And obsessive compulsive social disorder. The mechanism of disease formation

Obsessive-compulsive disorder is a mental illness of a person, otherwise called obsessive-compulsive disorder. For example, a pathological tendency to wash your hands two hundred times in one day because of thoughts of countless bacteria, or counting the pages of a book you are reading in an effort to know exactly how much time is spent on one sheet, or repeatedly returning home before work in doubt whether the iron is turned off. or gas.

That is, a person suffering from obsessive-compulsive disorder suffers from obsessive thoughts that dictate the need for tiring, repetitive movements, which leads to stress and depression. This condition undoubtedly reduces the quality of life and requires treatment.

Description of the disease

The official medical term "obsessive-compulsive syndrome" is based on two Latin roots: "obsession", which means "gripping or siege by obsessive ideas," and "compulsion", that is, "coercive action."

Sometimes there are local disorders:

• a purely obsessive disorder experienced only emotionally and not physically;
• in isolation, compulsive disorder, when restless actions are not triggered by explicit fears.

Obsessive-compulsive disorder occurs in about three cases out of a hundred in adults and about two out of five hundred in children. Pathology of the psyche can manifest itself in different ways:

• occur sporadically;
• progress from year to year;
• be chronic.

The first signs are usually observed no earlier than 10 years and rarely necessitate immediate treatment. The initial obsessive-compulsive neurosis is presented in the form of various phobias and strange obsessive states, the irrationality of which a person is able to understand independently.

By the age of 30, the patient may already have a pronounced clinical picture, with a refusal to perceive his fears adequately. In advanced cases, a person, as a rule, has to be hospitalized and treated with more effective methods than conventional psychotherapeutic sessions.

Causes

To date, the exact etiological factors of obsessive-compulsive syndrome are unknown. There are only a few theories and assumptions.

Among biological causes, the following factors are considered possible:

• pathology of the autonomic nervous system;
• the peculiarity of the transmission of electronic impulses in the brain;
• violation of the metabolism of serotonin or other substances necessary for the normal functioning of neurons;
• postponed craniocerebral trauma;
• infectious diseases with complications;
• genetic inheritance.

In addition to biological factors, obsessive-compulsive disorder can have a variety of psychological or socio-social causes:

• traumatic family relationships;
• strictly religious education;
• work in stressful industrial conditions;
• experienced fear due to a real threat to life.

Panic fear can be rooted in personal experience or be imposed by society. For example, watching crime news provokes anxiety about a burglar attack on the street or fear of car theft.

The person tries to overcome the arisen obsessions by repeating "control" actions: he looks over his shoulder every ten steps, pulls the handle of the car door several times, etc. But such compulsions do not give relief for long. If you do not start a fight with them in the form of psychotherapeutic treatment, obsessive-compulsive syndrome threatens to completely overwhelm the human psyche and turn into paranoia.

Symptoms in adults

Symptoms of obsessive-compulsive disorder in adults add up to approximately the same clinical picture:

1. First of all, neurosis manifests itself in obsessive painful thoughts:

• about perversions of a sexual nature;
• death, physical harm or violence;
• blasphemous or sacrilegious ideas;
• fears of diseases, virus infections;
• loss worry material assets and etc.

Such painful thoughts terrify the person with obsessive-compulsive disorder. He understands their groundlessness, but he cannot cope with the irrational fear or superstition that all this will one day become reality.

2. The syndrome in adults also has external symptoms, expressed in repetitive movements or actions:

• recalculation of the number of steps on the stairs;
• very frequent hand washing;
• rechecking several times in a row turned off taps and closed doors;
• restoring symmetrical order on the table every half hour;
• arranging books on a shelf in a certain order, etc.

All these actions are a kind of ritual for "getting rid" of the obsessive state.

3. Obsessive-compulsive disorder tends to get worse in crowded places. In a crowd, the patient may experience periodic panic attacks:

• fear of infection due to the slightest stranger sneeze;
• fear of touching the “dirty” clothes of other passers-by;
• nervousness due to "strange" smells, sounds, looks;
• fear of losing personal belongings or becoming a victim of pickpockets.

Due to these obsessive-compulsive disorders, a person with obsessive-compulsive neurosis tries to avoid crowded places.

