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

An obsessive state in a person is one that is characterized by the appearance of thoughts that prompt the patient to action. This disease has been known for a very long time, and many centuries ago sick people were called possessed. Today, obsessive states are referred to as melancholia.

obsessive-compulsive disorder

First concepts this disease was recorded in 1868. Diagnosing it is very difficult for a non-professional psychiatrist. The syndrome is practically beyond the control of the individual, it is significantly negatively reflected in the usual activities.

The obsessive-compulsive disorder is usually characterized by the frequent appearance of memories, thoughts, and doubts. Most of all, he is subject to insecure people suffering from feelings.

There are two types of obsession:

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

Causes of Obsessions

The causes of obsessions are:

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

Obsessions include involuntary thoughts, phobias, doubts, actions. At the same time, a person is aware of their uselessness, but can do nothing about it. All sorts of thoughts come into the patient's head that he cannot control.

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

Obsessive thoughts can be completely inadequate or absurd. Sometimes a sick person is characterized by ambivalence, which confuses psychiatrists. But it is impossible to say with 100% certainty that if you have such thoughts, then you are sick. Often they occur in absolutely healthy people, for example, after severe overwork or a mental disorder. Such a state can happen at least once in the life of every person.

Obsessive-compulsive disorder symptoms

Obsessive states in people are accompanied by a painful feeling, which greatly torments them. Sometimes it is accompanied by nausea, screaming, frequent urge to urinate. A person suffering from obsession enters into a stupor, his complexion quickly changes, he breathes quickly and sweats, his head is spinning, weakness in his legs appears.

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 the 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, because sometimes a person himself does not understand that he is performing them. This can be torsion in the hands of any object, biting nails, winding hair around a finger, sniffing, rubbing hands, and so on. A strong will allows them not to be restrained for a while, but not to get rid of them at all. When a person is distracted by something, he will definitely start doing them again.

Obsessive doubts are accompanied by difficult experiences, when a person cannot decide whether he did the right thing. For example, whether the light or gas is turned off before going to work, and so on. These thoughts do not allow a person to do his job, he has to check everything done once again. Often there are memories of those events that a person would like to completely forget about, for example, parting with a soulmate.

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

There are also quite contrasting states that are blasphemous. They offend the essence of man. For example, a son may have unsound thoughts about the sight of his naked mother, her uncleanliness. If this is a sick mother, then the obsessive thoughts may be in the form of a knife penetrating her child.

In young children, the disease manifests itself in the fear of being alone, polluting 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 such a disease in children are mental trauma, as well as poor education.

Treatment of obsessive-compulsive disorders

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

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

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

Obsessive-compulsive disorder, or abbreviated as OCD, and scientifically - obsessive-compulsive disorder, is characterized by the appearance of unpleasant obsessive thoughts, and after them - 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 combined under one “tag” - obsessive-compulsive disorders (or briefly OCD), which got its name from the Latin words that mean “siege, blockade” (obsession) and “ coercion" (compello).

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

1. Obsessive desires and thoughts. And it is characteristic of OCD that such drives arise without human control (against feelings, will, reason). Often such drives are unacceptable to the patient and contrary to his principles. Unlike impulsive drives, compulsive ones may not be realized in life. Obsession is hard experienced by the patient, remains deep inside, giving rise to a feeling of fear, disgust and irritation.

2) Compulsions that accompany bad thoughts. Compulsiveness also has an extended term, when the patient experiences any obsessions, and even obsessive rituals. As a rule, the main features of this type of disorder are repetitive thoughts with compulsive actions that the patient repeats over and over again (ritual creation). But in an expanded sense, the "core" of the disorder is the obsessive-compulsive syndrome, which in the clinical picture manifests itself in the form of a predominance of feelings, emotions, fears and memories that manifest themselves without the control of 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 is conditionally divided into two types:

• Obsessional urges occur within the consciousness of the individual, they often have nothing to do with the character of the patient and very often contradict the internal attitudes, norms of behavior and morality. However, at the same time, bad thoughts are perceived by the patient as their own, which makes OCD sufferers very much.
• 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, over-cleaning rooms to avoid "pollution". Attempts to drive away thoughts that are alien 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. According to some studies, about 1.5% of the population of developed countries suffer from OCD. And 2-3% - have relapses that are observed throughout life. Patients who suffer from compulsive disorders make up about 1% of all patients treated in psychiatric institutions.

Moreover, OCD does not have certain risk groups - both men and women are equally affected.

