Today, three out of a hundred adults and two out of five hundred children are diagnosed with obsessive-compulsive disorder. This is an ailment that requires mandatory treatment. We offer you to get acquainted with the symptoms of ACS, the causes of its occurrence, as well as possible treatment options.
What is ACS?
Obsessive-compulsive syndrome (or disorder) - constantly repeating the same obsessive involuntary thoughts and (or) actions (rituals). This condition is also called obsessive-compulsive disorder.
The name of the disorder came from two Latin words:
- obsession, which literally means siege, blockade, imposition;
- compulsion - coercion, pressure, self-compulsion.
Doctors and scientists began to be interested in obsessive-compulsive disorder syndrome in the 17th century:
- E. Barton gave a description of the obsessive fear of death in 1621.
- Philippe Pinel researched obsessions in 1829.
- IvanBalinsky introduced the definition of "obsessive thoughts" into the Russian literature on psychiatry, and so on.
According to modern research, obsessional syndrome is characterized as a neurosis, that is, it is not a disease in the truest sense of the word.
Obsessive-compulsive syndrome can be schematically depicted as the following sequence of situations: obsessions (obsessive thoughts) - psychological discomfort (anxiety, fears) - compulsions (obsessive actions) - temporary relief, after which everything repeats again.
Types of ACS
Depending on the accompanying symptoms, there are several types of obsessional syndrome:
- Obsessive phobic syndrome. It is characterized by the presence of only obsessive thoughts or anxieties, fears, doubts that do not lead to any actions in the future. For example, constant rethinking of situations in the past. It can also manifest as a panic attack.
- Obsessive-convulsive syndrome - the presence of compulsive actions. They may be related to establishing a permanent order or monitoring security. In time, these rituals can take up to several hours daily and take a lot of time. Often one ritual can be replaced by another.
- Obsessive-phobic syndrome is accompanied by convulsions, that is, there are obsessive ideas (thoughts) and actions.
ACS depending on the time of manifestation can be:
- episodic;
- progressive;
- chronic.
Reasonsobsessional syndrome
Specialists do not give a clear answer to why obsessive syndrome may appear. In this regard, there is only an assumption that some biological and psychological factors influence the development of ACS.
Biological causes:
- heredity;
- consequences of traumatic brain injury;
- complications in the brain after infectious diseases;
- pathologies of the nervous system;
- violation of the normal functioning of neurons;
- decreased levels of serotonin, norepinephrine or dopamine in the brain.
Psychological reasons:
- traumatic family relationships;
- strict ideological education (for example, religious);
- experienced serious stressful situations;
- stressful work;
- strong impressionability (e.g. overreacting to bad news).
Who is affected by ACS?
High risk of obsessive syndrome in people in the family who have already encountered such cases - hereditary predisposition. That is, if there is a person in the family with a diagnosis of ACS, then the probability that his closest offspring will have the same neurosis is from three to seven percent.
Also OCs are prone to the following personality types:
- too suspicious people;
- who want to keep everything under their control;
- people who suffered various psychological traumas in childhood or in whose families there were seriousconflicts;
- people who were overprotected in childhood or, conversely, who received little attention from their parents;
- survivors of various brain injuries.
According to statistics, there is no division in the number of patients with obsessive-compulsive disorder between men and women. But there is a tendency that neurosis most often begins to manifest itself in people aged 15 to 25.
ACS symptoms
Among the main symptoms of obsessive-compulsive disorder are the emergence of anxious thoughts and monotonous daily activities (for example, constant fear of the wrong word or fear of germs, which forces you to wash your hands often). Accompanying signs may also appear:
- sleepless nights;
- nightmares;
- poor or complete loss of appetite;
- sullenness;
- partial or complete withdrawal from people (social isolation).
Categories of people by type of compulsions
In most cases, people are subject to the following categories according to the types of compulsions (forced compulsions):
- Clean or those who are afraid of pollution. That is, patients have a constant desire to wash their hands, brush their teeth, change or wash clothes, and so on. Those who are constantly reinsured. Such people are disturbed by thoughts about a possible fire, a visit from a thief, and the like, so they often have to check whether the doors or windows are closed, whether the kettle is turned off, the oven is turned off.cabinet, stove, iron and so on.
- Sinners who doubt. Such people are afraid of being punished by higher powers or law enforcement agencies even because something is not done as flawlessly as they think.
- Almost perfectionists. They are obsessed with order and symmetry in everything: clothes, surroundings and even food.
- Assemblers. People who can't give up things, even if they don't need them, out of fear that something bad will happen or they will need them someday.
Examples of manifestations of ACS in adults
How to diagnose "obsessive-compulsive syndrome"? Symptoms of the disease can manifest themselves in each person in their own way.
The most common obsessions are:
- thoughts of attacking loved ones;
- For drivers: Worry about being hit by a pedestrian;
- anxiety that you can accidentally harm someone (for example, start a fire in someone's house, a flood, and so on);
- fear of becoming a pedophile;
- fear of becoming homosexual;
- thoughts that there is no love for a partner, constant doubts about the correctness of one's choice;
- fear of saying or accidentally writing something wrong (for example, using inappropriate vocabulary in a conversation with superiors);
- fear of living out of religion or morality;
- anxious thoughts about the occurrence of physiological problems (for example, with breathing, swallowing, blurred vision, etc.);
- fear of making mistakes in work or assignments;
- fear of losing material well-being;
- fear of getting sick, contracting viruses;
- constant thoughts of happy or unlucky things, words, numbers;
- other.