4. Since obsessive-compulsive disorder is more susceptible to people who are suspicious and have a habit of controlling everything in their lives, the syndrome is often accompanied by a very strong decrease in self-esteem. This happens due to a person's understanding of the irrationality of the changes taking place with him and powerlessness in front of his own fears.

Symptoms in children

Obsessive-compulsive disorder is less common in children than in adults. But it has a similar obsessive state:

• the fear of getting lost in the crowd forces already enough adult children to hold the hand of their parents and constantly check whether the hoop is tightly connected;
• fear of being in orphanage(if adults at least once threatened with such "punishment") makes the child want to ask his mother very often if he is loved;
• panic at school due to a lost notebook leads to a stupid recount of all school items while folding the portfolio, and at night wake up in a cold sweat and again rush to this lesson;
• obsessive complexes, which are intensified by the "persecution" of classmates due to dirty cuffs, can torment so much that the child completely refuses to go to school.

Obsessive-compulsive disorder in children is accompanied by gloom, unsociability, frequent nightmares and poor appetite. To get rid of the syndrome faster and prevent its development will help turning to a child psychologist.

What to do

Obsessive-compulsive personality disorder can occur sporadically in anyone, even a perfectly healthy person. It is very important at the very first stages to recognize the beginning symptoms and begin treatment with a psychologist, or, at least, try to help yourself by analyzing your own behavior and developing a certain defense against the syndrome:

Step 1. Learn what obsessive-compulsive disorder is.

Read the causes, symptoms and treatments several times. Write down the signs that you observe on a piece of paper. Leave room for each disorder detailed description and making a plan describing how to get rid of it.

Step 2. Ask for external evaluations.

If you suspect obsessive-compulsive disorder, it is best, of course, to see a specialist doctor who will help you start effective treatment. If it is very difficult to make the first visit, you can ask loved ones or a friend to confirm the symptoms of the disorder that have already been written out or add some others that the person himself does not notice.

Step 3. Look your fears in the eye.

A person with obsessive-compulsive disorder is usually able to understand that all fears are just an invention of their imagination. If every time a new desire arises to wash your hands or check the locked door, remind yourself of this fact and interrupt the next "ritual" with a simple effort of will, getting rid of the obsessive neurosis will be easier and simpler.

Step 4. Praise yourself.

You need to celebrate the steps to success, even the smallest ones, and praise yourself for the work done. When a sufferer of the syndrome at least once felt that he is stronger than his obsessive states, that he is able to control them, the treatment of the neurosis will go faster.

If a person finds it difficult to find sufficient strength in himself to get rid of obsessive-compulsive neurosis, he should consult a psychologist.

Psychotherapy methods

Treatment in the form of psychotherapeutic sessions for obsessive-compulsive syndrome is considered the most effective. Today, specialist psychologists have in the medical arsenal several effective techniques to get rid of a similar obsessive-compulsive disorder:

1. Cognitive behavioral disorder therapy. Founded by psychiatrist Jeffrey Schwartz, the idea is to resist the syndrome by keeping compulsions to a minimum and then to their complete disappearance. A step-by-step technique of absolute awareness of his disorder and its causes leads the patient to decisive steps that help get rid of the neurosis for good.

2. The method of "stopping thought". Behavioral therapy theorist Joseph Wolp formulated the idea of ​​using an outside perspective. A person suffering from neurosis is invited to recall one of the brightest situations when his obsessive states manifest themselves. At this moment, the patient is told loudly "Stop!" and analyzes the situation using a number of questions:

• Is there a high probability that this could happen?
• How much does a thought interfere with living an ordinary life?
• How strong is the internal discomfort?
• Would life be easier and happier without this obsession and neurosis?

Questions may vary. There can be many more. Their main task in the treatment of obsessive-compulsive disorder is to "photograph" the situation, to consider it, as in slow motion, to see it from all angles.

After such an exercise, it becomes easier for a person to face fears and control them. The next time, when obsessive-compulsive disorder begins to haunt him outside the walls of the psychologist's office, the inner exclamation “Stop!” Will work, and the situation will take on completely different outlines.

The above methods of psychotherapy are far from the only ones. The choice remains with the psychologist, after questioning the patient and determining the degree of obsessive-compulsive syndrome according to the Yale-Brown scale, which was specially developed to identify the depth of neurosis.

