The essence of obsessive-compulsive disorder, its main etiological factors. The clinical picture of the disorder and the main components of this disease. The main directions in the treatment of neurosis. Obsessive-compulsive disorder is a psychological disorder of an anxiety discharge, which is characterized by the appearance of constant annoying thoughts that are alien to a person, as well as uncontrolled actions. In addition, this nosology causes anxiety in patients, constant anxiety, and apprehension. Usually with the help of obsessive actions (compulsions), these symptoms are relieved or alleviated.
Description and development of obsessive-compulsive disorder
Psychologists began to distinguish obsessive-compulsive disorder as early as the beginning of the 19th century. A clear description, which is more in line with the modern understanding of the disease, was provided by Dominique Eskirol. He defined obsessional neurosis as a "disease of doubt", highlighting the main component of nosology. The scientist argued that patients suffering from this disorder are constantly confused and without stopping weighing the correctness of their actions. At the same time, any logical remarks and arguments do not work at all.
A little later, in his robots, M. Balinsky pointed out another important component of such a neurosis. The scientist argued that all obsessions that arise in the patient are perceived by him as strangers. That is, the concern is, in fact, the presence of constant thoughts and reflections that are alien to a person.
Modern psychiatry has abandoned all the principles established by its predecessors. Only the name has changed - obsessive-compulsive disorder (OCD). Such a diagnosis more accurately describes the essence of the disease and is included in the International Classification of Diseases 10 revision.
The prevalence of obsessive-compulsive disorder varies from country to country. Various sources report the incidence of the disease from 2 to 5% of the total population of the planet. That is, for every 50 people, there are 4 to 10 with symptoms of obsessive-compulsive disorder. Most studies show that the disease is gender independent. Both women and men get sick equally.
The causes of obsessive-compulsive disorder
At the moment, the most appropriate is considered to be the multifactorial theory of the onset of the disorder. That is, several weighty reasons are involved in the pathogenesis, which together can cause the formation of pathological symptoms.
It is necessary to highlight the main groups of triggers that increase the likelihood of developing obsessive-compulsive disorder:
- Personal characteristics … It is known that the characteristics of a person's character largely affect the likelihood of developing and the course of psychological disorders. So, for example, more suspicious individuals who are scrupulous about their duties are prone to the development of obsessive-compulsive disorder. They are pedantic in life and at work, they are accustomed to doing work to the smallest detail and are extremely responsible in their approach to business. Usually, such people often worry about what they have done and doubt every step. This creates an extremely favorable background for the development of obsessive-compulsive disorder. Often predisposed to the formation of this personality disorder, who are used to constantly reckoning with other people's opinions, are afraid not to justify someone's expectations and hopes.
- Heredity … The study of the genetic relationship of patients with obsessive-compulsive disorder made it possible to determine a certain tendency, which is much higher than the population frequency. That is, if a person has such a disease in his family, his chances of acquiring this nosology for himself automatically increase. Naturally, heredity does not mean 100% transmission of genes from parent to child. For the formation of obsessive-compulsive disorder, the concept of gene penetrance operates. Even in the presence of such a code in human DNA, it will manifest itself exclusively in the event of additional trigger factors. The heredity of genes is manifested in the violation of the synthesis of important components of neurotransmitter systems. Neurotransmitters that take part in the transmission of a nerve impulse, thereby carrying out various mental processes in the brain, may be formed in insufficient quantities due to specific DNA. Thus, various symptoms of obsessive-compulsive disorder are manifested.
- Exogenous factors … It is imperative to take into account the presence of causes from the external environment, which can also affect the mental functions of a person. Most often, this is a powerful physical, chemical or biological effect that causes a malfunction in the neurotransmitter systems and manifests itself in various symptoms, including obsessive thoughts. Chronic stress in a person's life, as well as overwork, significantly worsen brain activity. Psychotrauma plays an important role. Even one significant event in a person's life, which left a significant imprint on his mental state, can significantly worsen well-being and cause the development of obsessive-compulsive disorder. Among the physical factors of influence on mental functions, craniocerebral trauma should be distinguished. Even a concussion of any severity can cause changes in the human psyche. Biological factors of influence are represented by infectious agents, as well as other chronic diseases of organs and systems.
