What are obsessive states? Obsessive states: what is their danger and how to diagnose the disease

Obsessive states in a person are characterized by the appearance of thoughts that prompt the patient to take action. This disease has been known for a very long time, and many centuries ago sick people were called possessed. Today, obsessive states are classified as melancholy.

Obsessive Obsessive Syndrome

First concepts of this disease was recorded in 1868. It is very difficult for a lay psychiatrist to diagnose it. The syndrome is practically beyond the control of the individual; it has a significant negative impact on usual activities.

Obsessive-compulsive disorder is usually characterized by the frequent appearance of memories, thoughts, and doubts. Insecure people who suffer from anxiety are most susceptible to it.

There are two types of obsession:

• Distracted. They are characterized by thoughts and memories of long-forgotten insignificant events, which are accompanied by the commission of actions.
• Figurative. They are distinguished by the presence of emotional experiences when the patient experiences anxiety and fear.

Causes of obsessive states

The causes of obsessive states are:

• overwork, physical and psychological;
• other mental disorders;
• severe head injuries;
• infectious diseases;
• intoxication and others.

Obsessive states include involuntary thoughts, phobias, doubts, and actions. At the same time, a person realizes their uselessness, but cannot do anything about it. All sorts of thoughts come into the patient’s head that he cannot control.

People suffering from this disorder are quite polite when treated by psychiatrists, they easily make contact, but at the same time these thoughts remain in their heads. American doctors try to explain to patients that it is necessary to separate from themselves these thoughts, which should exist separately.

Obsessive thoughts can be completely inadequate or absurd. Sometimes a sick person is characterized by ambivalence, which confuses psychiatrists. But you cannot say with 100% certainty that if you have such thoughts, then you are sick. They often occur in completely healthy people, for example, after severe fatigue or mental illness. This condition can happen at least once in every person’s life.

Symptoms of obsessive disorders

Obsessive states in people are accompanied by a painful feeling that greatly torments them. Sometimes it is accompanied by nausea, screaming, and frequent urge to urinate. A person suffering from obsessiveness enters into a stupor, his complexion quickly changes, he breathes quickly and sweats, becomes dizzy, and feels weak in his legs.

A sick person has completely inadequate thoughts. For example, why a person has only two legs, why the sea is salty, and so on. He understands that his thoughts are absurd, but he cannot get rid of them on his own.

In addition, one of the symptoms of obsessive-compulsive disorder is a constant desire to count something, for example, the number of cars on the road. It can also manifest itself in more complex arithmetic operations, for example, in adding numbers, numbers, multiplying them, and so on.

Obsessive states are also characterized by obsessive actions. They are involuntary, since a person sometimes does not understand that he is performing them. This can be twirling any object in the hands, biting nails, twirling hair on a finger, sniffing, rubbing hands, and so on. A strong will allows you to restrain them for some time, but will not get rid of them completely. When a person is distracted by something, he inevitably begins to do it again.

Obsessive doubts are accompanied by difficult experiences when a person cannot decide whether he did the right thing. For example, is the light or gas turned off before going to work, and so on. These thoughts prevent a person from doing his job; he has to check everything he has done again. Memories of events often appear that a person would like to completely forget about, for example, breaking up with a significant other.

An obsessive fear that can be caused by almost anything is excruciating. For example, fear of heights, wide streets, open bodies of water, fear of the subway, and so on. There is also a fear of getting some kind of disease - this is nosophobia, or a fear of dying - thanatophobia. The patient has an obsessive desire to do something, for example, to push a person or spit at him.

Quite contrasting states also appear that are blasphemous. They insult the essence of man. For example, a son may have unhealthy thoughts about the sight of his naked mother, her uncleanliness. If this is a sick mother, then the intrusive thoughts may be in the form of a knife piercing her child.

In young children, illness manifests itself in the fear of being left alone, contaminating oneself, or getting sick. Sometimes a child is ashamed of his appearance and is afraid to speak in public. Inherent, for example, thumb sucking. The causes of this disease in children are mental trauma, as well as poor upbringing.

Treatment of obsessive disorders

If the patient cannot independently get rid of obsession in any of its forms, then it is necessary to seek qualified help, because a person’s entire daily life suffers. There are two methods of treating obsessive-compulsive disorder: medication and behavioral therapy. If the symptoms are quite severe, then sometimes the patient needs surgery.

In drug therapy, antidepressants are used, such as Clomipramine, Fluoxetine, as well as Lithium, Buspirone, and often these drugs are combined. Treatment with drugs must be completed to the end, because interruption of treatment threatens even greater consequences.

Behavioral therapy is a combination of obsessive provocations and action prevention. Doctors literally provoke the patient to commit obsessive actions, but at the same time reduce the time for their implementation. This therapy is very effective, but not all patients agree to it, as it causes them anxiety.

Obsessive-compulsive disorder, or OCD for short, and scientifically, obsessive-compulsive disorder, is characterized by the appearance of unpleasant obsessive thoughts, followed by compulsive actions, peculiar rituals that help the patient temporarily relieve anxiety and excitement.

Among mental illnesses, various kinds of syndromes can be distinguished into a special group, which are united under one “label” - obsessive-compulsive disorder (or OCD for short), which gets its name from the Latin words that mean “siege, blockade” (obsession) and “ compulsion" (compello).

If you dig into the terminology, then two points are of great importance for OCD:

1. Obsessive urges and thoughts. And what is characteristic of OCD is that such drives arise without control on the part of the person (contrary to feelings, will, reason). Often such drives are unacceptable to the patient and contradict his principles. Unlike impulsive drives, compulsive drives may not be realized in life. Obsession is difficult for the patient to experience and remains deep inside, giving rise to feelings of fear, disgust and irritation.

2) Compulsions that accompany bad thoughts. Compulsivity also has an expanded term, when the patient experiences any obsessions, and even obsessive rituals. Typically, the main features of this type of disorder are repetitive thoughts with compulsive actions that the patient repeats over and over again (creating a ritual). But in an expanded sense, the “core” of the disorder is the obsession syndrome, which in the clinical picture manifests itself in the form of a predominance of feelings, emotions, fears and memories that manifest themselves without control by the patient’s mind. And often, patients realize that this is not natural and illogical, but they cannot do anything about obsessive-impulsive disorder.

Moreover, this mental disorder can be divided into two types:

• Obsessive impulses occur within the consciousness of the individual; they often have nothing to do with the character of the patient and very often contradict internal attitudes, norms of behavior and morality. However, at the same time, bad thoughts are perceived by the patient as their own, which is why OCD patients suffer greatly.
• Compulsive actions can be embodied in the form of rituals, with the help of which a person relieves feelings of anxiety, awkwardness and fear. For example, washing hands too often, excessively cleaning rooms to avoid “contamination.” Trying to push away thoughts that are foreign to a person can lead to even deeper harm mentally and emotionally. And also to the internal struggle with oneself.

Moreover, the prevalence of obsessive-compulsive disorders in modern society is really high. Some studies estimate that about 1.5% of the population in developed countries suffers from OCD. And 2-3% have relapses that are observed throughout life. Patients who suffer from compulsive disorders account for about 1% of all patients treated in psychiatric institutions.

Moreover, there are no specific risk groups for OCD - both men and women are equally susceptible.

Causes of OCD

Currently, all types of obsessive-compulsive disorders that are known to psychology are combined in the International Classification of Diseases under a single term - “obsessive-compulsive disorder.”

For a long time in Russian psychiatry, OCD was defined as “psychopathological phenomena that are characterized by the fact that patients experience repeated feelings of burden and compulsion.” In addition, the patient experiences involuntary and uncontrollable volitional thoughts arising in the mind. Although these pathological conditions are alien to the patient, it is very difficult, almost impossible, for a person suffering from the disorder to free himself from them.

In general, obsessive-compulsive disorder does not affect the patient’s intellectual potential and does not impair the person’s overall functioning. But they lead to a decrease in the level of performance. During the course of the disease, the patient is critical of OCD and denial and substitution occurs.
Obsessive states are conventionally divided into such states in the intellectual-affective and motor spheres. But most often, obsessive states are “delivered” to the patient in a complex. Moreover, psychoanalysis of the human condition often shows a pronounced, depressive “foundation” at the basis of obsession. And along with this form of obsession, there are also “cryptogenic” ones, the cause of which is very difficult to find even for a professional psychoanalyst.

Most often, obsessive-compulsive neurosis occurs in patients with a psychasthenic character. In addition, anxious fears are clearly distinguished here, and such sensations are found within the framework of nervous-like states. Some researchers believe that the cause of obsessive states is a special nervousness, which is characterized by the fact that it predominates in the clinical picture of memories that remind a person of the emotional and mental trauma suffered at a certain period of life. In addition to this, the emergence of neurosis is facilitated by conditioned reflex stimuli that caused a strong and unconscious feeling of fear, as well as situations that became psychogenic due to the struggle with internal experiences.

The understanding of anxiety disorder and OCD has been redefined over the past fifteen years. Researchers have completely changed their view of the epidemiological and clinical significance of obsessive-compulsive disorders. If previously it was believed that OCD was a rare disease, now it is diagnosed in a large number of people; and the incidence rate is quite high. And this requires urgent attention of psychiatrists around the world.