Medication treatment

Treating some difficult cases obsessive-compulsive syndrome is not complete without medication. Especially when they discovered metabolic disorders necessary for the functioning of neurons. The main drugs for the treatment of neurosis are SSRIs (serotonin reuptake inhibitors):

• fluvoxamine or escitalopram;
• tricyclic antidepressants;
• paroxetine, etc.

Modern scientific research in the field of neurology has found therapeutic potential in agents that release the neurotransmitter glutamate and help, if not get rid of the neurosis, then significantly alleviate it:

• memantine or riluzole;
• lamotrigine or gabapentin;
• N-acetylcysteine, etc.

But conventional antidepressants are prescribed as a means of symptomatic effects, for example, to eliminate neurosis, stress arising from persistent obsessive states or mental disorders.

Obsessive compulsive disorder- This is a dysfunction of mental activity, manifested by involuntary thoughts of an obsessive nature that interfere with normal life, as well as various fears. These thoughts create anxiety, which can only be relieved by performing obsessive and tedious actions called compulsions.

Obsessive-compulsive disorder can be progressive, episodic, or chronic. Obsessive thoughts are ideas or gravities 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 underlying causes of the disorder in question are rarely found on the surface. Obsessive Compulsive OCD is characterized by compulsions (ritual activities) and obsessions (obsessive thoughts). The most common involuntary intrusive thoughts are:

- fear of contamination (for example, viruses, germs, from liquids, chemicals or excrement);

Signs of obsessive-compulsive disorder in children:

- wet, cracked hands (if the child suffers from compulsive hand washing);

- long stay in the bathroom;

- slow completion of 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 for closed or taps;

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

How is obsessive-compulsive disorder in children treated? Many parents want to know this. In the first turn, it is necessary to accurately determine whether their child suffers from obsessive-compulsive disorder or simply practices some of his rituals. There are quite normal rituals for childhood which parents often mistake for violations. These include:

- in children under the age of three, certain "traditions" of going to bed are often observed, by the school period this usually either passes 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, which contains their crumb. 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 realize that their actions are abnormal, so they try to resist them. This understanding pushes them to hide obsessive thoughts and ritual actions from the environment. Therefore, if the baby, before going to bed, does not hide a certain ritual, then this does not indicate the presence of an ailment. You need to understand that this behavior is only inherent in his age period.

Treatment for obsessive-compulsive disorder

The previously considered syndrome was considered a condition resistant (refractory) to treatment, since traditional psychotherapeutic methods based on principles have rarely been effective. Also, the results of the use of various medicines... However, in the eighties of the last century, the current 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 research.

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 for the disorder 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 ailment in question is the timely recognition of obsessive-compulsive disorder and the correct diagnosis.

Currently, the main drugs for the treatment of obsessive-compulsive disorder are selective serotonin reuptake inhibitors (Clomipramine), anxiolytics (Clonazepam, Buspirone), normotimics (Lithium preparations) and antipsychotics (Rimozide).

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

The prescription of anxiolytics in combination with other drugs is also practiced. It is not recommended to use them as a monotherapy drug. The appointment of normotimics is shown, namely, lithium preparations, 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 provides for the use of psychotherapeutic methods. An excellent psychotherapeutic effect is provided 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 symptoms.

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

So, home treatment for obsessive compulsive disorder involves:

- reducing the consumption of alcohol and drinks containing caffeine;

- getting rid of bad habits;

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

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

- massage;

- establishing an optimal sleep and wakefulness regime;

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

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

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

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

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

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

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

Common OCD obsessions include:

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

Nearly everyone has had such obsessive thoughts. However, in someone with OCD, the level of anxiety from such thoughts is off the charts. And to avoid too strong anxiety, a person is often forced to resort to some "protective" actions - compulsions (lat. Compello - "to force").

Compulsions in OCD are somewhat ritual-like. These are actions that a person repeats over and over in response to an obsession to reduce the risk of harm. Compulsion can be physical (like repeatedly checking to see if a door is locked) or mental (like saying a certain phrase in your mind). For example, this can be the uttering of a special phrase to "protect relatives from death" (this is called "neutralization").

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

The most common is the fear of microbial contamination combined with compulsive washing and cleaning. For fear of being infected, people go to great lengths: do not touch door handles, toilet seats, avoid shaking hands. Tellingly, with OCD, a person stops washing their hands not when they are clean, but when they finally feel "relief" or "right."