Causes of OCD

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

For a long time in Russian psychiatry, OCD meant “psychopathological phenomena that are characterized by the fact that patients experience a repeated feeling of burden and coercion.” In addition, the patient experiences involuntary and uncontrollable volitional decision the emergence of obsessive thoughts in the mind. Although these pathological conditions are alien to the patient, it is very difficult, almost impossible for a person suffering from a disorder to get rid of them.

In general, obsessive-compulsive disorders do not affect the patient's intellectual potential, and do not interfere with human activity in general. 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, substitution occurs.
Obsessive states are conditionally 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 disorder occurs in patients with a psychasthenic character. In addition, disturbing fears are clearly distinguished here, and such sensations are found within the framework of neurosis-like states. Some researchers believe that the cause of obsessive-compulsive disorders is a special nervosa, which is characterized by the fact that memories prevail in the clinical picture, reminding a person of an emotional and mental trauma suffered in 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 rethought 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 thought 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 calls for the urgent attention of psychiatrists around the world.

In addition, practitioners and theorists in psychology have expanded their understanding of the root causes of the disease: the fuzzy definition obtained with the help of the 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 most importantly, a correct understanding of the root causes of neurosis helped the doctor to treat OCD more effectively. Thanks to this, pharmacological intervention became possible, which became targeted, and helped millions of patients to recover.

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

Symptoms and signs of OCD

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

Frequent hand washing

The patient is obsessed with washing hands, constantly applying antiseptics. And this happens in a fairly large group of people suffering from OCD, for whom they came up with the designation - "washers". 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 "impurities" in the society surrounding a person.
When is help needed? If you cannot suppress and overcome the constant desire to wash your hands; If you are afraid that you are not washing thoroughly enough, or after going to the supermarket you are visited by thoughts that you caught the AIDS virus from the handles of a cart, then there is a high probability that you suffer from OCD. Another sign that you are a "washer" is washing your hands at least five times, thoroughly washing off the soap. We lather each nail separately.

Obsession with cleanliness

“Hand washers” often go to the other extreme as well – they are obsessed with cleaning. The reason for this phenomenon is that they experience a constant feeling of "impurity". Although cleaning reduces the feeling of anxiety, the effect of this is short-lived, and the patient starts a new cleaning.

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

Obsession in checking any actions

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

When should you seek help? It is perfectly reasonable to double-check the performed action. But if obsessive thoughts and actions prevent you from living (constantly being late for work, for example) or have already acquired the form of a “ritual” that cannot be broken, then be sure to make an appointment with a psychotherapist.

I want to keep counting

Some OCD patients have an obsessive craving to count everything all the time - the number of stairs that cars of a certain color have passed, and so on. 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 cannot get rid of the numbers in your head, and the calculations occur 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 - 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 job easier, then there is no sign of OCD. People with obsessive-compulsive disorder often organize the space around them unconsciously. Otherwise, the slightest "chaos" begins to frighten them in a panic.

Fear of violence

Every person at least once in his life has thoughts about an unpleasant incident, violence. And the more we try not to think about them, the more they manifest themselves in the mind in addition to control from the person himself. In people with obsessive-compulsive disorder, this feeling goes to extremes, and the troubles that have happened (even the most insignificant ones) cause a panic state, 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 have a fear of 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 stuck in an unpleasant story" - there are no signs of the development of the disorder. And when, because of these disturbing thoughts, the patient avoids any action (I don’t walk in the park, as they can be robbed there), then you 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 this type of 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 sense 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 presenting herself as a source of danger. Unfortunately, parents suffer a lot because of their OCD, they do not 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 frustrating types of OCD. As well as thoughts of violence, obsessive thoughts about obscene behavior or taboo desires often visit a person with OCD. Patients suffering from disorders can unwillingly imagine themselves with other partners, imagine that they are cheating on their wife, how they are pestering work colleagues, which they absolutely do not want to do in reality.

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

Many young people are familiar with homosexual OCD, or HOCD. Such an obsessive-compulsive disorder 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 are, for example, viewing photographs of men (for women with this type of OCD - photographs of women) in order to find out whether they are excited by representatives of their own sex. Many homo-OCD sufferers may even feel arousal, although any psychiatrist will tell you that this feeling of arousal is false, it is the body's response to stress. The person with OCD expects this reaction to be confirmed to his obsessive thoughts, and, as a result, he receives it.

It is not uncommon for new parents to face one of the most frustrating OCDs - 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 be realized, parents begin to avoid their own children. Bathing, changing diapers, and just spending time with your own child is torture for a mother or father with OCD.

