OCD diagnosis symptoms and treatment. How does the disease begin? Constant hand washing

Obsessive Compulsive Disorder is a dysfunction mental activity manifested by involuntary thoughts intrusive nature that interfere with normal functioning, and various fears. These thoughts give rise to anxiety, which can only be relieved by performing obsessive and tiresome activities called compulsions.

Obsessive-compulsive disorder can be progressive, episodic, or chronic. Obsessional thoughts are ideas or gravitations that are born again and again in a stereotyped form in a person's head. The essence of these thoughts is almost always painful, since they are either perceived as meaningless ideas or carry obscene or aggressive content.

Causes of Obsessive-Compulsive Disorder

The root causes of the disorder in question can rarely be found on the surface. Obsessive-compulsive OCD is characterized by compulsions (ritual acts) and obsessions (obsessive thoughts). The most common involuntary intrusive thoughts are:

— fear of contamination (for example, by viruses, microbes, liquids, chemicals or excrement);

Signs of obsessive-compulsive disorder in children:

Wet, chapped hands (if the child suffers from compulsive handwashing)

- prolonged stay in the bathroom;

- slow homework due to fear of making a mistake;

- making many corrections and amendments to school work;

- strange or repetitive behavior, such as constantly checking doors to see if they are closed or taps;

- tedious constant questions that require reassurance, for example, "Mom, touch, I have a fever."

How to treat obsessive-compulsive disorder in children? Many parents want to know. First of all, it is necessary to determine exactly whether their child suffers from obsessive-compulsive disorder or simply practices some of his rituals. It is possible to single out quite normal rituals for childhood, which parents often take for violations. These include:

- in children under the age of three, certain "traditions" of going to bed are often observed, to school period it usually either goes away or becomes mild;

- invented games with certain rules, collecting (starting from the age of five);

- excessive passion for some performer, subculture, which is a way of socialization, building relationships with peers who have similar hobbies.

Before getting rid of obsessive-compulsive disorder, parents need to differentiate it from the normal manifestations inherent in age period in which their baby is located. The main difference between the described syndrome and normal rituals is the understanding by adolescents and children of the abnormality of obsessive thoughts and ritual actions. Children are aware that their actions are deviant, so they try to resist them. This understanding pushes them to hide obsessive thoughts and ritual actions from the environment. Therefore, if a baby performs a certain ritual without hiding before going to bed, then this does not indicate the presence of an ailment. You need to understand that such behavior is only inherent in his age period.

Treatment of obsessive-compulsive disorder

Previously, the syndrome under consideration was considered a condition that is resistant (unresponsive) to treatment, since traditional psychotherapeutic methods based on the principles of , rarely brought an effect. Also, the results of the use of various drugs were not encouraging. However, in the 1980s, this situation changed dramatically due to the introduction of new methods of behavioral therapy and pharmacopoeial medicine, the effectiveness of which was proven through large-scale studies.

Scientists of that time, trying to find the answer to the question "how to treat obsessive-compulsive disorder" empirically proved that the most effective method behavioral therapy The violation in question is a method of preventing reaction and exposure.

The patient is instructed on how to resist performing compulsive actions, after which he is placed in a situation that provokes discomfort caused by obsessions.

The main thing in the treatment of the disease in question is the timely recognition of obsessive-compulsive disorder and the correct diagnosis.

At present, the main medications Treatments for obsessive-compulsive disorder are selective serotonin reuptake inhibitors (clomipramine), anxiolytics (Clonazepam, Buspirone), mood stabilizers (Lithium preparations), and antipsychotics (Rimozide).

How to get rid of obsessive-compulsive disorder? Most therapists agree that treatment this disease should begin with the appointment of antidepressants, namely drugs of the group selective inhibitors reuptake of serotonin in an adequate dose. Drugs in this pharmacotherapeutic group are better tolerated by patients and are considered safer than clomipramine (a tricyclic antidepressant that causes blocking of serotonin reuptake), previously widely used in the treatment of the disorder in question.

It is also practiced to prescribe anxiolytics in combination with other drugs. It is not recommended to use them as a monotherapy drug. The appointment of normotimic drugs, namely Lithium preparations, is shown, since Lithium promotes the release of serotonin.