In addition to this, practitioners and theorists in psychology have expanded their understanding of the root causes of the disease: a vague definition obtained through psychoanalysis of neurosis has been replaced by a clear picture with an understanding of neurochemical processes where neurotransmitter connections are disrupted, which in most cases is the “foundation” for the development of OCD .

And what is most significant is that a correct understanding of the root causes of neurosis helped the doctor treat OCD more effectively. Thanks to this, pharmacological intervention became possible, which became targeted and helped millions of patients recover.

The discovery that intensive serotonin reuptake inhibition (SSRI for short) is one of the most effective treatments for OCD was the first step in a therapy revolution. It also stimulated subsequent research, which shows the effectiveness of treatment modifications with modern means.

Symptoms and signs of OCD

What are common signs that you have obsessive-compulsive disorder?

Frequent hand washing

The patient is obsessed with washing his hands and constantly using antiseptics. Moreover, this happens in a fairly large group of people suffering from OCD, for whom the designation “washers” was invented. The main reason for this “ritual” is that the patient experiences an overwhelming fear of bacteria. Less often – an obsessive desire to isolate oneself from the “impurities” in the society around a person.
When will you need help? If you cannot suppress and overcome the constant urge to wash your hands; If you are afraid that you are not washing thoroughly enough, or after going to the supermarket you have thoughts that you caught the AIDS virus from the handles of the trolley, then there is a high probability that you suffer from OCD. Another sign that you are a “washer”: wash your hands at least five times, thoroughly rinsing off the soap. We soap each nail separately.

Obsession with cleanliness

“Handwashers” often, in addition to this, go to another extreme - they are obsessed with cleaning. The reason for this phenomenon is that they experience a constant feeling of “uncleanness”. Although cleaning reduces the feeling of anxiety, the effect is short-lived, and the patient begins cleaning again.

When should you seek help? If you spend several hours every day just cleaning the house, then you most likely suffer from OCD. If the satisfaction from cleaning lasts more than an hour, then the psychotherapist will have to “sweat” to diagnose you.

Obsessiveness in checking any actions

Obsessive-compulsive disorder is one of the most common disorders (about 30% of patients suffer from this type of OCD out of the total number of all patients), when a person checks the action performed 3-20 times: whether the stove is turned off, whether the door is closed, and so on. Such repeated checks arise due to a constant feeling of anxiety and fear for one’s life. Young mothers suffering from postpartum depression often notice symptoms of obsessive OCD, only such anxiety appears in relation to the child. A mother can change her baby’s clothes many times, rearrange his pillow, trying to convince herself that she did everything right and that the baby is comfortable, warm and not hot.

When should you seek help? It is quite reasonable to check the completed action twice. But if obsessive thoughts and actions interfere with your life (constantly being late for work, for example) or have already taken the form of a “ritual” that cannot be broken, then be sure to make an appointment with a psychotherapist.

I want to count all the time

Some patients suffering from OCD have an obsessive urge to constantly count everything - the number of steps that cars of a certain color have passed by, etc. Often, the root cause of such a disorder is some kind of superstition, fear of failure and other actions that have a “magical” character for the patient.

When should you seek help? If you can’t get rid of the numbers in your head, and the calculations happen against your will, then be sure to make an appointment with a specialist.

Organization in everything and always

Another common phenomenon in the field of obsessive-compulsive disorders is that a person brings the art of self-organization to perfection: things are always in a certain order, clearly and symmetrically.

When should you seek help? If you need your desk to be clean, organized, and tidy to make your work easier, then this is not a sign of OCD. People with obsessive-compulsive disorder often organize the space around them unconsciously. Otherwise, the slightest “chaos” begins to panic them.

Fear of violence

Every person at least once in his life has thoughts about an unpleasant incident or violence. And the more we try not to think about them, the more strongly they manifest themselves in consciousness beyond the control of the person himself. In people with obsessive-compulsive disorder, this feeling goes to the extreme, and troubles that happen (even the most minor ones) cause panic, fear, and anxiety. Young girls with this type of OCD are afraid that they might be raped, although there is no apparent reason for this. Young people tend to fear being in a fight, that someone might hit them or even kill them.

When should you seek help? It is important to clearly understand that in periodic fears and thoughts of “getting into an unpleasant situation” there are no signs of the development of a disorder. And when, due to these disturbing thoughts, the patient avoids any action (I don’t go for a walk in the park, as they might get robbed there), then they should seek help from a specialist.

OCD - causing harm

Intrusive thoughts of harm are one of the most common types of OCD. The patient suffers from obsessive thoughts, the center of which is his children, other family members, close friends or work colleagues. Postpartum depression in new mothers often contributes to the development of such OCD. As a rule, it is directed at one’s own child, less often at a husband or other close people.

Such fear begins because of great love for the child, a feeling of incredible responsibility, which often increases stress. A mother suffering from depression begins to blame herself for being a bad mother, eventually drawing negative thoughts onto herself and imagining herself as a source of danger. Unfortunately, parents suffer a lot because of their OCD; they don’t tell anyone about it, for fear of being misunderstood.

Sexual obsessions

Sexual stress disorders, obsessive fears and obscene sexual desires are one of the most unpleasant types of OCD. Just like thoughts of violence, OCD often involves obsessive thoughts about indecent behavior or taboo desires. Patients suffering from disorders can, without their will, imagine themselves with other partners, imagine that they are cheating on their wife, or harassing work colleagues, which they absolutely do not want to do in reality.

If this type of OCD occurs in a child or adolescent, then his parents often become the object of forbidden thoughts. The teenager begins to be afraid of his thoughts, because thinking and imagining various obscenities about his parents is not normal, they believe.

Many young people are familiar with homosexual OCD, or HOCD. Such obsessive-compulsive neurosis consists in the fact that a person begins to doubt his own sexual orientation. A kind of “trigger” for such obsessive thoughts can be an article in a newspaper, a television program, or simply an excess of information about sexual minorities. Suspicious and sensitive young people immediately begin to look for signs of homosexuality in themselves. Compulsions in this case include, for example, viewing photographs of men (for women with this type of OCD, photographs of women) in order to find out whether they are aroused by members of the same sex. Many homo-OCD sufferers may even feel agitated, although any psychiatrist will tell you that this feeling of agitation is false, it is the body's reaction to stress. A person with OCD expects confirmation of his obsessive thoughts in the form of such a reaction, and, as a result, receives it.

Often, young parents can face one of the most unpleasant OCD - the fear of becoming a pedophile. Most often, this type of contrasting obsessions manifests itself in mothers, but fathers also suffer from this type of OCD. Fearing that such thoughts may come true, parents begin to avoid their own children. Bathing, changing diapers, and just spending time with your own child turns into torture for a mother or father with OCD.

Does someone like OCD have compulsions? Many of them do not manifest themselves in the form of any obsessive movements, but compulsive thoughts are present in the minds of people with neurosis. For example, a person who is afraid of becoming gay or a pedophile will constantly repeat to himself that he is normal and try to convince himself that he is not a pervert. People who have obsessive thoughts about their children may keep returning to the same situation in their minds, trying to figure out whether they did everything right or whether they harmed their child. Such compulsions are called “mental chewing gum”; they are very tiring for a person with obsessive-compulsive disorder and do not bring relief.

When should you seek help? If most people who do not suffer from OCD will convince themselves that such thoughts are just imagination, and do not reflect their personality at all, then a person with a mental disorder will think that such thoughts are disgusting, they do not occur to anyone else, That means he’s probably a pervert, and what will they think of him now? From such an obsessive state, the patient’s behavior changes; Depending on the type of OCD and who is the object of indecent thoughts and impulses, the patient begins to avoid familiar people, his own children, or people with a non-traditional orientation.

Obsessive guilt

Another type of OCD that cannot be ignored. Typically, such a feeling of guilt is imposed and a similar obsessive-compulsive neurosis occurs against the background of depression. People with low self-esteem and those prone to hypochondria suffer from feelings of guilt. Often the cause of feelings of guilt is an unpleasant event, the culprit of which could well be the culprit of the OCD patient. However, people who do not suffer from obsessions will learn a lesson from this and move on. A person with OCD, on the contrary, will be “stuck” at this stage, and feelings of guilt will arise again and again.

It also happens that the feeling of guilt is imposed on a person, and is not his own conclusion regarding any situation. For example, an overly dominant partner may blame a person for something that he did not do. Aggressive attitudes and domestic violence play a significant role in the occurrence of neurosis. “You are a bad mother”, “You are a worthless wife” - such accusations will first cause resentment in a person and a healthy desire to protect himself. Constant attacks will sooner or later lead a person to depression, especially when one of the partners in the family is materially or spiritually dependent on the aggressor.

Intrusive memories and false memories

Intrusive memories are of the “mental chewing gum” type. A person focuses on some event from the past, carefully trying to remember every detail, or something very important to him. Often such memories are accompanied by an obsessive feeling of guilt. The plots of such memories can be very different. For example, an OCD patient painfully tries to remember whether he made any mistakes, whether he did something bad or immoral in the past (hitting someone with a car, accidentally killing someone in a fight and forgetting, etc.).

