsessive doubts do not disappear, but only cause psychological discomfort.

Persistent and irresistible sad memories of unpleasant, as well as shameful events, which are accompanied by a feeling of remorse and shame, fall into obsessive memories. These memories prevail in the mind of the patient, and this despite the fact that the patient is trying to distract from them in any way.

obsessive attraction pushed to exercise hard or very dangerous action. At the same time, the patient experiences a feeling of fear, horror and confusion about the impossibility of getting rid of it. The sick person has a wild desire to throw themselves under the train, as well as push under the train loved one or kill the wife in a cruel way, as well as the child. At the same time, sick people are very tormented and worried about the implementation of these actions.

Obsessions also appear in various options. In some cases, a vivid vision of the results of the obsessive drives themselves is possible. At this moment, patients vividly present a vision of a cruel act they have committed. In other cases, these obsessive ideas appear as something implausible, even as absurd situations, but the sick people take them for real. For example, the belief and conviction of a sick person that a buried relative was buried while still alive. At the peak of obsessive ideas, the awareness of their absurdity, as well as the improbability itself, disappears and an acute confidence in their reality prevails.

An obsessive feeling of antipathy, this also includes obsessive blasphemous thoughts, as well as antipathy towards loved ones, unworthy thoughts towards respected people, towards saints, as well as ministers of the church.

Obsessive actions are characterized by actions that are committed against the wishes of the sick and despite all the restraining efforts made for them. Some of the obsessive actions are burdensome for the patient himself and this continues until they are realized.

And other obsessions pass by the patient himself. Obsessive actions are most painful when others pay attention to them.

obsessive fear or phobias include fear of large streets, fear of heights, confined or open spaces, fear of large crowds, fear of sudden death, and fear of contracting an incurable disease. And some patients develop phobias with fear of everything (panphobia). And finally, there may be an obsessive fear (phobophobia).

Nosophobia or hypochondriacal phobias are associated with an obsessive fear of any serious illness. Stroke-, cardio-, AIDS-, syphilo-, phobia of malignant tumors are very often noticed. At the very peak of anxiety, patients often lose their critical attitude towards their health and often resort to doctors for examination, as well as treatment of non-existent diseases.

Specific or isolated phobias include obsessive fears caused by a specific situation (fear of heights, thunderstorms, nausea, pets, treatment at the dentist, etc.). For patients experiencing fear, avoidance of these situations is characteristic.

Obsessive fears are often supported by the development of rituals - actions that are involved in magic spells. Rituals are performed because of protection from imaginary misfortune. Rituals may include snapping fingers, repeating certain phrases, singing a melody, and so on. In such cases, the relatives themselves are not at all aware of the existence of such disorders in relatives.

Obsessions that are affectively neutral in nature include obsessive sophistication, as well as obsessive counting or recall. neutral events, wording, terms, etc. These obsessions burden the patient and interfere with his intellectual activity.

Contrasting obsessions or aggressive obsessions include blasphemous as well as blasphemous thoughts, obsessions are filled with fear of fear of harm not only to themselves, but also to others.

Patients with contrasting obsessions are disturbed by irresistible desires to shout out cynical words that are contrary to morality, they are able to commit dangerous, as well as ridiculous actions in the form of injuring themselves and their loved ones. Often, obsessions go in combination with object phobias. For example, fear sharp objects(knives, forks, axes, etc.). This group of contrasting obsessions includes sexual obsessions (the desire for perverted sexual acts with children, animals).

Mysophobia — obsessions pollution (fear of contamination by earth, urine, dust, feces), small objects (glass fragments, needles, specific types of dust, microorganisms); fear of harmful and toxic substances (fertilizers, cement, toxic waste) entering the body.