A number of researchers have proven the effectiveness of prescribing atypical antipsychotics(olanzapine) in combination with serotonergic antidepressants.

In addition to the use of drugs in the treatment of obsessions and compulsions modern approach involves the use of psychotherapeutic methods. An excellent psychotherapeutic effect is given by the four-step technique, which provides an opportunity to simplify or modify ritual procedures. This method is based on the patient's awareness of the problem and the gradual overcoming of the symptoms.

Obsessive-compulsive disorder home treatment is not recommended, but there are a number of treatment and preventive measures that can reduce the severity of manifestations.

So, obsessive-compulsive disorder treatment at home involves:

- reducing the consumption of alcohol and drinks containing caffeine;

- getting rid of bad habits;

- regular meals, because the feeling of hunger, lack nutrients, a decrease in sugar levels can provoke a stressful condition that will cause the onset of symptoms of obsessive-compulsive disorder;

- regular execution exercise, since the systematic release of endorphins improves metabolism, increases stress resistance and improves overall human health;

- massage;

— establishing optimal mode sleep and wakefulness;

- taking warm baths, during which a cool compress should be placed on the head of the suffering individual, this procedure should be carried out several times a week for twenty minutes, each procedure should be lowered in water temperature;

- to relieve anxiety, in order to relax and calm the sick individual, ingestion herbal decoctions and infusions with sedative effect(the herb of valerian officinalis, lemon balm, motherwort is used);

- the systematic use of St. John's wort, which allows you to increase mental concentration, improve clarity of consciousness, affecting the power of compulsion to perform ritual actions;

— daily holding breathing exercises, which allows you to restore a normal emotional background, contributing to a "sober" assessment of the current situation.

After the therapy, social rehabilitation is required. Only in case of successful adaptation after treatment of obsessive-compulsive disorder clinical symptoms will not come back. The complex of rehabilitation measures includes training in fruitful interaction with the social and immediate environment. For complete cure from obsessive-compulsive disorder, the support of loved ones plays a special role.

Don't part with hand sanitizer? your wardrobe in literally tiered? Such habits may be a reflection of a person's character or beliefs. Sometimes they cross an invisible line and turn into obsessive-compulsive disorder (OCD). Consider the main causes of their appearance and the methods of treatment offered by doctors.

Description of the disease

OCD is mental disorder affecting the quality of human life. Experts classify it as a phobia. If the latter include only obsessions, then compulsions are added to OCD.

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

How the disease begins

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

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

Main reasons

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

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

AT separate group doctors propose to introduce social causes of the disorder. Among them, the most common are the following:

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

Inherent in this mental illness may be based on personal experience or imposed by society. A striking example of the consequences of such a disorder is the viewing of crime news. A person tries to overcome the fears that have appeared by actions that convince of the opposite. He can double-check a closed car several times or count banknotes from a bank. Such actions bring only short-term relief. Getting rid of yourself is unlikely to succeed. In this case, the help of a specialist is required. Otherwise, the disease will completely absorb the human psyche.

This disease affects both adults and children. However, children are less likely to suffer from its manifestations. Symptoms of the disorder may vary depending on the age of the patient.

How does the disease manifest itself in adults?

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

The disorder also has external symptoms, which are expressed in the form of repetitive movements. For example, such a person can constantly count the steps, several times a day go to wash his hands. Symptoms of the disease are often noted by colleagues and colleagues. People with OCD always have a perfect order on the table, with all items arranged symmetrically. Books on the shelves are either alphabetically or by color.

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

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

Symptoms in children

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

Even sufficiently grown children are often haunted by the fear of getting lost among a large number of people on the street. He makes the children hold their parents tightly by the hand, periodically check whether the fingers are tightly clasped.
Older brothers and sisters scare many kids by sending them to an orphanage. Fear of being in this institution makes the child constantly ask again if his parents love him.
Almost all of us have lost personal belongings at least once in our lives. However, not everyone's feelings about this go unnoticed. Panic over a lost notebook often leads to a manic count of school supplies. Teenagers may even wake up at night to double-check all personal belongings.