Thinking about it again and again, a person is afraid that he has missed something. In a panic, he tries to “think it through” in order to fully understand and feel the situation. Because of this, one’s own memories are often mixed with fantasies about this event, since a person with obsessive-compulsive neurosis tends to think only about the bad and invent the most negative scenario for the development of events. As a result, the neurosis intensifies even more, since the OCD patient is no longer able to discern where his real memories are and where they are made up.

Unhealthy relationship analysis

People who suffer from obsessive-compulsive disorder are also known for constantly analyzing their relationships with others. For example, they may worry for a long time because of a misunderstood phrase, which will cause separation from a loved one, for example. This state can increase the sense of responsibility to the limit, as well as complicate the correct perception of unclear situations.
When should you seek help? “Break off relations with a loved one” - such a thought can turn into a cycle in a person’s mind. Over time, in people suffering from OCD, such thoughts turn into a “snowball”, becoming overgrown with anxiety, panic and a drop in self-esteem.

Fear of embarrassment

Patients who experience obsessive-compulsive disorder often seek support from family and friends. If they are afraid of embarrassing themselves at a public event, they often ask their friends to “rehearse” all the actions several times.

When should you seek help? It's normal to ask friends and loved ones for help. But if you find yourself asking the same question, or your friends tell you about it, then you should make an appointment with a psychotherapist. This may be the cause of obsessive-compulsive disorder. Particular attention should be paid to your own condition after support has been received. Usually, in people with OCD, their mental and emotional state only gets worse.

“I look bad in the mirror” - dissatisfaction with my appearance

This is not a whim at all: often uncertainty and even self-loathing arises from obsessive-compulsive neurosis. OCD is often accompanied by dysmorphophobia - the belief that there is some flaw in one's appearance, which forces people to constantly evaluate parts of the body that seem “ugly” to them - the nose, ears, skin, hair, etc.

When should you seek help? It's completely normal to not be excited about a certain part of your body. But for people with OCD it looks different - a person spends hours in front of the mirror, looking at and criticizing his “flaw” in appearance.

Intrusive Thoughts: Symptoms of OCD

Already in the 17th century, researchers drew attention to the existence of obsessive states in some people. They were first described by Platter in 1617. A few years later (1621), Barton described the obsessive fear of death in psychiatry. Mentions of the existence of such states of the human psyche are found in the later works of F. Pinel (the end of the first decade of the 19th century). Researcher I. Balinsky put forward the designation of the term “obsessive ideas,” which has taken root in Russian psychiatric literature.

At the end of the 19th century, Westphal introduced the term “agoraphobia,” which, in his opinion, meant the fear of being in the company of other people. Around the same time, Legrand de Sol suggests that the peculiarity of the dynamics of obsessive states occurs in the form of “insanity of doubt with delusion of touch.” At the same time, he points to a gradually progressing clinical picture - obsessive doubts are replaced by absurd fears such as “fear of contact” with any object. And besides, the patient begins to perform “protective rituals” that significantly “spoil” his life.

But it is noteworthy that only at the turn of the 19th-20th century, researchers came to a more or less unified view of the clinical picture of the disease, and characterized the “syndrome” of diseases in the OCD sphere. In their opinion, the onset of the disease occurs in adolescence and youth. The maximum clinical manifestations were found by researchers in patients aged 10-25 years.

Let's take a closer look at the clinical picture of this disease. From the medical reference book, the term “obsessive thoughts” means painful thoughts, ideas, images and beliefs that arise against the will of the patient. As a rule, it is incredibly difficult, if not impossible, for a patient to “drive away” such thoughts. And such thoughts can take the form of individual phrases and even poems. Such images can be blasphemous and unpleasant to the person experiencing them.

Whereas obsessive images are nothing more than “vividly imagined scenes” with elements of violence, sex, and perversion. Obsessive impulses are a severe form of the disease, when the patient, against his will, wants to commit some action that is destructive and dangerous for the person himself. For example, jumping out onto the road in front of a car, injuring a child, or shouting obscene words in public.

The “rituals” that people with OCD perform include both mental activities and repetitive behaviors. For example, counting in your head endlessly or washing your hands 5-10 times in a row. Some of them combine mental and physical activities (hand washing is associated with the fear of contracting germs). However, there are other “rituals” that do not have such a connection (folding clothes before putting them on). Most patients want to repeat the action several times. And if this doesn’t work (do it in a row, without stopping), then people will repeat the action from the beginning. Both obsessive thoughts and rituals complicate a person’s life in society.

Obsessive rumination, which psychiatrists call mental chewing, is an internal debate with oneself that considers the pros and cons of even the simplest actions. Moreover, some obsessive thoughts have a direct connection with a previously committed action - did I turn off the stove, did I lock the apartment, etc. Other thoughts also apply to complete strangers - I’m driving and can hit a cyclist and so on. Often, doubts are also associated with a possible violation of religious canons, which are accompanied by strong remorse.

All these difficult thoughts accompany compulsive actions - the patient repeats stereotypical actions that take the form of “rituals”. By the way, such rituals for the patient mean “protection, amulet” from possible troubles that are dangerous for the patient or his loved ones.

In addition to the disorders described above, there is also a number of outlined symptoms and complexes, among which are phobias, contrasting obsessions and doubts.

It happens that obsessive neuroses and compulsive rituals begin to intensify in certain cases: for example, while holding a knife, an OCD patient begins to experience an increased impulse to “stab” a loved one with it, etc. And in addition to this, anxiety is a common “companion” of OCD patients. Some rituals reduce the feeling of anxiety somewhat, but in other cases it can be quite the opposite. In some patients, this occurs according to the “script” of a psychologically motivated reaction to the stimulus and OCD symptom, but in other cases, patients experience episodes of relapse of depression that occur independently of each other.

Obsessions (or obsessions, in simple terms) are divided into figurative (sensual) and obsessions of completely neutral content. The first type of obsessions includes:

• Doubts (about the correctness of one’s actions);
• Flashbacks (obsessive memories of something unpleasant, repeated over and over again);
• Attractions;
• Actions;
• Representation;
• Fears;
• Antipathy;
• Concerns.

Now let's go through each type of sensory obsession.

Obsessive doubts are intrusively arising, contrary to the mind and will of the patient, uncertainties that are accompanied when making decisions and taking any actions. The contents of doubts are varied, ranging from everyday concerns (is the door closed, is water, gas and electricity turned off, etc.) to doubts that are related to work (whether the report was calculated correctly, whether there was a signature on the last document, etc.). Despite the fact that a person with OCD checks the action he has performed several times, the obsession does not go away.
Psychologists classify intrusive memories as those that are persistent and painful in nature. Sad, shameful events for the patient, which were accompanied by feelings of guilt and shame, have this effect. Coping with such thoughts is not easy - a patient with OCD cannot suppress them simply by an effort of will.

Obsessive drives are impulses that “demand” a person to perform certain dangerous, scary, terrible actions. Often, the patient cannot free himself from such a desire. For example, the patient is overcome by the desire to kill a person, or to throw himself under a train. This desire intensifies when a stimulus is detected (a weapon, an approaching train, etc.).

Manifestations of “obsessive ideas” are varied:

• A clear vision of the actions being taken;
• Images of absurd, implausible situations and their results arise.

An obsessive feeling of antipathy (and also “blasphemous, blasphemous” thoughts) is an unjustified, alien to the patient’s consciousness, aversion to a certain (usually close) person. These may also be cynical thoughts, ideas about loved ones.

Compulsions are when patients do things that were against their will, despite their best efforts “not to do it.” Obsessive thoughts pull a person to do something imagined until it is realized. And some of them are simply not noticed by humans. Obsessive actions are incredibly painful, especially in cases where their results are visible to people around them.

Experts consider the following to be obsessive fears (phobias): fear of heights, streets that are too wide; the onset of sudden death. It also happens that people are afraid to find themselves in confined/open spaces. And even more common cases are the phobia of contracting an incurable disease.
And, in addition, some patients experience fear of the occurrence of any fear (phobophobia). And now a few lines about what classifications of phobias there are.

Hypochondriacal – a person experiences an obsessive fear of becoming ill with a difficult-to-treat (or generally incurable) virus. For example, AIDS, heart disease, various forms of tumors and other symptoms that accompany a suspicious person. At the peak of anxiety, patients “lose their heads,” stop doubting their “morbidity” and begin to see doctors at the appropriate levels. The emergence of hypochondriacal phobias occurs both in “pair” with somatogenic, mental provocations, and independently of them. Usually, the result of a phobia is the development of hypochondriacal neurosis, which is accompanied by frequent medical examinations and pointless medication.

Isolated phobias are obsessive states that arise only in certain conditions and situations - fear of heights, thunderstorms, dogs, dental treatment, etc. Since “contact” with such situations causes intense anxiety in the patient, patients with such a phobia often avoid such events in their lives.

The obsessive fears that OCD patients experience are often accompanied by “rituals” that supposedly protect them and protect them from imaginary misfortune. For example, before starting any action, the patient certainly repeats the same “spell” in order to avoid failure.
Such “defensive” actions can be snapping fingers, playing a melody, repeating certain words, etc. In such cases, even relatives may not know that the patient is sick. Rituals take the form of an established system that has existed for years.