In many cases, the fear of pollution itself can be limited, manifesting itself only, for example, in personal hygiene (very frequent change of clothes, repeated washing of hands) or household issues (food handling, frequent washing of floors, no pets). Of course, such monophobias do not affect the quality of life, they are perceived by others as personal habits of cleanliness. Clinically recurring variants of these phobias are classified as severe obsessions. They consist in cleaning things, as well as in a certain sequence of use detergents and towels to keep the bathroom sterile. Outside the apartment, the sick person initiates protective measures. Appears on the street only in special and maximum covered clothes. In the later stages of the disease, the patients themselves avoid pollution, moreover, they are afraid of going out into the street and do not leave their own apartments.

One of the places in the series of obsessions was occupied by obsessive actions, as isolated, monosymptomatic movement disorders. AT childhood they include tics. People with tics are able to shake their heads, as if checking if my hat fits well, make hand movements, as if discarding interfering hair, and constantly blink their eyes. Together with obsessive tics actions such as biting lips, spitting, etc.

Obsessive Compulsive Disorder - Treatment

As noted earlier, cases of complete recovery are observed relatively rarely, but stabilization of the condition is possible, as well as mitigation of symptoms. Mild forms of obsessive-compulsive disorder are treated favorably on an outpatient basis, and the reverse development of the disease occurs no earlier than 1 year after treatment.

And more severe forms obsessive-compulsive disorder (phobias of infection, sharp objects, pollution, contrasting performances or multiple rituals) become more resistant to treatment.

Obsessive-compulsive disorder is very difficult to distinguish from schizophrenia, as well as Tourette's syndrome.

As well as schizophrenia interfere with the diagnosis of obsessive-compulsive disorder, so to exclude these diseases, you need to contact a psychiatrist.

For effective treatment of obsessive-compulsive disorder, stressful events must be removed, and pharmacological intervention should be directed to serotonergic neurotransmission. Unfortunately, science is powerless to cure this mental illness forever, but many experts use the method to stop thoughts.

Drug therapy is a reliable treatment for OCD. Self-medication should be refrained from, and a visit to a psychiatrist should not be postponed.

Obsessives often involve family members in their rituals. In this situation, relatives should treat the sick person firmly, but also sympathetically, if possible, softening the symptoms.

Drug therapy in the treatment of obsessive-compulsive disorder includes serotonergic antidepressants, anxiolytics, small antipsychotics, MAO inhibitors beta-blockers to stop autonomic manifestations, and triazole benzodiazepines. But the main ones in the treatment regimen for obsessive-compulsive disorder are atypical antipsychotics- quetiapine, risperidone, olanzapine in combination with SSRI antidepressants or with antidepressants such as moclobemide, tianeptine, as well as benzodiazepine derivatives (these are alprazolam, bromazepam, clonazepam).

One of the main tasks in the treatment of obsessive-compulsive disorder is the establishment of cooperation with the patient. It is important to inspire the patient to believe in recovery and overcome prejudices against the harm of psychotropic drugs. Required support from relatives in the likelihood of healing the patient

Obsessive Compulsive Disorder - Rehab

Social rehabilitation includes the establishment of intra-family relations, learning how to properly interact with other people, professional education and learning skills for everyday life. Psychotherapy is aimed at gaining faith in one's own strength, self-love, mastering ways to solve everyday problems.

Often, obsessive-compulsive disorder is prone to relapse, and this, in turn, requires longitudinal prophylactic medication.

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.

Frequent hand washing

People with OCD often have an exaggerated fear of infection. The result of a phobia is washing hands too often. 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.

Excessive desire for cleanliness

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 door with his elbows so as not to touch them with his hands). Sometimes patients are unable to business as usual seeing dishes left on the table or crumpled napkins.

The habit of double-checking your actions

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.

Tendency to count

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 certain color or brands. 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.

Pathological order requirements

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.

Excessive fear of trouble

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 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.

obsessive sexual fantasies

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 tendency to constantly analyze relationships with others

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 this.

The habit of rehearsing future actions

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.

Constant dissatisfaction with one's appearance

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 improve your 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 pursued 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. It means that imaginary threats the patient is constantly disturbed, 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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Obsessive-compulsive disorder (OCD) is a mental illness characterized by obsessive thoughts, doubts, and constant double-checking of actions taken.