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

Diagnostic methods

If symptoms suggestive of anxiety obsessive-compulsive disorder appear, seek help from a mental health professional. Often people with OCD are unaware of their problems. In this case, close relatives or friends should very carefully hint at this diagnosis. By itself, this disease does not go away.

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

A person has pronounced obsessive obsessions.
There is a compulsive behavior that he wishes to hide in any way.
OCD interferes with the usual rhythm of life, communication with friends and work.

Disease symptoms to have medical significance, must be repeated on at least 50% of days within two weeks.

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

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

Can a person help himself?

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

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

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

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

Step 4: Reward yourself. Psychologists advise constantly marking steps on the path to success, even the smallest ones. Praise yourself for the changes you have made and the skills you have gained.

Methods of psychotherapy

OCD is not a sentence. The disorder responds well to treatment with the help of psychotherapeutic sessions. Modern psychology offers several effective methods. Let's consider each of them in more detail.

The authorship of this technique belongs to Jeffrey Schwartz. Its essence is reduced to resistance to neurosis. A person is first aware of the presence of a disorder, and then gradually tries to deal with it. Therapy involves the acquisition of skills that allow you to stop obsessions on your own.
Method "Stop thought". Designed by Joseph Wolpe. The psychotherapist suggested treatment based on the assessment of the situation by the patient. To do this, Wolpe recommends that the person remember one of the recent bouts of frustration. He uses leading questions to help the patient assess the significance of the symptoms and their impact on daily life. The therapist gradually leads to the realization of the unreality of fears. This technique allows you to completely overcome the disorder.

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

Medical treatment

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

Fluvoxamine.
Tricyclic antidepressants.
Paroxetine.

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

All well-known antidepressants in this disorder are used only as a means. With their help, neurosis and stressful tension that arise against the background of obsessive-compulsive disorders can be eliminated.

It should be noted that the medicines listed in the article are dispensed from pharmacies only by prescription. The choice of a specific medication for treatment is carried out by the doctor, taking into account the patient's condition. Not the last role in this matter is played by the duration of the syndrome. Therefore, the doctor should know how long ago obsessive-compulsive disorder appeared.

Treatment at home

OCD belongs to the group of mental illnesses. Therefore, it is unlikely that it will be possible to cure the disorder without third-party support. However, therapy with folk remedies always helps to calm down. To this end, healers are advised to prepare herbal decoctions with sedative properties. These include the following plants: lemon balm, motherwort, valerian.

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

Rehabilitation

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

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

Obsessive-compulsive disorder: what is it in simple words

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

The symptoms of OCD appear as:

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

A striking example of OCD psychologists consider:

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

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

Causes

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

Symptoms and Treatment of Bipolar affective disorder:

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

The mechanism of the formation of the disease

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

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

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

OCD in men, women and children - differences in manifestation

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

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

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

For men, the source of anxiety is:

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

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

Women's anxieties are more due to:

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

Compulsions can be expressed:

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

Obsessions are present in the form:

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

Signs and symptoms

The symptoms of obsessive-compulsive disorder are as follows:

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

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

Methods of treatment

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

Psychotherapy

It involves the use of medical techniques, how:

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

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

group and family
rational and aversive:
other types.

Medical therapy with psychotropic drugs

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

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

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

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

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

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

To change life for the better, it is important:

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

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

Anxiety, to one degree or another, is common to all people, and many of us sometimes perform rituals of varying degrees of irrationality, designed to insure us from trouble - bang their fist on the table or put on a lucky T-shirt. significant event. But sometimes this mechanism gets out of control, causing a serious mental disorder. Theories and Practices explains what tormented Howard Hughes, how an obsession differs from schizophrenic delusions, and what magical thinking has to do with it.