The next type of obsessions is affectively neutral. They are expressed in the form of memories of terms, formulations, neutral events; formation of obsessive wisdom, counting and other things. Despite their “harmlessness,” such obsessions disrupt the patient’s usual rhythm of life and interfere with his mental activity.

Contrasting obsessions, or as they are also called “aggressive” obsessions, are blasphemous and blasphemous actions that carry with them the fear of harming others and oneself. Patients who experience contrasting obsessions often complain of an irresistible urge to shout obscenities in the company of other people, add endings, repeat after others, adding a hint of anger, irony, etc. At the same time, people experience fear of losing control over themselves, and, as a result, of possibly committing terrible acts and ridiculous actions. At the same time, such an obsession is often combined with phobias of objects (for example, fear of knives and other cutting objects). Obsessions of a sexual nature are often included in the group of contrasting (aggressive) obsessions.

Pollution obsessions. Experts include in this group:

• Fear of “getting dirty” (with soil, urine, feces and other impurities);
• Fear of getting dirty with human waste (for example, semen);
• Fear of chemicals and other harmful substances entering the body;
• Fear of small objects and bacteria entering the body.

In some cases, this type of obsession never shows up, remaining at the preclinical stage of development for many years, manifesting itself only in personal hygiene (changing underwear or washing hands, refusing to touch door handles, etc.), or in the order of management everyday life (careful processing of food before cooking, etc.).
Such phobias do not have a particularly strong effect (or no effect at all) on the patient’s life, and also remain unnoticed by the people around them. But in the clinical picture, “mysophobia” is considered as a severe obsession, where gradually becoming more complex “protective rituals” come to the fore: sterility in the bathroom, ideal cleanliness in the apartment (washing the floors several times a day, etc.).

Staying on the street for people who suffer from this type of disease is necessarily accompanied by wearing long, careful clothing that “protects” the exposed coverings of the body, which must be “washed after going outside.” In the later stages of the development of severe obsession, people stop going outside, and even beyond the boundaries of a “perfectly clean room.” To avoid dangerous contacts with the “infected”, the patient is protected from all other people. Mysophobia also includes the fear of contracting some terrible disease that cannot be cured. And in the first “place” is the fear of what comes “from outside”: the penetration of “bad” viruses into the body. Fearing infection, an OCD patient develops defensive reactions in the form of compulsions.

A notable place among obsessions is occupied by obsessive actions, which have the appearance of specific movement disorders. Some of them develop in childhood - for example, tics, which, unlike natural deviations, are a much more complex motor “act” that has lost its meaning. Such actions are often perceived by others as exaggerated physiological movements - a caricature of certain actions, gestures that are natural for everyone.

Typically, patients who suffer from tics may shake their heads for no reason (as if checking whether they have a hat), make some movements with their hands without meaning (checking the time on a wristwatch, without having one), blink their eyes (as if they were wearing a hat). got dirty).

Along with such obsessions, pathological actions develop, such as spitting, lip biting, teeth grinding, etc. They differ from obsessions that arise for objective reasons in that they do not cause feelings of guilt, experiences that are alien and painful to a person. Neurotic conditions that are characterized only by obsessive tics usually have a favorable outcome for the patient. Most often appearing during school age, tics go away by the end of puberty. True, there are cases that they persist for many years.

Obsessive states: the course of neurosis

Unfortunately, obsessive-compulsive disorder most often becomes chronic. Moreover, cases of complete recovery of a patient suffering from OCD are extremely rare in our time. True, in many patients only one type of obsession remains, and long-term stabilization of a person’s mental health is quite possible.

In such cases, there is a gradual (usually after thirty years) tendency towards a decrease in symptoms and social adaptation occurs. For example, patients who previously experienced fear of public speaking or traveling on an airplane eventually cease to experience (or receive a milder form without anxiety) this obsession.

More severe, complex forms of OCD, such as phobias of infection, fear of sharp objects, aggressive obsessions, as well as numerous rituals that follow them, on the contrary, can turn out to be very resistant to any treatment and become chronic with frequent relapses. At the same time, despite the fact that the patient is undergoing active therapy. Further deterioration of these symptoms leads to the fact that the clinical picture of the disease becomes more and more complex.

Diagnosis of obsessive-compulsive disorder neurosis

Many people with OCD are afraid to go to the doctor, believing that they will be mistaken for crazy or maniacs. This is especially true for people with sexual obsessions or obsessive thoughts of harm. However, it is important to know that OCD is treatable! Therefore, anyone who suffers from intrusive thoughts should see an experienced psychotherapist who specializes in the treatment of OCD.

It is worth understanding that the symptoms of obsessive-compulsive disorder are similar to those of other mental illnesses. In some cases, OCD should be distinguished from schizophrenia (an experienced psychiatrist will be able to make the correct diagnosis). Moreover, during the development of sluggish schizophrenia, an increase in the complexity of rituals is observed - their persistence, an antagonistic tendency in the human psyche (inconsistency of actions and thoughts), monotonous emotional manifestations.

Prolonged obsessions of a complex form, which are characteristic of OCD, also need to be separated from schizophrenia. In contrast to its manifestations, obsessions are usually accompanied by a growing feeling of anxiety, significant systematization and an expansion of the circle of obsessive associations that acquire the character of “special meaning.” For example, events, random remarks and objects that, by their “presence”, remind the patient of their biggest phobia, or unpleasant thoughts. As a result, things or events become dangerous in the imagination of a person with obsessive-compulsive disorder.

In such cases, the patient should definitely seek help from qualified specialists in order to exclude schizophrenia. Certain difficulties in establishing a differential diagnosis arise with Gilles de la Tourette syndrome, in which generalized disorders predominate.

Nervous tics, in this case, are localized in the neck, face, jaws, and are accompanied by grimaces, protruding tongue, etc. The syndrome can be excluded in such cases based on the fact that it is characterized by roughness of movements, variable movement disorders, and also more complex mental disorders.

Despite the fact that experts have conducted a lot of research on obsessive-compulsive disorders, they have not yet identified what is the main cause of the disease. Physiological factors may be as important as psychological factors. Let's look at this in more detail.

Genetic causes of OCD

It is worth emphasizing that when OCD occurs, research has shown that the neurotransmitter serotonin is of great importance. Moreover, it has been proven in many scientific works that an obsessive state can be transmitted from generation to generation in the form of a tendency to develop the disease.

A study of this issue in adult twins showed that this disorder is moderately hereditary. However, they were never able to identify the gene that is responsible for the occurrence of OCD. However, the genes that have the most prerequisites for this are hSERT and SLC1A1, which contribute to the development of the disease.

As a rule, the task of the hSERT gene is to collect “waste” substances in nerve structures. And as we wrote above, a neurotransmitter is required for the transmission of impulses in neurons. There are studies that clearly indicate hSERT mutations among certain groups of OCD patients. As a result of such mutations, this gene begins to work too quickly, taking away even usable serotonin.
SLC1A1 also affects the development of the disease, and possibly its appearance. This gene has a lot of similarities with the gene described above, but its task is to transmit another substance - the neurotransmitter glutamate.

Autoimmune reaction

What autoimmune reaction occurs to obsessive-compulsive disorder? In addition, the occurrence of obsessive-compulsive disorder also depends on autoimmune diseases. It is worth emphasizing that in childhood OCD occurs as a consequence of infection with group A streptococcus, which causes dysfunction and inflammation of the basal ganglia. These cases are grouped into clinical conditions called PANDAS.

Another study suggests that episodic manifestations of OCD disorders are not due to a streptococcal infection, but as a result of taking prophylactic antibiotics that fight the infection. Various forms of obsessive states can also arise as a result of the immune system’s reaction to pathogens.

Incorrect brain function

What neurological problems occur? Thanks to modern developments in technology and the ability to scan the brain, researchers have been able to study the activity of various parts of the brain. They were able to prove that some parts of the brain in people suffering from OCD have unusual activity. These departments are:

• Thalamus;
• Striatum;
• Orbitofrontal cortex;
• Caudate nucleus;
• Anterior cingulate cortex;
• Basal ganglia.

The results of brain scans of OCD patients revealed that the disease affects the functionality of the chain communication between the departments. Such a circuit that regulates instinctive behavioral aspects (aggression, bodily secretions, sexuality); triggers the corresponding behavior, in the normal state it can “turn off”. That is, a person, having washed his hands once, will no longer do so in the near future. And he will move on to another matter. However, in patients who suffer from OCD, this circuit cannot “switch off” immediately, and signals are ignored, which causes a breakdown in “communication” between departments. Obsessions and compulsions continue, triggering repetitions of the action.

At the moment, medicine has not found an answer to the nature of such actions. But without a doubt, this disorder is associated with problems in brain biochemistry.

Behavioral psychology. What are the reasons for obsession?

According to the postulates of one of the laws of behavioral psychology: repetition of the same action makes it easier to reproduce in the future. But in the case of patients who suffer from obsessive-compulsive disorder, all they do is repeat the “same” action. And for them, this plays the role of a “protective ritual” in order to “drive away” obsessive thoughts/actions. Such activities temporarily reduce fear, anxiety, anger, etc., but the paradox is that it is “rituals” that lead to the appearance of obsession in the future.