Common compulsions include:
- constant cleaning and keeping a certain order of things;
- frequent hand washing;
- security check (are locks locked, are electrical appliances turned off, gas, water, etc.);
- often repeating the same set of numbers, words or phrases to avoid bad events;
- constant rechecking of the results of their work;
- constant step counting.
Examples of manifestations of ACS in children
Children are subject to obsessive-compulsive syndrome much less frequently than adults. But the symptoms of manifestation are similar, only adjusted for age:
- fear of being in a shelter;
- fear of falling behind parents and getting lost;
- anxiety about grades that develops into obsessive thoughts;
- frequent handwashing, brushing teeth;
- complexes in front of peers, developed into an obsessive syndrome and so on.
Diagnosis of ACS
Diagnosis of obsessive-compulsive syndrome is to identify those very obsessive thoughts and actions that have taken place over a long period of time (at least half a month) and are accompanied by a depressed state ordepression.
Among the characteristics of obsessive symptoms for diagnosis, the following should be highlighted:
- the patient has at least one thought or action and resists it;
- the idea of fulfilling an impulse does not give the patient any joy;
- repetition of an obsessive thought is disturbing.
Difficulty in making a diagnosis is that it is often difficult to separate obsessive-depressive syndrome from simple ACS, since their symptoms occur almost simultaneously. When it is difficult to determine which of them appeared earlier, then depression is considered to be the primary disorder.
The test itself will help to identify the diagnosis of "obsessive-compulsive syndrome". As a rule, it contains a number of questions related to the type and duration of actions and thoughts characteristic of the patient with ACS. For example:
- amount of daily time spent thinking about intrusive thoughts (possible answers: not at all, a couple of hours, more than 6 hours, etc.);
- amount of daily time spent doing compulsions (same answers as for the first question);
- feelings from obsessive thoughts or actions (possible answers: none, strong, moderate, etc.);
- do you have control over obsessive thoughts/actions (possible answers: yes, no, slightly, etc.);
- do you have trouble washing your hands/showering/brushing your teeth/dressing/laundry/tidying/taking out the trash, etc. (possible answers:yes, like everyone else, no, I don’t want to do this, constant cravings and the like);
- how much time do you spend showering/brushing your teeth/doing your hair/dressing/cleaning/taking out the trash and so on (possible answers: like everyone else, twice as much; several times as much, etc.)
To more accurately diagnose and determine the severity of the disorder, this list of questions can be much longer.
The results depend on the number of points scored. Most often, the more of them, the higher the likelihood of having an obsessive-compulsive syndrome.
Obsessive Compulsive Syndrome – Treatment
For help in the treatment of ACS, you should contact a psychiatrist who will not only help in an accurate diagnosis, but also be able to identify the dominant type of obsessive disorder.
And how can you generally defeat the obsessive syndrome? Treatment of ACS consists of a series of psychological therapeutic measures. Medicines take a backseat here, and often they can only support the result achieved by the doctor.
As a rule, tricyclic and tetracyclic antidepressants are used (for example, Melipramine, Mianserin and others), as well as anticonvulsants.
If there are metabolic disorders that are necessary for the normal functioning of brain neurons, then the doctor prescribes special drugs for the treatment of neurosis. For example, Fluvoxamine, Paroxetine and so on.
As a therapyhypnosis and psychoanalysis do not involve. In the treatment of obsessive-compulsive disorder, cognitive-behavioral approaches are used, which are more effective.
The goal of this therapy is to help the patient stop focusing on obsessive thoughts and ideas, gradually drowning them out. The principle of operation is as follows: the patient should focus not on anxiety, but on refusing to perform the ritual. Thus, the patient experiences discomfort no longer from obsession, but from the result of inaction. The brain switches from one problem to another, after several such approaches, the urge to perform compulsive actions subsides.
Among other well-known methods of therapy, in addition to cognitive-behavioral therapy, the “thought-stopping” technique is also used in practice. The patient at the time of the occurrence of an obsessive idea or action is recommended to mentally say to himself “Stop!” and analyze everything from the outside, trying to answer questions like:
- How likely is this to actually happen?
- Do obsessive thoughts interfere with a normal life and to what extent?
- How big is the feeling of inner discomfort?
- Will life become much easier without obsessions and compulsions?
- Will you be happier without obsessions and rituals?
The list of questions goes on. The main thing is that their goal should be to analyze the situation from all sides.
It is also possible that the psychologist will decide to use another treatment method as an alternative or as an additional help. It already depends on the specific case and its severity. For example, this could be family or group therapy.
Self-help for ACS
Even if you have the best therapist in the world, you need to make an effort yourself. Not many doctors - one of them, Jeffrey Schwartz, a very famous ACS researcher - say that self-management of their condition is very important.
For this you need:
- Research yourself all possible sources about obsessive disorder: books, medical journals, articles on the Internet. Gather as much information about neurosis as you can.
- Practice the skills your therapist has taught you. That is, try to suppress obsessions and compulsive behaviors on your own.
- Keep in touch with loved ones – family and friends. Avoid social isolation, as it only exacerbates the obsessive disorder.
And most importantly, learn to relax. Learn at least the basics of relaxation. Use meditation, yoga, or other methods. They can help reduce the impact and frequency of obsessional symptoms.