Avoidant behaviors are central to OCD and include:

1. the desire to avoid situations that cause feelings of anxiety;
2. the need to perform obsessive actions.

Obsessive-compulsive neurosis can cause many problems, usually accompanied by shame, guilt, and depression. The disease creates chaos in human relationships and affects performance. According to the WHO, OCD is one of the ten most disabling diseases. People with OCD do not seek professional help because they are shy, afraid, or unaware that their condition is treatable, incl. non-drug.

What Causes OCD

Despite a lot of research on OCD, it is still not clear what is the main reason violations. Both physiological factors (chemical imbalance in nerve cells) and psychological factors can be responsible for this condition. Let's consider them in detail.

Genetics

Studies have shown that OCD can be passed down through the generation to close relatives, in the form of a greater tendency to develop obsessive-compulsive disorders.

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

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

SLC1A1 is another gene that may be involved in obsessive-compulsive disorder. This gene is similar to hSERT, but it is responsible for transporting another neurotransmitter, glutamate.

Autoimmune reaction

Some cases of rapid onset of OCD in children may be a consequence of Group A streptococcal infection, which causes inflammation and dysfunction of the basal ganglia. These cases are grouped into clinical conditions called PANDAS (Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infection).

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

Neurological problems

Brain imaging techniques have allowed researchers to study the activity of specific areas of the brain. It has been shown that the activity of certain parts of the brain in people with OCD has unusual activity. Those involved in OCD symptoms are:

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

A circuit that includes the above areas regulates primitive behavioral aspects such as aggression, sexuality, and bodily secretions. Activating the circuit triggers appropriate behaviors, such as washing hands thoroughly after touching something unpleasant. Normally, after the necessary act, the desire decreases, that is, the person stops washing his hands and moves on to another occupation.

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

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

Causes of OCD from a Behavioral Psychology Perspective

According to one of the fundamental laws of behavioral psychology, the repetition of a behavioral act facilitates its reproduction in the future.

The only thing people with OCD do is try to avoid things that trigger fear, “fight” their thoughts, or perform “rituals” to reduce anxiety. Such actions temporarily reduce fear, but paradoxically, according to the law outlined above, increase the likelihood of intrusive behavior in the future.

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

The most susceptible to the occurrence of pathology are people who are under stress: they start a new job, end relationships, suffer from overwork. For example, a person who has always calmly used public restrooms, suddenly, in a state of stress, begins to "wind up" himself, they say, the toilet seat is dirty and there is a danger of catching a disease ... Further, by association, fear can spread to other similar objects: public sinks, showers, etc.

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

Cognitive Causes of OCD

The behavioral theory described above explains the onset of pathology as "wrong" behavior, while cognitive theory explains the onset of OCD by the inability to correctly interpret one's thoughts.

Most people have unwanted or obsessive thoughts several times a day, but all those suffering from the disorder greatly exaggerate the importance of these thoughts.

For example, against the background of fatigue, a woman raising a child may periodically have thoughts about harming her baby. Most, of course, brush aside such obsessions, ignore them. People with OCD exaggerate the importance of thoughts and react to them as if they were a threat: "What if I really am capable of this ?!"

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

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

As we noted earlier, repetitive avoidance behaviors can get stuck, and tend to be repetitive. It turns out that obsessive-compulsive disorder is caused by the interpretation of obsessive thoughts as catastrophic and true.

Researchers suggest that OCD sufferers attach exaggerated importance to their thoughts due to false beliefs acquired during childhood. Among them:

• exaggerated responsibility: the belief that a person has an all-encompassing responsibility for the safety of others or the harm caused to them;
• belief in the materiality of thoughts: the belief that negative thoughts can "come true" or affect other people and should be under control;
• exaggerated sense of danger: the tendency to overestimate the likelihood of danger;
• exaggerated perfectionism: the belief that everything should be perfect and that mistakes are unacceptable.

Environment, distress

Stress and trauma can trigger the OCD process in people with a tendency to develop this condition. Studies of adult twins have shown that obsessive-compulsive neurosis in 53-73% of cases is due to adverse environmental influences.