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

The reasons

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

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

Symptoms of the disease

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

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

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

obsessive thoughts

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

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

obsessive doubts

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

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

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

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

Contrasting obsessions

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

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

Obsessions of pollution

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

Sometimes the fear of pollution is not very pronounced. At the same time, a person for many years only washes his hands too hard or several times a day without apparent reason mop the floor. Such phobias do not significantly affect the quality of human life, and others are regarded only as increased cleanliness.

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

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

obsessive actions

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

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

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

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

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

Treatment of the disorder

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

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

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

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

OCD stands for Obsessive Compulsive Disorder. It is a neurosis associated with obsessive-compulsive states. The habits that many people have and are even considered useful can cross the invisible line, turning into real mental disorders that prevent a person from living a normal life and require psychotherapeutic help.

OCD involves neurosis accompanied by obsessive-compulsive disorders

Along with phobias, OCD is classified as obsessive-compulsive disorder (phobias and compulsions are part of the structure of this syndrome), but unlike phobic manifestations, they include obsessions (obsession) and compulsions (compulsion).

Most often, these diseases are encountered in 10-35 years. It may take several years from the onset of the disease to the appearance of its initial pronounced symptoms. Among adults, OCD occurs in every third (in a more or less pronounced form), among children, every second out of five thousand is sick.

At first, a person realizes the irrationality of his obsessive state, but if he does not receive any psychological and, possibly, medical assistance, this disorder further aggravates. It is no longer possible to adequately assess the patient's situation.

Causes of neurosis

Name the exact factors leading to the occurrence of the described mental illness scientists fail. But most theories agree that the causes can be concluded in:

• disturbed metabolism;
• craniocerebral injuries;
• genetic predisposition;
• complications of infectious diseases;
• dysfunction of the autonomic system.

It should be noted the likelihood of such causes of obsessive-compulsive neurosis:

• strict upbringing rules (often related to religion);
• lack of normal relationships with colleagues and superiors at work;
• regular stress.

The driver for the development of panic fear can be a negative experience or an experience imposed by social circumstances.

Often similar troubles begin in people who have reviewed crime news bulletins. To defeat the fears that have appeared, the patient performs actions that prove, in his opinion, the opposite:

• checks a dozen times whether he closed the apartment;
• more than once counts banknotes received at an ATM;
• washes his hands vigorously, despite the fact that they have long been clean.

But these actions performed by a person, like rituals, do not help - with their help it is possible to achieve only short-term relief.

Over time, the disease can literally "absorb" human psyche. Children are less likely to experience this disease than adults. The symptoms of obsessive-compulsive disorder, not least, depend on the age of the patient.

"Rituals" Performed by OCD Patients Provide Only Temporary Relief

Symptoms of the disorder

The diagnosis of OCD suggests different kinds of this disorder, but their overall clinical picture is almost the same. First of all, we are talking about painful thoughts and fantasies associated with:

• sexual violence;
• imminent death;
• loss of financial well-being, etc.

Even realizing the groundlessness of such ideas, the patient still cannot free himself from them on his own. It seems to him that these fantasies will one day become reality.

The main symptoms of this mental disorder are associated with the repetition of the same movements. Someone counts the steps everywhere, someone does not get tired of washing their hands several dozen times a day. It’s hard for those around you – colleagues, friends and relatives – not to notice such behavior.

Often in people with OCD, workplace kept in perfect order: the symmetrical placement of all objects catches the eye. The books in the bookcase can be sorted alphabetically or by color.

When the patient finds himself in a crowd, the signs of his disorder intensify, panic attacks begin. There may be a fear of infection with some terrible virus, fear of losing personal belongings or their theft. Respectively, public places such people should visit as little as possible.

Possibly decreased self-esteem. In general, suspicious individuals often have to suffer from compulsive-obsessive disorder: with a tendency to control everything they do, they suddenly realize that certain changes are taking place and they have no way to influence this.