In this case, it turns out that it is the “avoidance of fear” that becomes one of the fundamental reasons for the formation of an obsessive state. And this, unfortunately, leads to increased symptoms of OCD. People who are most often subject to pathological changes are those who have been under great stress for a long time: for example, they start working in a new place, end a dry relationship, or suffer from constant overwork. For example, if a person has previously calmly used public toilets, then at “one fine moment” the patient may develop a phobia of “contamination” from unclean toilet seats, which is why one can catch a “disease”. Further, a similar association may appear to other objects in social life - public sinks, cafes, restaurants, etc.

Soon, a person who develops OCD begins to perform “protective rituals” - obligingly wiping down door handles, trying to avoid public toilets, and much more. Instead of overcoming his fear, convincing himself of the illogicality of obsession, the person becomes more and more subject to phobia.

Other causes of OCD

In fact, the behavioral theory, as we described above, explains why pathologies with “wrong” behavior arise. In turn, cognitive theory can explain why patients with OCD are not taught to correctly interpret their thoughts and actions that occur under the influence of the disease.

Most people experience obsessions in thoughts and actions several times a day, much more than people with a healthy psyche. And unlike the latter, patients with obsessive-compulsive disorder exaggerate the importance of the thoughts that come into their heads.
How does obsession develop in young mothers? For example, against the background of fatigue, a woman who is raising a child may often have thoughts about harming her child. Most mothers do not pay attention to stupid thoughts, attributing it to stress. But people who suffer from the disease begin to exaggerate the importance of the thoughts and actions that come into their minds.

The woman begins to think and realize that she is an “enemy” for the child. And this causes him fear, anxiety, and other negative thoughts. The mother begins to feel shame towards the child, mixed feelings of disgust and guilt. Fear of one's own thoughts leads to attempts to neutralize the “root causes.” And most often, mothers begin to avoid situations during which such thoughts arise. For example, they stop feeding their baby, devote insufficient time to him, and develop their own “protective rituals.”

And as we wrote above, the emergence of “rituals” helps behavioral disorders to “get stuck” in the human psyche and repeat this “ritual.” It turns out that the cause of OCD is the understanding of stupid thoughts as one’s own, along with the fear that they will certainly come true. Researchers also believe that people who suffer from obsessions received false beliefs in childhood. Among them:

• Exaggerated sense of danger. People with obsessions often overestimate the likelihood of danger.
• Belief in the materiality of thoughts is a blind “faith” that all negative thoughts will actually come true.
• Exaggerated responsibility. A person is convinced that he bears full responsibility not only for his own actions and actions, but also for the actions/actions of other people.
• Maximalism in perfectionism: mistakes are unacceptable, and everything must be perfect.

How does the environment affect the psychological state?

It is worth emphasizing that stress and condition environment(both nature and the surrounding society) can trigger harmful processes of obsession in people who are susceptible at the genetic level to this disease. Studies have shown that neurosis in more than half of cases occurs precisely due to environmental influences.

In addition, statistics show that patients who suffer from obsessions have experienced a traumatic event in their life in the recent past. And such episodes can not only become a “prerequisite” for the appearance of the disease, but also for its development:

• Serious illness;
• Abuse of an adult or child, history of violence;
• Death of a family member;
• Changing of the living place;
• Relationship problems;
• Changes at work/school.

What makes OCD worse?

What helps obsessive-compulsive disorder become “stronger”? In order to cure OCD, knowing exactly the causes of the disorder is not so important. The doctor needs to understand the underlying mechanisms that support the progression of the disease. Overcoming these will be the key to resolving problems in a person’s mental health.

It is important to understand that obsessive-compulsive disorder is maintained by such a cycle - obsession, the emergence of fear/anxiety and a response to the “stimulant”. Every time a patient with neurosis avoids a situation/action that causes him fear, the behavioral disorder is fixed in the neural circuit of the brain. Next time, the patient will act along the “beaten path”, which means the chance of neurosis will increase.

Compulsions also become reinforced over time. A person experiences discomfort and severe anxiety if he has not checked “enough” times whether the lights, stove, etc. are turned off. And as research shows, with a new “rule” in behavior fixed, a person will continue to perform such operations in the future.

Avoidance and “protective rituals” work at first - a person calms himself down with the thought that if he hadn’t checked, a disaster could have happened. But in the long term, such actions only bring a feeling of anxiety, which fuels obsessive syndrome.

Belief in the materiality of thoughts

A person who suffers from obsessions overestimates their capabilities and influence on the world. And as a result, he begins to believe that his bad thoughts can cause a “catastrophe” in the world. Whereas if you perform “magic spells”, “rituals” - this can be avoided. Thus, a patient with a developing mental disorder feels more comfortable. It’s as if the “spells” performed give you control over what is happening. And bad things won’t happen, a priori. But over time, the patient will perform such rituals more and more often, and this leads to an increase in stress and the progression of OCD.

Excessive concentration on your thoughts

It is important to understand that obsessions and doubts, which are often absurd and the opposite of what a person actually does and thinks, appear in every individual. The problem is that people who do not have OCD simply do not attach importance to stupid thoughts, while a person with neurosis takes their thoughts too seriously.

In the 70s of the last century, a number of experiments were conducted where healthy people and patients with OCD were asked to list their thoughts. And the researchers were surprised - obsessive thoughts of both categories were practically no different from each other!

Thoughts represent the deepest fears of the individual. For example, any mother is always worried that her child will get sick. The child is the greatest value for her, and she will be in despair if something happens to the child. That is why neuroses with obsessive thoughts about harming the child are especially widespread among young mothers.

The main difference between obsessions in healthy people and those suffering from OCD is that the latter have painful thoughts much more often. And this happens due to the fact that the patient attaches too much importance to obsession. It is no secret that the more often obsessive thoughts, images and actions occur, the worse it affects the patient’s psychological balance. Healthy people often ignore them and do not attach importance to them.

Fear of uncertainty

Another important aspect is that the OCD patient overestimates the danger/underestimates his ability to cope with it. Most people with obsessions believe that they must be one hundred percent sure that nothing bad will happen. For them, “protective rituals” are akin to an insurance policy. And the more often they perform such magical spells, the more “security” they will receive, the more certainty in the future. But in fact, such efforts only lead to the emergence of neurosis.

The desire to do everything “perfectly”

Some types of obsession make the patient think that everything needs to be done perfectly. But the slightest mistake will lead to catastrophic consequences. This occurs in patients who strive for order and suffer from anorexia nervosa.

“Focus” on a certain thought/action

As people say, “fear has big eyes.” Here's how a person with OCD neurosis can "cheat" himself:

• Low tolerance for disappointment. Moreover, any failure is perceived as something “terrible, unbearable.”
• “Everything is terrible!” - for a person, literally every event that deviates from his “picture of the world” becomes a nightmare, the “end of the world.”
• “Catastrophe” - for people suffering from OCD, a catastrophic outcome becomes the only possible outcome.

With obsession, a person “works himself up” to a state of anxiety, and then tries to suppress this feeling by performing obsessive actions.

Treatment of OCD

Can obsessive-compulsive disorder be cured? In approximately 2/3 of OCD cases, improvements occur within a year. If the disease lasts more than a year, then doctors will be able to track fluctuations in its course - when periods of exacerbation “change” with periods of improvement, which last several months, and sometimes several years. The doctor may give a worse prognosis if there are severe symptoms of the disease, continuous stressful events in the life of a patient with a psychasthenic personality. Severe cases can be incredibly persistent. Studies have shown that symptoms in such cases can remain unchanged for 13-20 years!

How are obsessive thoughts and actions treated? Despite the fact that OCD is a complex psychological illness, which includes a number of symptoms and forms, the principles of treatment for them are similar. The most reliable way to recover from OCD is considered to be drug therapy, which is determined individually for each patient, taking into account a lot of factors (age, gender, manifestations of obsessions, etc.). In this regard, we warn you - self-medication with medications is strictly prohibited!

If symptoms similar to psychological disorders appear, it is necessary to contact specialists at a psychoneurological dispensary or any other institutions of such a profile to establish an accurate diagnosis. And this, as you probably already guessed, is the key to effective treatment. At the same time, it is worth recalling that a visit to a psychiatrist does not have any negative consequences - there has long been no “registration of mentally ill people”, which has been replaced by consultative and therapeutic assistance and observation.

During therapy, it should be remembered that OCD is often progressive in nature with “episodic” periods when deterioration is accompanied by improvement. The pronounced suffering of a person with neurosis would seem to require radical action, but we remember that the course of the condition is natural, and in many cases intensive therapy should be excluded. It is important to remember that OCD, in most cases, is accompanied by depression. Therefore, treatment of the latter will “erase” the symptoms of obsession, which makes adequate treatment difficult.

Any therapy aimed at curing obsession should begin with consultations, where the doctor proves to the patient that this is not “madness.” Those suffering from one disorder or another often try to involve healthy family members in their “rituals,” so relatives should not make concessions. But you shouldn’t be too harsh either - this can aggravate the patient’s condition.

Antidepressants for OCD

The following pharmacological drugs are currently used for OCD:

• Benzodiazepine anxiolytics;
• Serotinergic antidepressants;
• Beta blockers;
• MAO inhibitors;
• Triazole benzodiazepines.

And now more about each of the groups of drugs.