Statistics support the fact that most people with OCD symptoms have experienced stress or traumatic event in life just before the onset of the disease. Such events can also exacerbate existing manifestations of the disorder. Here is a list of the most traumatic environmental factors:

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

What contributes to the progression of OCD

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

Avoidance and compulsive rituals

Obsessive-compulsive disorder maintains a vicious cycle of obsession, anxiety, and response to anxiety.

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

Compulsions also get fixed. The person feels less anxious after checking to see if the lights are off. Therefore, it will act in the same way in the future.

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

Exaggerating your capabilities and "magical" thinking

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

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

Excessive concentration on thoughts

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

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

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

Reassessment of hazard and intolerance of uncertainty

Another important aspect is overestimating the danger of the situation and underestimating your ability to cope with it. Many OCD patients feel that they need to know for sure that bad things will not happen. For them, OCD is a kind of absolute insurance policy. They think that if they try hard and do more rituals and hedge better, they'll get more certainty. In reality, great effort only leads to increased doubts and increased feelings of uncertainty.

Perfectionism

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

Looping

As they say, fear has big eyes. Exists typical ways"Wind up" yourself, increase your anxiety with your own hands:

• "Everything is awful!" - means a tendency to describe something as "terrible", "nightmarish" or "the end of the world." It only makes the event seem more intimidating.
• "Catastrophe!" - means the expectation of a catastrophe as the only possible outcome. The thought that something catastrophic is bound to happen if not prevented.
• Low tolerance for disappointment - when any excitement is perceived as "unbearable" or "intolerable".

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

Treating OCD

Research shows that psychotherapy is significant in 75% of patients with obsessive-compulsive disorder. There are two main ways of treating neurosis: medication and psychotherapy. They can also be used together.

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

For the treatment of obsessive-compulsive disorder, cognitive-behavioral therapy (CBT), short-term strategic psychotherapy, and also are used.

Exposure — the controlled encounter with fear — has also been used in the treatment of OCD.

The confrontation technique with the parallel suppression of anxiety reactions was recognized as the first effective psychological method for dealing with OCD. Its essence consists in carefully dosed confrontation with fears and obsessive thoughts, but without the habitual avoidance response. As a result, the patient gradually gets used to them, and the fears begin to subside.

However, not everyone feels able to go through this treatment, so the technique has been refined with CBT, which focuses on changing the meaning of obsessive thoughts and urges (cognitive part) and changing the response to urge (behavioral part).

Obsessive Compulsive Disorder: Causes

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It is impossible to make a diagnosis of OCD based on one or two facts. It is important to understand whether the person is suffering from mental health problems, or whether they are just scared or upset. Unpleasant thoughts, excitement, anxiety are inherent in absolutely healthy people.

What is obsessive compulsive disorder?

Psychiatrists refer to OCD as an obsessive-compulsive disorder. A healthy person is able to brush aside doubts and disturbing thoughts. Those who suffer from obsessive-compulsive disorder do not have this opportunity. Disturbing ideas torment him, forcing him to think over and over again. Thoughts like these cannot be controlled or eliminated in OCD, which is very stressful. To cope with anxiety, a person has to perform certain rituals.

Thus, obsessive-compulsive disorder (OCD, obsessive-compulsive discord, obsessive compulsive) includes two phases: obsession - anxious, obsessive thoughts; and compulsions are special actions that help drive them away for a short time.

In a mild form, the diagnosis of "OCD" almost does not cause a person inconvenience, does not interfere with performance. But over time, the number of compulsions and obsessive states increases, and the disease will become chronic. And for a patient diagnosed with OCD, due to the abundance of disturbing thoughts and the rituals following it, it will become difficult to maintain a social and personal life.

What obsessive thoughts do people diagnosed with OCD suffer from the most?

Examples of possible compulsions:

• Fear of infections. A constant urge to wash your hands or rub with a disinfectant. Wearing gloves. Wipe down surfaces that will have to come into contact. Taking a shower many times a day.
• Painful passion for symmetry and order. The requirement that everything should be in place, according to the rank. Correction of even slightly asymmetrical designs. Strong emotional stress in case of violation of the order, symmetry.
• Fear of harm... A person diagnosed with OCD tries not to be alone or tête-à-tête with someone whom the obsession is likely to harm. Hides potentially dangerous items: kitchen knives, soldering irons, hammers, axes.
• Controlling Potential Dangers... Carrying with you protective equipment(bricks, gas cartridges) - for fear of being robbed. Or checking several times gas valves, sockets where electrical appliances are connected.
• Attempts to foresee everything... Constant rechecking of pockets, briefcases, bags - are all things you may need in place.
• Superstition... A person diagnosed with OCD can cast a spell, put on happy clothes for important meetings, look in the mirror if he forgot something at home. In a single shot, items and words of good fortune can boost self-esteem. But if they don't work, the OCD sufferer will increase the number of compulsions to pathological levels.
• Mental Violations of Religious Doctrines... After thinking something that seems blasphemous to him, a person diagnosed with OCD spends nights in prayer or gives every last penny to the church.
• Erotic thoughts which seem unacceptable. Fearing to do something indecent or rude, the patient refuses to be close to a loved one.

It would seem that illiterate people should be so superstitious or suspicious. However, as Wikipedia assures, patients who are diagnosed with OCD mostly have high level intelligence. The Wiki also states that OCD was identified as a separate disease in psychiatry in 1905, but the ancient Greeks and Romans still suffered from the disease.

Did you know that young children are also diagnosed with OCD? They, too, may suffer from compulsive disorders. In their case, the fear of being lost, the fear of being abandoned by their parents, and of forgetting something important to school are more common.

Obsessive Compulsive Disorder Symptoms:

Compulsive syndrome is somewhat reminiscent of a religious ritual. This response to an intrusive thought can be physical (checking gas valves or decontaminating hands) or mental (casting spells). Also possible with a diagnosis of OCD avoidant behavior - attempts to get away from an anxious situation.

Signs of OCD to consider when making a diagnosis:

• The patient realizes that he himself generates obsessions. He does not suffer from otherworldly voices.
• The person tries to fight back obsessive thoughts, but to no avail.
• Obsessions frighten the patient, cause feelings of guilt and shame. In serious cases, a person diagnosed with OCD refuses social activity, may lose his job and family.
• The obsession state is often repeated.

This disorder is more likely to affect people who want to control everything, or those who could not survive childhood psychological trauma. Less commonly, OCD is triggered by physical influences and head injuries.

Some psychiatrists divide this neurosis into two subtypes:

When diagnosed with "OFR", patients admit the presence of obsessive thoughts. But they are sure that the rituals are not performed. This is not always true. Possibly latent compulsive behavior. Patients themselves may not be aware of the ritual: some kind of convulsive movement - shaking the head, leg, snapping fingers.

What Causes OCD?

Globally, three out of 100 adults and two out of 500 children are diagnosed with obsessive-compulsive disorder.

The diagnosis of OCD requires compulsory therapy. Scientists can only talk about the risk factors for the syndrome. But it is impossible to immediately identify the diagnosis of OCD and eliminate the cause, thereby alleviating the patient's condition.

What physiological factors can trigger compulsive disorder?

• Heredity - the disease can be transmitted through a generation. If one of the grandparents has been diagnosed with OCD, the risk of getting sick increases.
• Neurological diseases. Most often, they are caused by a metabolic disorder that causes problems in the functioning of neurons.
• Consequences of infectious and autoimmune diseases, head injuries.

According to research by psychiatrists, a decrease in the level of serotonin, norepinephrine, or dopamine in the brain tissues can also lead to the diagnosis of OCD.

Behavioral psychology assumes that any repeated action is later easier to reproduce. This law explains why the diagnosis of OCD progresses and the likelihood of intrusive behavior in the future.

Most susceptible to the development of neurosis are people who are in a state of stress and depression - when moving, new beginnings, loss of loved ones, overwork. Two thirds of patients diagnosed with OCD experienced some form of stress.

Other causes of the psychological nature of the disorder are more often attributed to childhood trauma. This upbringing was too harsh - religious, militarized. Or family relationships have caused serious trauma, which responded in adulthood with the diagnosis of "OCD".

People who are susceptible to exaggeration are more at risk of developing OCD.

An example would be a young mother, who, against the background of fatigue and stress, begins to be afraid of harming her baby. This translates into a diagnosis of OCD: pathological cleanliness, endless checks of devices, a variety of prayers and incantations.

Why more and more people are diagnosed with this and why is the disease progressing?