Manifestations of obsessive-compulsive disorder
Obsessions and compulsions are considered to be the main components of the clinical picture of obsessive-compulsive disorder. These are obsessive thoughts that require the performance of obsessive actions. Sometimes the latter take the form of special rituals, and after their performance, anxiety and anxiety are significantly reduced. That is why the first and second components of the disease are so interconnected.
The main symptoms of obsessive-compulsive disorder are:
- Fears … Often, people with this disorder have a compulsive fear that something bad is going to happen. In any situation, they bet on the worst outcome and do not rationalize arguments at all. Such people are afraid of ordinary failures, both in serious and responsible moments, and in daily affairs. For example, they often find it difficult to perform in front of an audience. They are afraid of being ridiculed, worried that they will not live up to expectations or will do something wrong. This also includes the fear of blushing in public - a completely irrational phobia that cannot be explained logically.
- Doubts … In most cases with obsessive-compulsive disorder, there is uncertainty. People very rarely can say something for sure. As soon as they try to remember all the details, they are immediately overcome by doubts. The classic examples are considered to be constant torment, whether the iron is turned off at home, whether the front door is closed, whether the alarm is set, whether the tap with water is closed. Even being convinced of the correctness of his actions and the groundlessness of doubts, after a while a person begins to analyze. That is why suspiciousness of character very often becomes the background for the development of obsessive-compulsive disorder.
- Phobias … Formed fears are also part of the structure of obsessive-compulsive disorder. They can be completely different and belong to different categories. For example, phobias of diseases are common. People are afraid of catching a contagious infection or aggravating an existing disease to a mild degree. Many suffer from fear of heights, open areas, pain, death, enclosed spaces, etc. Such phobias are often found in the composition of not only obsessive-compulsive disorder, but also independently. Fears fetter a person's consciousness, irrationalize his thinking and contribute to the emergence of other obsessive states. Often the presence of such a disorder can be suspected only after the appearance of one of the phobias in the clinical picture.
- Thoughts … There are also obsessive thoughts that do not carry any rational explanation. That is, the same phrase, song or name "gets stuck" in the head, and the person constantly scrolls it on repeat. These thoughts often do not coincide with the opinion of the person himself. For example, it is typical for him to express himself completely censorship and never swear dirty, and obsessive thoughts constantly make him think about not quite decent words. Unfortunately, in such a state, a person is not able to independently change the topic of reflections, they are like an incessant waterfall of thoughts that cannot be stopped.
- Memories … Obsessive-compulsive disorder is also characterized by emerging passages from the past. A person's memory returns him in time, demonstrating the most important events or traumatic situations. The difference from standard memories is their alienation. That is, a person cannot control what he remembers. These can be images, melodies, sounds that took place in the past. Most often, such memories have a bright negative connotation.
- Actions (compulsions) … Sometimes such patients have an obsessive desire to perform a certain movement or move in a specific way. This desire is so strong that it is eliminated only after the person performs the corresponding action. For example, sometimes he can pull to count something, even fingers on his hands. The person knows and understands that there are only ten of them, but he still has to perform the action. The most common compulsions are: licking lips, correcting hair or makeup, certain facial expressions, winking. They do not carry a logical load, that is, they are generally useless and play the role of an obsessive habit, which is very difficult to get rid of.
Methods for dealing with obsessive-compulsive disorder
The choice of a particular method of treatment depends on the severity of OCD. Lighter cases can be treated on an outpatient basis. Regular use of medication supportive therapy or periodic sessions with a psychologist can help a person cope with symptoms of the disease and lead a normal life without obsessions. In severe cases, hospitalization and treatment in an inpatient setting are necessary. It is very important not to start the disease and start therapy in a timely manner.
Drug treatment
Pharmacological drugs are widely used to treat obsessive-compulsive disorder. Most often, combined therapy is used, consisting of several drugs from different groups. This approach provides optimal coverage of all disease symptoms.