Anxiolytic drugs provide a short-term therapeutic effect and reduce symptoms, but they should not be used for more than several weeks in a row. If treatment with the drug requires more time (1-2 months), then the patient is prescribed a small dosage of tricyclic antidepressants, as well as minor antipsychotics. The basis in therapy against the disease, where ritualized obsessions and negative symptoms form the basis, are atypical antipsychotics, such as risperidone, quetiapine, olanzapine and others.

It is important to understand that any concomitant depression can be treated with antidepressants in an acceptable dosage. There is evidence that, for example, the tricyclic antidepressant clomipramine has a specific effect on the symptoms of obsession. However, the trial results showed that the effect of this drug is insignificant and appears in patients with clear signs of depression.

In those cases where symptoms of obsessive neurosis appear during the course of diagnosed schizophrenia, intensive treatment in combination with pharmacotherapy and psychotherapy has the greatest effect. Here high doses of serotonergic antidepressants are prescribed. But in some cases, traditional antipsychotics and benzodiazepine derivatives are used.

Help from a psychologist for OCD

What are the features of psychotherapy in the treatment of OCD? One of the fundamental tasks for the effective treatment of a patient is the establishment of fruitful contact between the patient and the doctor. It is necessary to instill in the patient faith in the possibility of recovery, to overcome all his prejudices and fears about the “harm” of psychotropic drugs. And also “introduce” the confidence that regular visits, taking medications in prescribed doses, and following all doctor’s recommendations are the key to effective treatment. Moreover, the patient’s relatives also need to maintain faith in recovery.

If a patient suffering from OCD has formed “protective rituals,” then the doctor needs to create for the patient the conditions under which he tries to carry out such “spells.” The study showed that improvement occurs in 2/3 of patients who suffer from moderate obsessions. If, as a result of such manipulation, the patient stops performing such “rituals,” then obsessive thoughts, images and actions recede.
But it is worth remembering that behavioral therapy does not show effective results for correcting obsessive thoughts that are not accompanied by “rituals.” Some practitioners practice the “thought stopping” method, but its effect has not been proven.

Is it possible to permanently cure OCD?

We have previously written that a nervous disorder has an oscillating development, which is accompanied by an alternation of “improvement and deterioration.” Moreover, regardless of what treatment measures were taken by doctors. Until a significant period of recovery, patients benefit from supportive conversations and providing hope for recovery. In addition, psychotherapy is aimed at helping the patient, correcting and getting rid of avoidant behavior, and in addition to this, reducing sensitivity to “fears”.

We emphasize that family psychotherapy will help correct behavioral disorders and improve family relationships. If marital problems cause the progression of OCD, then joint therapy with a psychologist is indicated for the spouses.

It should be emphasized that it is important to determine the correct timing of treatment and rehabilitation. So, first there is long-term therapy (no more than two months) in a hospital, after which the patient is transferred to outpatient treatment with a continuation of the course of therapy. And in addition to this, holding events that will help restore family and social ties. Rehabilitation is a whole range of training programs for patients with obsessive-compulsive disorder, which will help them think rationally in the company of other people.

Rehabilitation will help set up proper interaction in society. Patients receive vocational training in the skills needed in everyday life. Psychotherapy will help those patients who experience a feeling of inferiority to feel better, to treat themselves adequately, and to gain faith in their own strengths.

All these methods, if used in combination with drug therapy, will help increase the effectiveness of treatment. But they cannot fully replace drugs. It is important to emphasize that the method of psychotherapy does not always bear fruit: some patients with obsessions experience deterioration, since “future treatment” makes them think about objects and things, which causes fear and anxiety. Often, obsessive-compulsive disorder can return again, even despite the positive results of the previous therapy.

Obsessive-compulsive disorder is a neurotic disorder that occurs due to psycho-emotional imbalance and is manifested by compulsive actions and phobic experiences. In the medical literature it can often be found as obsessive-compulsive disorder (OCD).

In the international nomenclature of diseases, OCD occupies 9 codes from F40 to F48, which speaks in favor of the wide variability of neurosis in modern society. Considering that neurosis is a functional disorder, that is, it does not carry any organic pathology, the fight against obsessive thoughts can be carried out on an outpatient basis with the help of a psychologist or psychotherapist. In severe forms, you should consult a psychiatrist, since severe symptoms may be a consequence of schizophrenia or bipolar personality disorder. This disorder occurs equally in both men and women.

Obsessive-compulsive disorder can develop at any age, but its peak occurs during puberty and adulthood. The number of children with this diagnosis is growing inexorably, which is associated with improper upbringing, social and economic disadvantage, the reluctance of peers to support each other for some reason, and an insufficient level of trust between the parent-child link, where the teenager does not share his experiences.

Obsessive-compulsive disorder never occurs for no apparent reason. So, this pathology can be caused by:

• Specific personality traits. Most people with neurosis, before the onset of the disease, experience anxiety, suspiciousness, low self-esteem and increased demands on themselves and others. Which, inexorably, leads to intrapersonal conflict, undermining the already weak psycho-emotional background;
• Genetic predisposition;
• Chronic stress;
• Physical and mental stress;
• Frequent conflict situations.

Sometimes neurosis occurs with VSD (vegetative-vascular dystonia), although, to be more precise, fluctuations in pressure, body temperature, chilliness and sweating of the extremities most often arise as a result of dystonia, and not VSD is the original cause of neurosis.

Any, even minor, bad event can be the last straw in the formation of neurosis. A striking example is a person’s increased ability to work, successfully completing all tasks and responsibilities at work, and when he comes home he is so exhausted that even the lack of milk in the refrigerator or a phone call causes a nervous breakdown. If it had happened a day or two before, the person would not have paid attention to it. But over time, energy reserves are depleted and rest and calm are vital to replenish them.

Clinical picture

Obsessive-compulsive neurosis has three components, which are expressed to varying degrees, depending on the person’s perception of the stress factor (in some cases there is a combined form):

• Phobic experiences;
• Obsession of actions (compulsiveness);
• Obsessive thoughts (obsessions).

At first, neurosis occurs as banal overwork, and then excessive irritability, unmotivated fatigue, insomnia, vasomotor disorders (manifestations of vegetative-vascular dystonia - increased or decreased blood pressure, sweating of the palms, changes in heartbeat, etc.) join in. And all this against the background of a complete absence of organic pathology.

With advanced neurosis, contrasting obsessions are a frequent companion. These are creepy and incomparable thoughts or images that significantly reduce a person’s quality of life.

Contrasting obsessions have two forms:

• Thoughts about hurting another person;
• The desire to “punish” oneself through suicide or physical violence.

In both cases, the negative flow of thoughts ends in self-blame and denial of what is happening. A person is ashamed of himself, but he cannot do anything about it. There is a theory that people with a penchant for perversion suffer from obsessive-compulsive disorder. It is not known whether it is completely reliable, however, it undoubtedly has its own confirmatory criteria. After all, constant obsessive thoughts change human consciousness over time, forcing them to “taste” the sinful fruit.

Phobias

An obsessive state of fear is very quickly perceived by a person as a given and part of his character. For example, a person with cancerophobia (fear of getting cancer) sees oncology in all his symptoms. He will go to see specialists every time something hurts him, and he will perceive a hint of going to a psychotherapist as an unwillingness to treat him. Does he consider himself sick? Sick - yes. Mentally, no. With mild forms of neuroses, people themselves often turn to psychologists, since they have criticism of their condition and can interpret changes in their body as pathological, but not from the somatic sphere. And in severe, borderline forms, a functional disorder can develop into schizophrenia, especially if such symptoms were also observed in relatives. By the way, simple schizophrenia has a sluggish course and is not always diagnosed, since throughout life a person may experience minor symptoms and not pay any attention to it. In favor of psychiatric pathology is the fear of going crazy. Any phobia (fear of closed spaces, darkness, heights, etc.) tends to progress. That is, if a person is afraid of heights, with each new onset of neurosis, the distance that a person is able to endure decreases to the point that he begins to be afraid of one flight between floors.

Obsessive actions

Obsessive actions (compulsions) usually arise after the manifestation of phobias.

They are divided into tics (simple) and obsessive actions themselves (rituals):

• Simple compulsions are the performance of certain manipulations during a stressful situation. This may include nail biting, hair straightening, and leg twitching. The desire to crush, tear, or straighten something in the absence of such objects at hand leads to disfigurement of the fingers (removing the cuticle, picking the nail plate, etc.). A person cannot control himself and sometimes does not even pay any attention to it, he believes that this is a self-evident phenomenon;
• True obsessive actions (rituals) have more complex psychological aspects and are directly related to phobic experiences. All actions are aimed at combating your fears and striving to obtain the desired peace of mind from this. A striking example would be constant hand washing (elementary manifestations of sanitary and hygienic rules do not count). A person can wash their hands more than 50 times a day. At first glance, there is nothing special about this, but from frequent use of antibacterial agents, the skin not only dries out, but also cracks, which makes it easier for microorganisms to penetrate inside, causing inflammation. That is, the phobia of contracting something from unwashed hands leads to the fact that a person gets sick from it. This also applies to other phobic experiences, and the relief from these rituals is only temporary.

