Obsessive-compulsive disorder (obsessive-compulsive disorder)

Obsessive and disturbing thoughts, fixation on special actions, which sometimes develop into entire rituals... Sometimes all this speaks not of simple oddities, but of symptoms of mental illness. What is obsessive-compulsive disorder, what are its causes and how is it treated?

Obsessive-compulsive disorder (OCD) can be characterized as an uncontrolled manifestation of negative obsessive thoughts and fears, which the patient tries to get rid of through the same obsessive actions (compulsions).

Symptoms of obsessive-compulsive disorder

Obsessions, or intrusive thoughts

Obsessions are recurring thoughts, images, or urges that cause anxiety, worry, shame, or disgust. They arise uncontrollably, and patients cannot drive them away through logical arguments. A person with OCD tries to suppress such obsessions by “interrupting” them with other thoughts or actions. Typical obsessive thoughts in OCD are the fear of contamination, the need for symmetry or precision, certain immoral ideas or impulses that are alien to the personality of the patient himself. Obsessions can be triggered by any events that somehow indirectly remind of their object - for example, an extraneous cough, contact with a “non-sterile” object (handrails, door handles, etc.)

Compulsions, or obsessive actions

To combat obsessions, OCD patients perform defensive, repetitive actions (compulsions). Compulsions are similar to peculiar rituals that “prevent” the embodiment of negative thoughts and fears. Washing hands too often, wiping objects, constantly checking electrical appliances, repeating words, counting. For example, to make sure that the door is locked, a person with OCD needs to pull the door handle a specific number of times (and count the times). After such a ritual, the patient feels relief for a while, but then the obsessive thoughts return, and everything repeats again and again. In severe cases, compulsions can take up a huge amount of the patient's time, interfering with daily activities. A patient with OCD describes his condition as follows:

I've always had a terrible fear of bacteria, to the point where I washed my hands dozens of times a day, but I didn't think it had anything to do with OCD. Then it became unbearable for me to be at home in the same clothes in which I went out, I could not eat bread in the place where I grabbed it with my hands, I carefully examined all the dishes before using them. It began to take up more and more time and attention and interfered with my life.

At the same time, compulsions are often accompanied by a feeling of depression and melancholy, because a person with OCD does not lose the awareness that such actions are irrational and meaningless.

What are obsessions and compulsions?

Most often, obsessive thoughts and fears are centered around certain topics. The most common of them are cleanliness and sterility, perfectionism, loss of control, religiosity, and forbidden sexual acts. The rituals that “protect” a person with OCD from these thoughts and “prevent” fears can vary. Most often, the nature of the obsession determines a certain type of compulsion.

It has been noticed that the stronger the patient’s desire to resist obsessive thoughts, the more clearly the obsessive-compulsive neurosis manifests itself. The efforts not only do not give the desired result, they further aggravate the problem - the obsessions return in an even more pronounced form.

When such conditions occur, it is very important not to try to cope with the problem on your own - only a doctor can provide effective professional assistance.

Stages

Doctors distinguish three stages of development of the disease:

• The first one . Fear and negative thoughts arise only when a person is directly confronted with a traumatic situation.
• Second . The worries are becoming more and more frequent. The patient often has thoughts that something bad will happen to him or that he needs to do something urgently.
• Third . The patient is unable to get rid of bad thoughts on his own. They constantly pester him, which makes a normal lifestyle and productive work activity impossible.

OCD is most easily corrected at the first stage. In advanced cases, doctors have to put in much more effort to help the person.

Diagnosis of OCD

According to the International Classification of Diseases (ICD-10), to make a diagnosis, it is important that obsessions and/or compulsions have been observed with noticeable frequency for at least two consecutive weeks and are accompanied by a state of distress. Symptoms must have the following characteristics:

• The patient's thoughts or impulses are his own, not caused by external factors.
• There is at least one thought or action that the patient tries unsuccessfully to resist.
• The thought of performing a compulsive action is in itself unpleasant (merely reducing tension or anxiety is not considered pleasant in this sense).
• Thoughts, images, or impulses repeat themselves in a stereotypical manner.

When diagnosing OCD, it is important to separate its symptoms from those of other diseases. Obsessions and compulsions can develop during exacerbations of schizophrenia, as well as with Tourette's syndrome. Problems similar to OCD may also be characteristic of obsessive-compulsive personality disorder. But if people with OCD realize that their obsessive actions are irrational, and they themselves experience discomfort from them, for a person with a personality disorder, the obsessive desire for accuracy is perceived as a manifestation of perfectionism and brings him pleasure.

Signs of obsessional neurosis

Among the signs characteristic of the disorder:

• obsessive fears that have no good reason;
• harassing thoughts and judgments;
• obsessions;
• actions of the same type, reminiscent of a ritual.

Patients with OCD may be afraid of getting infected with something, meeting someone, or not liking someone. Many of them have a painful form of perfectionism. Then a person tries to achieve ideal order and cleanliness in everything. The most common “rituals” are checking whether the front door is closed, whether the gas stove or lights are turned off. A sick person may wash their hands too often or look out the window.

Patients often come up with very unusual rituals - for example, they squat three times before putting on their shoes, or turn around their axis several times before entering the apartment. This behavior seems very strange to others.

Treatment of OCD at the Mental Health Clinic

At the Mental Health clinic, under the leadership of its founder, MD, psychiatrist V.L. Minutko, the author of the book “Obsessive Disorders” (the first complete guide to this problem in 100 years), has experienced doctors who have been successfully treating obsessive-compulsive disorders for more than ten years.

In our clinic, treatment of obsessive disorders is carried out comprehensively and strictly according to an individual program . We take into account not only the clinical picture of the disease, but also the personal data of each individual patient. It is necessary to start treatment as early as possible - only in this case will it be as effective as possible.

One of the advantages of our clinic is that the diagnosis and future treatment plan is necessarily discussed with the patient. The doctor introduces the patient to the basic methods used to treat obsessive-compulsive disorders, the examinations performed, as well as the clinical symptoms of the disease (we have found that obsessive-compulsive neurosis is caused by chronic infections, such as staphylococcal or streptococcal).

The clinic's medical facilities include an outpatient center in Moscow, as well as a 24-hour sanatorium-type hospital in the Moscow region with the possibility of accommodation for relatives. Depending on the indications, as well as personal preferences, patients can choose the most suitable treatment option for themselves.

Obsessive movement neurosis

Obsessive movement neurosis in the modern world is becoming a disease of many people of different ages. The onset of pathology is associated with the inability to get rid of constantly accumulating tension. To relax from switching, a person begins to perform unconscious movements, which in a short time become a ritual.

To treat obsessive movement syndrome, a combination of prescribing sedatives and courses of psychotherapy is used. Consultation with a specialist helps to get rid of the psychological stress that has become habitual. Classes are complemented by physiotherapy courses. The prognosis for treatment of the pathology is positive.

Symptoms of obsessive disorders

People who suffer from OCD complain of:

• intrusive thoughts that occur too often;
• internal experiences;
• increased level of aggression;
• worries about loved ones;
• fear of possible events;
• inability to resist obsessions;
• inability to relax;
• insomnia.

Psychologists have noticed that people of a melancholic temperament, who are suspicious, worry about trifles and take any problems very seriously, are more likely to experience the disorder. They are unsettled by any stress or conflict.