Childhood neurosis

Obsessional neurosis occasionally occurs in children. There are several examples:

• Fear of suddenly being alone in the crowd - because of this, the child strongly clings to the hand of an adult, checks the strength of the grip of the fingers.
• Fear of being in orphanage(often due to the fact that parents or older brothers scare kids with an orphanage as an incentive to do something or not to do something).
• Panic caused by a lost thing. Some children even wake up at night to count their belongings and school supplies.

Among the signs of such a disease in children can be noted:

• sullenness;
• tearfulness;
• unimportant mood;
• loss of appetite;
• bad dream.

Some symptoms are rare, while others recur more frequently. Parents watching their children similar signs You need to seek help from a psychotherapist.

Diagnosis: a visit to the doctor

People suffering from obsessions and compulsions are not always aware of their own illnesses. However, those around them - relatives, acquaintances, colleagues - should carefully point this out to them: one should not expect that the ailment will go away on its own.

Diagnosis can only be carried out by a professional psychologist. The diagnosis of OCD and the determination of the degree of the disorder are made according to special rating scales, the decoding of which is within the power of a qualified specialist.

OCD should be treated by a qualified physician

Here is what the therapist should pay attention to first of all:

• The presence of pronounced obsessive obsessions (which are already a sign of a disorder).
• Signs of compulsive neurosis, which the patient, however, tries to hide.
• Violation of the normal rhythm of life.
• Difficulty communicating with colleagues and friends.

Symptoms are considered significant for accurate diagnosis if repeated 50 percent of the time over a couple of weeks.

The doctor examines the patient, conducts a conversation with him, gives special tests and makes a diagnosis. He must explain to the person:

• what does obsessive compulsive disorder mean?
• by what symptoms it can be identified;
• what are the causes of this problem;
• what should be the treatment - medical and psychological.

You should not think that the disease is incurable - in fact, many people manage to successfully cope with disorders and return to a normal life, not burdened by obsessive-compulsive states.

Is it possible to cure the described disease at home? Theoretically, it is possible to cope with the problem if it is detected at a very early stage of development, the patient himself has realized it, accepted it and is doing everything necessary to recover.

Here are the options for therapy that you can carry out on your own:

• Learn more about OCD, its symptoms and causes. For this there is specialized literature, the Internet (this site, in particular). Write down symptoms that cause particular concern. Formulate a strategy to deal with these symptoms.
• Look fear straight in the eye. Most patients are aware of the irrationality of obsessive-compulsive states, their "fictitious" nature. And if you want to wash your hands once again or check if the door is closed, you need to remind yourself of the futility of such actions and psychologically force yourself not to do them.
• For every successful step, you should praise yourself, even if it was insignificant.

Although, of course, it is better to contact a qualified medical specialist on psychotherapy. There may be certain difficulties at the first visit to the doctor, but once he makes a diagnosis, prescribes treatment, everything will be much easier.

Some folk remedies help patients calm down: these are decoctions of lemon balm, valerian and other sedative herbs.

Breathing exercises are also considered useful. All that is required is to correctly change the strength of the breath. Gradually, this restores a normal emotional state and makes a person's assessment of everything that happens in his life more sober and adequate.

Psychotherapeutic methods

Based OCD symptoms doctors may prescribe the following treatment options:

• Cognitive behavioral techniques. Designed by Dr. Jeffrey Schwartz. To begin with, a person must realize that he has a disorder, and then begin to resist. Gradually, the patient acquires skills, thanks to which he independently copes with obsessions.
• "Stop Thought" The author of this method is Joseph Wolpe. The patient recalls a recent attack of OCD, and he determines its significance for his life (thanks to the psychotherapist's leading questions). Gradually the patient must realize how unrealistic all his fears are.

There are other therapeutic methods, however, the above are considered the most effective and in demand.