The following groups of drugs are most commonly used:
- Antidepressants … Often, obsessive thoughts and memories of unpleasant events can cause a depressive mood. A person quickly becomes discouraged and disappointed in everything. Constant experiences, emotional and nervous tension cause changes in the affective background. People can withdraw into themselves, delve into their own thoughts and problems. That is why a depressive reaction is a very common symptom of obsessive-compulsive disorder. Among all generations of antidepressants in this case, the preference is given to the third. The dosage is selected individually by the attending physician, who takes into account all the symptoms, as well as the constitutional characteristics of the patient.
- Anxiolytics … This group of drugs is also known as tranquilizers or normotimics. The main action of anxiolytics is anti-anxiety. Obsessive thoughts, phobias, memories easily disrupt the inner peace of a person, prevent him from finding a balance in mood, therefore, such drugs are used as part of the complex therapy of neurosis. Anxiety and anxiety arising from obsessive-compulsive disorder are stopped with the help of Diazepam, Clonazepam. Valproic acid salts are also used. The choice of a specific drug is made by the doctor based on the symptoms and the drugs that the patient takes together with anxiolytics.
- Antipsychotics … They represent one of the broadest groups of psychotropic drugs. Each drug differs in the characteristics of its impact on the human psyche, therapeutic effects, and dosage. That is why a qualified physician should make the choice of a suitable antipsychotic. The most commonly used subgroup of atypical antipsychotics. They are suitable for the treatment of obsessive-compulsive disorder that have become chronic. Most often, among all representatives of this subgroup, Quetiapine is used.
Cognitive Behavioral Psychotherapy
This direction in psychology and psychiatry is the most demanded and widespread today. Cognitive behavioral therapy is used for most of all diseases of the psychiatric spectrum, so its effectiveness speaks for itself. Moreover, it is quite simple for both the doctor and the patient.
This method of treatment is based on behavior analysis, which determines the presence of various kinds of obsessions. Before starting work with each patient, it is most important to limit the range of problems that need to be solved. The specialist tries to logically discuss the existing obsessions with the patient, to develop optimal behavior patterns that should be implemented next time.
Also, as a result of cognitive-behavioral therapy, special attitudes are formulated that help to respond correctly and act the next time when symptoms occur. The maximum efficiency from the sessions of such psychotherapy is possible only with high-quality joint work of the specialist and the patient.
Thought-stopping method
This is the most common method of psychotherapy for obsessive-compulsive disorder. It is specially designed to get rid of obsessions. Therefore, it helps to get rid of obsessive-compulsive disorder and eliminate its main symptoms. Naturally, most of the effectiveness depends solely on the patient's desire to work on himself and the problems that bother him.
This method consists of 5 consecutive steps:
- Lists … As with cognitive behavioral therapy, it is also important for this method to draw up a detailed list of obsessions that need to be eliminated. Before starting work, you need to know what you are dealing with.
- Switching … In the second step, a person is necessarily taught to find pleasant thoughts and memories. When all sorts of obsessions arise, it is necessary to switch to one of these positive waves. It is advisable to remember or think about something carefree, joyful and cheerful.
- Team building … The word "stop" is included in the installation. A person must learn to pronounce it every time obsessions arise in order to stop them. In this case, at this step, you need to do it out loud.
- Pinning a command … Step 4 of this technique for getting rid of obsessions is based on the mental pronunciation of the word "stop" in order to stop the rolling wave of obsessions.
- Revision … Step 5 is the most serious and difficult. Here, a person must learn to identify the positive aspects of his obsessions and fix his attention on them. For example, excessive concern about an open door - but a person always approaches it responsibly and, in fact, never leaves it open.
How to deal with obsessive-compulsive disorder - watch the video:
If symptoms of this disease appear, you should immediately seek help. Such a disease will never go away on its own, and the earlier the appropriate therapy is started, the more likely the symptoms of the disorder will be completely eliminated. Moreover, only a qualified doctor understands how to treat obsessive-compulsive disorder without complications and relapses.