Obsessions

Obsessive ideas are less common in practice, but this does not mean that this form causes less harm than others. Thoughts arise spontaneously and, most often, during rest and before bed. Surely everyone has encountered such a phenomenon as “mental chewing gum”. This is an endless stream of reflection that is aimed at self-knowledge and realization. It is possible that many philosophers had in their knowledge not only high intelligence, but also obsessive-compulsive neurosis itself. Obsessions can be short-term in nature, for example, playing a song in your head that was heard on the radio a few hours earlier is also some kind of manifestation of an obsessive thought. If you turn on another song or engage in vigorous physical activity, it may disappear spontaneously. But the severe form of obsessive ideas includes a forceful thought process about the future, the meaning of life, etc. This already indicates an advanced neurosis, which must be identified and treated before its transformation into depression begins. Memories of even good things cause an irresistible melancholy in a person, because it will not happen again and will not happen again. Whereas in a person with a normally functioning psyche, such images may have a slight tinge of sadness, but do not depress his overall well-being.

Features in children

Obsessive-compulsive disorder in children is slightly different from this disorder in adults. The first phobias appear when a child is read fairy tales or shown cartoons, and parents scare him with all sorts of stories. “If you behave badly, we’ll give you to that aunt over there,” “the old man comes for bad kids,” etc. The child’s psyche is a rather fragile phenomenon, and even such a threat, which is funny for adults, can greatly affect it. Being in puberty, schoolchildren begin to skip classes because they are afraid of their teacher. A phobia in the form of fear of losing one's parents is often observed. Careless words like “it would be better if you weren’t here”, “but the neighbor has a child...” affect his mood and feelings. You shouldn’t be surprised in the future why your child is emotionally unstable; such upbringing is a variant of pathology. In response to stress and the impossibility of solving it, he withdraws into himself, begins to get nervous, and the first rituals appear (biting nails, the inability to sit still in the form of cleft foot syndrome, etc.). The condition is aggravated by obsessive thoughts, often leading to suicide. Therefore, the excuse like “he has a bad character, he will outgrow it” should be forgotten once and for all. Any deviation in behavior is not the norm. And instead of lecturing your child, trying to share life experiences and scolding him for every mistake, just sit down and talk with your child.

Diagnostics

First of all, diagnostic manipulations are aimed at excluding organic pathology and mental disorders. If there is no basis for the above, only then, by the method of exclusion, is a diagnosis of “neurosis” made. There are a number of questionnaires that will reveal the instability of the emotional background. It includes questions like “how do you communicate with other people”, “Is it difficult for you to resolve conflict situations”, etc. Accordingly, the more points scored, the more severe the form of neurosis.

Treatment

Therapy for obsessive-compulsive disorder neurosis can almost always be treated with medication, but psychotherapy should certainly play the main role in treatment.

Psychotherapy

A highly qualified psychotherapist should work with the patient, who, by asking leading questions, is able to identify the root of the problem. Testing is carried out to identify weak personality traits and suggest ways to correct them. Group psychotherapy and auto-training give good results. Sometimes sessions with a psychotherapist are enough to achieve mental well-being. But if the conversations could not help, then only then drug therapy is used.

Drug therapy

Medicines are prescribed depending on the severity of the neuroses. In mild cases, it is possible to prescribe sedatives of plant origin (novo-passit, valerian, motherwort, etc.). In more difficult cases or if the therapy is ineffective, it is possible to use daytime tranquilizers (Adaptol, Afobazol), then powerful anti-anxiety drugs (Phenozepam, Diazepam). For severe depressive states, antidepressants (Amitriptyline, Fluoxetine).

Without medical help

Getting rid of obsessive thoughts without the help of a psychotherapist is not so easy, but it is possible. Neuroses are quite common, and their provoking factor is overexertion. Healthy sleep, rest, good nutrition with a high content of B vitamins have a good effect on the state of the nervous system. If you feel tired, rest, put things off until later. It's much better to take a couple of hours to yourself and then get to work than to finish everything too early and have a nervous breakdown. For preventive purposes, you can take a course of light sedatives, especially at those moments in life when they are needed by emotionally unstable people (session, major project, visit of superiors, etc.). If the above methods do not have the desired effect, and the symptoms intensify, interfering with your life, then consult a psychotherapist and take care of your health.

What kind of person doesn’t have thoughts or ideas that cling and can’t let go? Obsessive-compulsive disorder, also called obsessive-compulsive disorder, or obsessive-compulsive disorder, is not a disease that necessarily needs to be treated with psychiatrists. It’s just that this condition has its own causes and symptoms, which to some extent will interfere with the normal existence of a person who ultimately wants to get rid of them.

So, the psychiatric help website does not call obsessive-compulsive disorder a pathology that should be treated with electric shock and pills, but to some extent a person becomes a puppet in the hands of his psyche. This can interfere with the normal social existence of a person, who will appear funny or strange in the eyes of others.

Obsessive states are thoughts or ideas that force a person to perform certain actions, otherwise they will constantly be present in his head, causing fear, anxiety or panic, until the desired actions are finally completed. The actions that a person must perform are called rituals. Until a person performs a certain ritual, he will not calm down psychologically and emotionally.

The peculiarity of obsessive thoughts is that they have a negative connotation and seem to be foreign, foreign, imposed or coming from outside. A person understands that they are in his head and are constantly spinning in certain situations, prompting him to take action. However, he cannot refuse them, because he experiences anxiety, fear of the consequences that will arise if he does not take the necessary actions.

What are obsessive-compulsive disorders?

An obsessive state is a mental disorder when a person is subject to certain thoughts that are alien and unpleasant to him. These thoughts usually arise in a certain situation, prompting him to take specific actions. In other circumstances, these ideas do not arise, so the person can be considered healthy and normal.

Ritual actions that arise during obsessive states are also called by some psychologists habits that a person has developed in the course of life. They didn’t just arise for him. The emergence of obsessive states was preceded by certain social factors.

Examples of ritual actions could be:

1. The desire to thoroughly wash one's hands in a public restroom because one feels that there are a lot of germs on them.
2. The desire to double-check whether the kettle or iron is turned off.
3. Uncertainty that the person closed the door to the apartment, although he clearly took out the keys and turned them.

Obsessive thoughts mean that a person is not sure and cannot reliably remember whether he did the right thing. And since he cannot remember, he fears that “the apartment will burn down because the kettle is not turned off,” “he will be robbed by house thieves,” or “he will get sick if he does not get rid of germs.”

Obsessive states are controlled by obsessive thoughts. And here psychologists draw the attention of readers to the fact that all this happens in their heads. In real life, a person looks very anxious and restless because of his thoughts, so he performs the same action many times:

1. Washes his hands.
2. Enters the room to check that the device is turned off.
3. Pushes the front door to check if it is closed.

Obsessive states consist of two factors:

1. Thoughts - a person is driven by obsessive thoughts that arise in his head in a certain situation and bother him until he takes the desired action, switches his attention or leaves the environmental circumstances.
2. Ritual actions - when a person, under the influence of his thoughts, performs certain actions many times, because he is not sure of the effectiveness of the actions already taken or forgets whether he has done everything necessary, double-checks himself.

Obsessive states are more characteristic of people who are highly critical of themselves or others, and also put forward excessive demands on themselves or others. These are the so-called perfectionists, for whom everything must be “perfect”.

You can get rid of obsessive states, with help from psychologists who will explain the mechanism of development of disorders and the principles of getting rid of them.

Obsessive Obsessive Syndrome

For the first time, obsessive-compulsive disorder syndrome was proposed by the psychiatrist R. Krafft-Ebing, who at one time could not fully explain this phenomenon. He viewed the disorder in the context of a mental disorder in which a person cannot control either the content of his thoughts or his actions.

Naturally, an obsessive state disrupts a person’s usual activities. That is why it is recommended to eliminate this disorder, no matter how it manifests itself.

They become obsessive in the syndrome:

1. Attractions.
2. Memories from the past.
3. Ideas.
4. External actions.
5. Doubts.
6. Thoughts.

A person becomes, and often is, concerned about something. Obsessive states are:

• Abstract obsessions – counting, thoughts, memories, detailing an event.
• Imaginative obsessions are when a person has negative emotional experiences.

Causes of obsessive states

Psychologists identify the following causes of obsessive states:

• Overwork.
• Chronic intoxication of the body.
• Head injuries.
• Lack of sleep.
• Infectious diseases.
• Asthenization.
• Mental illnesses.

Some people with obsessive-compulsive disorder are treated by psychiatrists. However, not every person who experiences obsessive-compulsive disorder becomes a patient in a psychiatric hospital. Obsessive states are quite characteristic of healthy people, but to some extent weakened by life, physically or emotionally.

Let's try to more accurately describe what an obsessive state is - these are thoughts that burden a person and cause him a painful experience about their non-realization. If a person tries to control his thoughts or refuses to perform the action that they impose on him, then he feels bad and becomes even more immersed in his thoughts, which tell him what can happen to him.

Symptoms of obsessive disorders

Perhaps every person in his life has been subject to an obsessive state. If we are talking about a healthy person, then, most likely, his condition quickly passed with a change in activity or environment. If a person does not change his life or is sick with various mental disorders, then his symptoms become aggravated.