Psychotherapists use different methods in the treatment of OCD

Medication treatment

As regards the medicinal OCD treatment, most often, doctors prescribe inhibitors that reuptake serotonin. In particular, this applies to Paroxetine, Fluvoxamine, tricyclic antidepressants.

The study of obsessive emotions in this disease, including hatred and aggression, is ongoing. Today enough detail about this disorder You can read Wikipedia, view many informational articles on this site.

That ongoing research is not in vain is proven by new discoveries by researchers in this field: for example, agents that release the neurotransmitter glutamate can perform a therapeutic function. Thanks to them, neurotic manifestations are softened. True, a complete recovery, thus, will not be achieved. These agents can be found in lamotrigine and memantine.

Antidepressants help, but only to cope with the symptoms: they relieve tension and relieve neurosis.

By the way, almost all of these medicines are sold in pharmacies, but they are sold by prescription. One way or another, you should not prescribe them yourself - this should be done by the doctor, based on the current state of the patient and his individual characteristics. The duration of this syndrome is also important: the doctor should find out exactly when the OCD began.

There are many effective psychotherapeutic methods for the treatment of obsessive-compulsive disorders, but often medication is indispensable.

Rehabilitation after treatment

When the course of treatment is over, the patient still needs social rehabilitation. Without normal adaptation, OCD symptoms will return again.

Therapeutic activities carried out for support are associated with learning productive interaction with work colleagues, relatives, society. It is important that relatives and friends help to rehabilitate.

Rehabilitation is not a single event, but a whole range of procedures aimed at ensuring that a person can adapt to everyday life, control his own behavior, and become quite self-confident.

It is important that loved ones support a person being treated and cured of OCD

A lot of space is given to OCD psychiatry today, since the danger of such disorders cannot be underestimated, nor can their treatment be delayed. How earlier man finds out (most often people around him tell him about it) that he has obsessive-compulsive disorders, goes to the doctor and starts treatment, the more opportunities he has to cope with all this quickly, easily and avoiding consequences.

Obsessive psychological disorders have been known for centuries: in the 4th century BC. e. this disease was referred to as melancholy, and in the Middle Ages, the disease was considered an obsession.

The disease was studied and tried to systematize for a long time. He was periodically attributed to paranoia, psychopathy, manifestations of schizophrenia and manic-depressive psychosis. On the this moment obsessive-compulsive disorder (OCD) considered one of the varieties of psychosis.

Facts about obsessive-compulsive disorder:

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

THE REASONS

The etiology of OCD has not been elucidated, and there are several hypotheses in this regard. The reasons may be biological, psychological or socio-social in nature.

Biological reasons:

• birth trauma;
• pathology of the autonomic nervous system;
• features of signal transmission to the brain;
• metabolic disorders with changes in metabolism necessary for normal operation neurons (decrease in serotonin levels, increase in dopamine concentration);
• traumatic brain injury in history;
• organic brain damage (after meningitis);
• chronic alcoholism and drug addiction;
• hereditary predisposition;
• complicated infectious processes.

Socio-public and psychological factors:

• children's psychological trauma;
• psychological family trauma;
• strict religious upbringing;
• overprotective parenting;
• professional activity under stress;
• life-threatening shock.

CLASSIFICATION

Classification of OCD according to the features of its course:

• a single attack (observed throughout the day, week or longer than a year);
• relapsing course with periods of no signs of the disease;
• continuous progressive course of pathology.

Classification according to ICD-10:

• mainly obsessions in the form of intrusive thoughts and reflections;
• predominantly compulsions - actions in the form of rituals;
• mixed form;
• other OKRs.