Endless Ritual

The hero of Jack Nicholson in the famous film "It doesn't get better" was distinguished not only by a complex character, but also by a whole set of oddities: he constantly washed his hands (and every time with new soap), ate only with his cutlery, avoided other people's touches and tried not to step on cracks on asphalt. All these "eccentricities" - typical signs obsessive-compulsive disorder, a mental illness in which a person is obsessed with obsessive thoughts that cause him to repeat the same actions regularly. OCD is a real find for a screenwriter: this disease is more common in people with high intelligence, it gives the character originality, noticeably interferes with his communication with others, but at the same time is not associated with a threat to society, unlike many other mental disorders. But in reality, the life of a person with obsessive-compulsive disorder cannot be called easy: constant tension and fear are hidden behind innocent and even funny, at first glance, actions.

In the head of such a person, it’s as if a record is stuck: the same unpleasant thoughts regularly come to his mind, which have little rational basis. For example, he imagines that dangerous microbes are everywhere, he is constantly afraid of hurting someone, losing some thing, or leaving the gas on when leaving home. A leaky faucet or an asymmetrical arrangement of objects on a table can drive him crazy.

The flip side of this obsession, that is, obsession, is compulsion, the regular repetition of the same rituals, which should prevent impending danger. A person begins to believe that the day will go well only if, before leaving the house, he reads a children's rhyme three times, that he will protect himself from terrible diseases if he wash his hands several times in a row and use his own cutlery. After the patient performs the ritual, he experiences relief for a while. 75% of patients suffer from both obsessions and compulsions at the same time, but there are cases when people experience only obsessions without performing rituals.

At the same time, obsessive thoughts differ from schizophrenic delusions in that the patient himself perceives them as absurd and illogical. He is not at all happy to wash his hands every half an hour and zip up his fly five times in the morning - but get rid of obsession otherwise he simply cannot. The level of anxiety is too high, and rituals allow the patient to achieve temporary relief from the condition. But at the same time, in itself, the love of rituals, lists or putting things on the shelves, if it does not bring discomfort to a person, does not belong to the disorder. From this point of view, the aesthetes who diligently arrange carrot peels lengthwise in Things Organized Neatly are absolutely healthy.

Obsessions of an aggressive or sexual nature cause the most problems in OCD patients. Some become afraid that they will do something bad to other people, up to and including sexual violence and murder. Obsessional thoughts can take the form of single words, phrases, or even lines of poetry - a scene from the movie The Shining can serve as a good illustration, where main character, going crazy, begins to type on the typewriter the same phrase "all work and no play makes Jack a dull boy." A person with OCD experiences tremendous stress - he is simultaneously horrified by his thoughts and tormented by guilt for them, tries to resist them, and at the same time tries to make the rituals he performs go unnoticed by others. In all other respects, however, his consciousness functions perfectly normally.

There is an opinion that obsessions and compulsions are closely related to "magical thinking", which arose at the dawn of mankind - a belief in the ability to take control of the world with the help of the right mood and rituals. magical thinking draws a direct parallel between a mental desire and a real consequence: if you draw a buffalo on the wall of a cave, tuning in to a successful hunt, you will certainly be lucky. Apparently, this way of perceiving the world is born in the deep mechanisms of human thinking: neither scientific and technological progress, nor logical arguments, nor the sad personal experience, proving the futility of magical passes, do not save us from the need to look for a relationship between random things. Some scientists believe that it is embedded in our neuropsychology - the automatic search for patterns that simplify the picture of the world helped our ancestors survive, and the most ancient parts of the brain still work according to this principle, especially in a stressful situation. Therefore, when elevated level anxiety, many people begin to be afraid of their own thoughts, fearing that they can become reality, and at the same time, they believe that a set of some irrational actions will help prevent an undesirable event.

Story

In ancient times, this disorder was often associated with mystical reasons: in the Middle Ages, people obsessed with obsessive ideas were immediately sent to exorcists, and in the 17th century the concept was reversed - it was believed that such states arise due to excessive religious zeal.

In 1877, one of the founders of scientific psychiatry, Wilhelm Griesinger, and his student Karl-Friedrich-Otto Westphal found that the basis of "compulsive disorder" is a thought disorder, but it does not affect other aspects of behavior. They used the German term Zwangsvorstellung, which, being variously translated in Britain and the United States (as obsession and compulsion respectively), became the modern name for the disease. And in 1905, the French psychiatrist and neurologist Pierre Maria Felix Janet singled out this neurosis from neurasthenia as individual disease and called it psychasthenia.