Obsessive states are accompanied by both physical and psycho-emotional changes:

1. The emergence of fear.
2. Nausea and bouts of vomiting.
3. Tiki.
4. Hand tremors.
5. Urge to urinate.
6. Dizziness.
7. Increased breathing and heart rate.
8. Heartache.
9. Weakness in the legs.

Obsession with ideas manifests itself in the fact that a person asks himself questions to which it is practically impossible to find answers. For example, why do humans have two legs, and animals have four?

Obsessive counting manifests itself in the fact that a person begins to count absolutely any objects that surround him or simply reproduces the count in his head, for example, counting the number of steps taken.

Obsessive actions arise under the influence of emotions. A person may chew on a pencil, scribble on paper, crumple it while talking on the phone, or draw something with a pen.

Obsessive doubts manifest themselves in the fact that a person constantly doubts something. In particular, he doubts the correctness of his conclusions, decisions or actions, even after he has made them.

Intrusive memories manifest themselves in the fact that a person constantly returns his thoughts to some event from his past. This event should cause vivid negative experiences within a person so that he returns to it and suffers.

Obsessive fears can be called phobias, when a person is afraid of something that does not threaten him. For example, with fear of heights, which occurs when a person is on a hill or simply imagines being on a tall building. With this fear, a person does not fall from a height, but he vividly imagines how this will happen, how he will crash to the ground, how scared he will be while flying and how painful he will be when falling.

Obsessive desires or drives are similar to phobias, since a person imagines a picture of what he wants to do. Presented in the form:

1. The desire to spit in another person's face.
2. The desire to jump out of the car at speed.
3. The desire to push someone.

Treatment of obsessive disorders

Treatment of obsessive disorders is carried out in various directions. You can be treated either independently, if the person is still able to control the process, or together with a psychologist.

If you turn to a psychologist, then medication methods and behavioral psychotherapy will be offered:

• Behavioral psychotherapy assumes that a person will be created conditions under which obsessive states arise. In such a situation, he must do something that causes him fear and anxiety. He must give up his usual actions and do what usually causes him stress. However, some people refuse behavioral therapy because they are not ready to face and cope with their experiences.
• Drug therapy should only be prescribed by a psychiatrist or psychotherapist. Medicines are also prescribed in case of complications.

A person can also try to get rid of obsessive states himself. You can try, it won't hurt anyway.

A person is asked to switch his attention to something else. Don't try not to think about what is being imposed on you. Just try to become interested in something else, distract yourself with something else.

Take a conscious approach to business. In the situation in which you usually have obsessive thoughts and actions, you need to be “here and now.” Understand what is around you, what you are doing, what thoughts are spinning in your head, and also remember every detail of what is happening (this will save you from doubts and the desire to double-check your actions).

Do not be afraid of your obsessive states, do not consider yourself sick and do not blame yourself for having them. Of course, you played some role in their emergence. However, while you are running and afraid, obsessive thoughts become even deeper and more persistent.

Bottom line

If you cannot get rid of your obsessive condition on your own, do not resort to pills, but rather seek the help of a specialist. He has a whole arsenal of things that can be done in your situation.

Obsessive-compulsive disorder (OCD) affects 1 to 3% of people. Predisposition to the disease is largely determined by hereditary factors, but in young children there are practically no symptoms. In most cases, OCD is first diagnosed between the ages of 10 and 30.

Today we will talk about the signs that may indicate that a person has obsessive-compulsive disorder.

Frequent hand washing

People with OCD often experience an exaggerated fear of infection. The consequence of the phobia is washing your hands too often. Moreover, the process is associated with a number of strange actions. For example, a person soaps his palms a strictly certain number of times or wipes each finger on all sides, always in the same order. As a result, a routine hygiene procedure turns into a strictly regulated ritual. The inability to perform all actions in the usual order causes anxiety and irritation in the patient.

Excessive desire for cleanliness

An exaggeration of the risk of infection in OCD is manifested by an obsessive desire to clean the premises as often as possible. The patient constantly experiences discomfort: all surrounding objects seem not clean enough to him. If a person washes the floors several times a day, is eager to check all surfaces for dust, and unnecessarily uses strong disinfectants - this is an alarming signal.

In some people suffering from obsessive-compulsive disorder, a painful desire for cleanliness is manifested by a fear of touching various objects (for example, the patient refuses to press buttons in an elevator or opens doors with his elbows so as not to touch them with his hands). Sometimes patients are unable to do normal activities when they see dishes left on the table or crumpled napkins.

The habit of repeatedly checking your actions

Each of us has at least once found ourselves in a situation where, after leaving the house, we could not remember whether we had locked the front door. This usually happens when we think and are distracted from actions performed automatically. This kind of distraction is normal. We can talk about pathology if a person stops trusting himself and is afraid of the consequences of losing control over a familiar situation.

People with OCD experience these kinds of fears all the time. To protect themselves and calm down, they form numerous rituals associated with double-checking their own actions. When leaving the house, a person can count out loud the number of turns of the key, pull the locked door the “required” number of times, walk around the apartment along a strictly defined route, checking that there are no electrical appliances turned on, etc.

Tendency to count everything

Obsessive-compulsive disorder may manifest itself as a pathological tendency to count. The patient constantly counts the objects around him: the steps in the entrance, the steps he takes on his usual path, cars of a certain color or brand. Moreover, the action itself is often ritual in nature or associated with irrational hopes and fears. For example, a person gains unreasonable confidence in future luck if the count “adds up”, or begins to fear the harmful consequences of not having time to count some items.

Pathological requirements for order

An OCD patient organizes a strictly regulated order around himself. This is especially noticeable in everyday life. A sign of pathology is not so much the habit of arranging all the necessary items in a certain way, but rather an inappropriately sharp, painful reaction to any violation of the once and for all established placement pattern.

If your relative or friend refuses to sit down at the table when he notices that the fork is at an angle to the plate, throws a noisy tantrum about shoes placed a few centimeters further from the sofa than usual, or cuts an apple into perfectly even slices every time, he should consult a doctor.

Excessive fear of troubles

Life's troubles make no one happy, but usually people solve problems in the order in which they arise. A person with OCD worries excessively about troubles that may happen in the future. At the same time, his behavior is dominated not by the desire to take real steps in advance that can prevent the onset of an unpleasant situation, but by irrational fear. He gives preference to actions of a ritual nature that are in no way related to the essence of the problem, but supposedly capable of influencing the development of events (arranging objects in the “correct” order, “lucky” calculations, etc.).

A sign of pathology is also a specific reaction to attempts by others to calm the patient down, analyzing the situation and giving advice on preventing troubles. As a rule, sympathy and the desire to help cause mistrust and rejection.

Obsessive sexual fantasies

An OCD patient may be haunted by sexual fantasies of a perverted nature, often directed at people with whom the patient is in constant contact (relatives, co-workers). At the same time, the person experiences shame, considers himself “unclean,” but cannot get rid of fantasies. Thoughts about obscene or cruel behavior are not put into practice, but become a cause of internal discomfort, a desire for isolation, and a refusal to communicate with loved ones.

Tendency to constantly analyze relationships with others

Obsessive-compulsive disorder changes the patient's understanding of the meaning of contacts with others. He tends to overly meticulously analyze every conversation or action, suspect other people of hidden thoughts and intentions, evaluate his own and other people's words as stupid, harsh or offensive. It is very difficult to communicate with a person suffering from OCD: he constantly considers himself either offended or an offender, without having any real reason for this.

The habit of rehearsing future actions

The tendency to experience events that have not yet occurred too acutely is manifested in an OCD patient by constant attempts to rehearse his future actions or conversations. At the same time, he imagines all possible and impossible complications, multiplying his own fears. Actions that normally help a person prepare for future difficulties and develop an optimal model of behavior only provoke increased anxiety in an OCD patient.

People suffering from obsessive-compulsive disorder often try to get support from family and friends. What should cause alarm is not an ordinary request for help, but repeated appeals with the same problem (usually voiced in the same terms) to all your friends in a row - while completely ignoring their reactions and advice.

Constant dissatisfaction with your appearance

Patients with OCD often suffer from body dysmorphic disorder. This disorder is manifested by acute obsessive dissatisfaction with one’s own appearance (in whole or in individual parts). The internal discomfort that a person experiences has nothing to do with unsuccessful attempts to improve his figure or get rid of excess weight. The patient is simply sure that his nose (eyes, hair, etc.) are ugly and disgust others. Moreover, the person completely ignores the fact that no one except him notices the “defects” of his appearance.

In the presence of obsessive-compulsive disorder, the patient is not able to adequately assess reality. He is haunted by numerous imaginary dangers (obsessions). To reduce anxiety, he performs defensive actions (compulsions), which serve as a kind of barrier between him and the aggressive world around him.

A characteristic feature of OCD is the stereotyping of obsessions and compulsions. This means that imaginary threats constantly disturb the patient, and protective actions are of a ritual nature: repetitions of the same type of actions, a tendency to superstition, and irritation when it is impossible to complete habitual actions are noticeable.

Obsessions and compulsions have diagnostic significance when they appear consistently for two weeks in a row. Imaginary fears should cause distinct discomfort, and defensive actions should cause temporary relief. It should be kept in mind that a diagnosis of OCD can only be confirmed by a psychiatrist.

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