SYMPTOMS of obsessive-compulsive disorder

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

The main symptoms of OCD are:

• The appearance of painful and intrusive thoughts. They are usually in the nature sexual perversions, blasphemy, thoughts of death, fear of reprisals, illness and loss of material wealth. From such thoughts, a person with OCD is horrified, realizes all their groundlessness, but is not able to overcome his fear.
• Anxiety. The OCD patient has a constant internal struggle, which is accompanied by a feeling of anxiety.
• repetitive movements and actions can manifest themselves in the endless counting of the steps of the ladder, frequent washing hands, the arrangement of objects symmetrically to each other or in some order. Sometimes patients with the disorder can come up with their own intricate system for storing personal belongings and constantly follow it. Compulsive checks are associated with repeated return home in order to detect the light, gas, check whether entrance doors. The patient conducts a kind of ritual to prevent unlikely events and to get rid of obsessive thoughts, but they do not leave him. If the ritual fails to complete, the person starts over.
• Obsessive slowness in which a person performs daily activities extremely slowly.
• Strengthening the severity of the disorder in crowded places. The patient has a fear of infection, disgust, nervousness from the fear of losing his things. In this regard, patients with obsessive-compulsive disorder try to avoid the crowd as much as possible.
• Decreased self-esteem. The disorder is especially susceptible to suspicious people who are used to keeping their lives under control, but are unable to cope with their fears.

DIAGNOSTICS

Diagnosis requires a psychodiagnostic conversation with a psychiatrist. A specialist can differentiate OCD from schizophrenia and Tourette syndrome. special attention deserves an unusual combination of obsessive thoughts. For example, simultaneous obsessions of a sexual and religious nature, as well as eccentric rituals.

The doctor takes into account the presence of obsessions and compulsions. obsessive thoughts have medical significance in case of their repetition, stability and importunity. They should cause a feeling of anxiety and suffering. Compulsions are considered in the medical aspect if, when they are performed, the patient experiences fatigue in response to obsessions.

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

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

TREATMENT

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

Treatment options for OCD:

• Cognitive Behavioral Psychotherapy allows the patient to resist intrusive thoughts by changing or simplifying rituals. When talking with a patient, the doctor clearly divides the fears into justified and caused by the disease. At the same time, it provides concrete examples from life healthy people, better than those that cause respect in the patient and serve as authority. Psychotherapy helps to correct some of the symptoms of the disorder, but does not completely eliminate obsessive-compulsive disorder.
• Medical treatment. Taking psychotropic drugs is an effective and reliable method of treating obsessive-compulsive disorder. Treatment is selected strictly individually, taking into account the characteristics of the disease, the age and gender of the patient, as well as the presence of concomitant diseases.

Medical treatments for OCD:

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

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

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

The unanimous opinion of doctors is the impossibility of self-healing from OCD. Any attempt to cope on their own with such a disorder only exacerbate the situation.

For the treatment of mild forms, outpatient observation is suitable, in this case, the recession begins no earlier than a year after the start of therapy. More complex forms of obsessive-compulsive disorder, associated with fear of contamination, pollution, sharp objects, complex rituals and versatile ideas, show particular resistance to treatment.

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

COMPLICATIONS

Possible complications of OCD:

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

PREVENTION

Primary prevention measures for OCD:

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

Methods for secondary prevention of OCD:

• regular medical examination;
• conversations with the aim of changing a person's attitude to situations that traumatize the psyche;
• phototherapy, increasing the illumination of the room (the sun's rays stimulate the production of serotonin);
• general strengthening measures;
• diet provides good nutrition with a predominance of products containing tryptophan (an amino acid for the synthesis of serotonin);
• timely treatment of concomitant diseases;
• prevention of any kind of drug addiction.

PROGNOSIS FOR RECOVERY

Obsessive Compulsive Disorder is chronic illness, for which complete recovery and episodicity are not typical or seen in rare cases.

In the treatment of mild forms of the disease in an outpatient setting, the regression of symptoms is observed no earlier than 1-5 years after the detection of the disease. Often the patient has some signs of the disease that do not interfere with his daily life.

More severe cases of the disease are resistant to treatment and prone to recurrence. OCD is aggravated by overwork, lack of sleep, and stress factors.

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

Improvement in the condition of some patients is associated with taking medications, therefore, after their withdrawal, the likelihood of relapse increases significantly.

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