Opinions differed about the cause of the disorder - for example, Freud believed that obsessive-compulsive behavior refers to unconscious conflicts that manifest themselves in the form of symptoms, and his German colleague Emil Kraepelin attributed it to "constitutional mental illness" caused by physical causes.

suffer from obsessional disorder, including famous people- for example, the inventor Nikola Tesla counted steps while walking and the volume of servings of food - if he failed to do this, the dinner was considered spoiled. And entrepreneur and American aviation pioneer Howard Hughes was terrified of dust and ordered employees to "wash themselves four times, each time using a large amount of lather from a new bar of soap," before visiting him.

Defense mechanism

The exact causes of OCD are not clear even now, but all hypotheses can be divided into three categories: physiological, psychological and genetic. Supporters of the first concept associate the disease either with the functional and anatomical features of the brain, or with metabolic disorders (biologically active substances that transmit electrical impulses between neurons, or from neurons to muscle tissue) - first of all, serotonin and dopamine, as well as norepinephrine and GABA. Some researchers have noted that many patients with obsessive-compulsive disorder had birth trauma upon birth, which also confirms physiological causes OKR.

Supporters psychological theories believe that the disease is associated with personal characteristics, temperament, psychological trauma and improper response to the negative impact of the environment. Sigmund Freud suggested that the occurrence of obsessive-compulsive symptoms is associated with the protective mechanisms of the psyche: isolation, elimination and reactive formation. Isolation protects a person from anxiety-causing affects and impulses, forcing them into the subconscious, liquidation is aimed at combating repressed impulses that pop up - on which, in fact, the compulsive act is based. And, finally, reactive formation is a manifestation of patterns of behavior and consciously experienced attitudes that are opposite to emerging impulses.

There is also scientific evidence that genetic mutations contribute to OCD. They were found in unrelated families whose members suffered from OCD - in the serotonin transporter gene, hSERT. Studies of identical twins also confirm the existence of a hereditary factor. In addition, in patients with OCD more likely have close relatives with the same disorder than healthy people.

Maksim, 21 years old, suffering from OCD since childhood

It started for me around 7 or 8 years old. The neurologist was the first to report the likelihood of OCD, even then there was a suspicion of obsessive neurosis. I was constantly silent, scrolling through various theories in my head like "mental chewing gum." When I saw something that caused me anxiety, obsessive thoughts about it began, although the reasons were very insignificant in appearance and, perhaps, would never have touched me.

At one time there was an obsessive thought that my mother might die. I turned over the same moment in my head, and it captured me so much that I could not sleep at night. And when I ride in a minibus or in a car, I constantly think about the fact that now we will have an accident, that someone will crash into us or we will fly away from the bridge. A couple of times the thought arose that the balcony under me would fall apart, or someone would throw me out of there, or I myself would slip in the winter and fall.

We never really talked with the doctor, I just took different medicines. Now I am moving from one obsession to another and I am following some rituals. I constantly touch something, no matter where I am. I go from corner to corner throughout the room, adjusting the curtains, wallpaper. Maybe I am different from other people with this disorder, everyone has their own rituals. But it seems to me that those people who accept themselves as they are are more lucky. They are much better than those who want to get rid of it and are very worried about it.

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

What is obsessive-compulsive disorder

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

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

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

Contrasting obsessions

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

obsessive actions

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

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

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

Obsessive-phobic disorders

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

obsessive rituals

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

Obsessive Compulsive Disorder - Symptoms

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

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

Obsessive Compulsive Disorder in Children

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

Obsessive Compulsive Disorder - Causes

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

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

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

Obsessive Compulsive Disorder - Treatment

An almost complete recovery is not excluded, but long-term therapy will be required to get rid of obsessive-compulsive neurosis. How to treat OCD? Treatment of obsessive-compulsive disorder is carried out in a complex with sequential or parallel application of techniques. Compulsive personality disorder in severe OCD requires drug treatment or biological therapy, and for mild - use the following methods. It:

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

Medical treatment for OCD

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

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