In compulsive disorders, anxiety always occurs first.. It is replaced by an obsessive thought, then the anxiety is fixed. A person recalls an action that temporarily reduces the activity of a neurosis. But the next obsessive state will require more than one repetition of the ritual. The results will be disastrous: loss of time, existence in a regime of severe stress, loss of social qualities of an individual, up to the point of refusal to interact with other people.

What causes an exacerbation of obsessive-compulsive disorders:

• Misplaced self-esteem and magical realism. A person with OCD exaggerates their own capabilities and impact on the surrounding reality. He is confident that he can prevent any negative situation with the help of spells, prayers, magical rituals. Temporarily they give the illusion of comfort, but then they require new and new repetitions.
• Perfectionism... Certain types of OCD require perfect fit. certain rules... A person represents the ideal state of life, which must be achieved at any cost. And minor errors or asymmetries will lead to pathological consequences. This type of compulsive disorder often goes hand in hand with anorexia nervosa.
• Attempts to take control and reassessment of danger... A person suffering from obsessive-compulsive disorder feels obligated to anticipate any danger. Even one that in reality cannot be. And compulsions in this case become a kind of insurance. The patient thinks: 25 checks closed door will give a guarantee that thieves will not enter the house. But repeated repetitions only increase the feeling of anxiety and uncertainty.

Avoiding a situation or ritual will only make OCD worse. After all, trying not to get into dangerous situation lead to constant thinking about how best to do it and to a feeling of their own abnormality. Relatives are also capable of aggravating the situation, who prohibit rituals, taunt the patient, call them crazy.

However, the diagnosis of OCD does not apply to mental illness - this ailment does not change personality traits. But it can spoil the life of the patient thoroughly.

Treatment for obsessive-compulsive disorder:

Obsession at home is treated if the ailment has not gone too far and the diagnosis is made on time. Analyze your condition - whether you can cope with the problem on your own.

1. Accept the diagnosis of OCD as part of your psyche.
2. Make a list of the signs of OCD you see in yourself.
3. Read all of the relevant psychological literature on diagnosing and treating OCD and make a plan for getting rid of the condition.
4. Ask family and friends for help. People are biased in making a diagnosis, so someone should double-check your “alarming” list of OCD symptoms.
5. Accept the unreality of your fears. This should always be remembered when you are tempted to perform a ritual. One of simple ways get rid of anxiety - imagine what will happen if the fear is realized. Will you stay alive? So why rituals ?!
6. Support yourself with praise and even nice prizes and gifts. Rewards will reinforce the thought: you are stronger than anxieties, you are able to overcome them.

Additionally, you can use breathing exercises and traditional medicine. Sedative decoctions and tinctures based on motherwort, mint, peony, lemon balm, valerian will help. For OCD, you can use aromatic oils such as: lavender, orange, bergamot, rose, ylang-ylang.

If you cannot cope with OCD diagnosis on your own, you need to see a doctor and this is necessary so as not to aggravate your situation.

Which doctor should you contact?

For help from a psychotherapist, psychotherapy without additional medication leads to a cure for OCD in 70 cases out of 100. drugs the effect will be more persistent, and there will be no side effects.

How to Treat OCD Without Pharmaceuticals? The following techniques will help:

• Cognitive Behavioral Therapy.
• Hypnotic impact.
• EMDR therapy.
• Strategic short-term psychotherapy.

Each of these treatments for OCD aims to get out of the wheel of anxiety, obsessions, and avoidance of an unpleasant situation. Attention can be focused on reducing discomfort from obsessive moments, on counteracting negative thoughts, or on changing the response to the urge to repeat the ritual. Group therapy is helpful - it makes it clear that you are not the only person in the universe with OCD, and you are not crazy at all.

Physical therapy will help reduce anxiety - massage, swimming, relaxing baths.

Medications for the diagnosis of OCD are prescribed if psychotherapeutic techniques do not help. These include serotonin reuptake antidepressants, atypical antipsychotics. At physiological reasons diseases are prescribed special drugs that help to heal them. Combine psychotherapy with medication for the diagnosis of "OCD" in cases where you need to quickly remove acute condition.

In order to prevent obsessive-compulsive disorder, we recommend:

1. You can include regular medical examination.
2. Taking vitamins.
3. Maximum avoidance stressful situations and overwork.
4. Relaxing practices - yoga, qigong, meditation.

An accurate diagnosis of OCD can only be made by experts in the field of psychiatry.