Does this type of OCD have compulsions? Many of them do not manifest themselves in the form of any obsessive movements, however, compulsive thoughts are present in the head 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, trying to convince himself that he is not a pervert. People who have obsessive thoughts about their children may keep revisiting the same situation over and over again, trying to find out if they did everything right, if 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 fiction 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, so he is 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 obscene thoughts and urges, the sufferer begins to avoid familiar people, their own children, or gay people.

An obsessive feeling of guilt

Another type of OCD that cannot be ignored. Usually such a feeling of guilt is imposed and a similar obsessive-compulsive disorder arises against a background of depression. Guilt affects people with low self-esteem, prone to hypochondria. Often the cause of guilt is an unpleasant event that the OCD patient could well have been responsible for. However, people who do not suffer from obsessions will learn from this lesson and move on. A person with OCD, on the other hand, will get "stuck" at this stage, and the feeling of guilt will arise again and again.

It also happens that a sense of guilt is imposed on a person, and is not his own conclusion regarding any situation. For example, an overbearing partner may blame the person for something they didn't do. Aggressive attitudes and domestic violence play a significant role in the emergence of neurosis. "You are a bad mother", "You are a worthless wife" - such accusations will first cause resentment and a healthy desire to protect oneself in a person. 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 sense of guilt. The plots of such memories can be very different. For example, an OCD sufferer struggles to remember if he made any mistake, did something bad or immoral in the past (hit someone in a car, accidentally killed in a fight and forgot, etc.).

Thinking about it over and over again, a person is afraid that he has missed something. In a panic, he tries to "think out" in order to fully understand and feel the situation. Because of this, their own memories are often mixed with fantasies about this event, since a person with obsessive-compulsive disorder 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 make out where his real memories are and where are his fictions.

Unhealthy Relationship Analysis

People who suffer from obsessive-compulsive disorder are also known for constantly analyzing relationships with other individuals. For example, they may worry for a long time because of an incorrectly understood phrase, which will cause parting with 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? “Breaking 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", acquiring anxiety, panic and a drop in self-esteem.

Fear of disgrace

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? Asking for help from friends and loved ones is normal. But if you catch yourself thinking that you are asking the same question, or friends are telling 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 the support has been received. Usually, in people with OCD, the mental, emotional state only worsens.

“I don’t look good in the mirror” - dissatisfaction with my appearance

This is not a whim at all: often insecurity and even self-hatred arises on the basis of obsessive-compulsive disorder neurosis. Often OCD is accompanied by body dysmorphia - the belief that there is some kind of flaw in appearance, which causes people to constantly evaluate parts of the body that seem "ugly" to them - the nose, ears, skin, hair, and so on.

When should you seek help? It is quite normal not to be delighted with some part of the body. But for people with OCD, it looks different - a person spends hours in front of a mirror, looking at and criticizing their "flaw" in appearance.

Obsessive Thoughts: Symptoms of OCD

Already in the 17th century, researchers drew attention to the existence of obsessive-compulsive disorders 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 about 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 is rooted in Russian psychiatric literature.

At the end of the 19th century, Westphal introduces the term "agoraphobia", which, in his opinion, meant the fear of being in the company of other people. At about the same time, Legrand de Sol suggests that a feature of the dynamics of obsessions occurs in the form of "doubt insanity with delusions of touch". Along with this, he also points to a gradually progressive clinical picture - obsessional 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 gave a description of the "syndrome" of OCD diseases. In their opinion, the onset of the disease occurs in adolescence, adolescence. The maximum clinical manifestations were found by researchers in patients aged 10-25 years.

Let's analyze in detail the clinical picture of this disease. From a medical reference book, the term "obsessional 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 the patient to “drive away” such thoughts. And such thoughts can take the form of both individual phrases and even poems. Such images can be blasphemous and unpleasant for the very person who experiences them.

Whereas obsessional images are nothing more than "vivid scenes" with elements of violence, sex, perversion. Obsessional impulses are a severe form of the disease, when the patient, against his will, wants to perform some action that is destructive, dangerous for the person himself. For example, jump out on the road in front of the car, injure a child, yell obscene words in society.

The "rituals" that OCD sufferers perform include both mental activities and repetitive behaviors. For example, mental counting without end or washing hands 5-10 times in a row. Some of them combine mental and physical activities (washing hands is associated with a fear of infection with 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 does not work out (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, what psychiatrists call mental chewing gum, is an internal debate with “oneself” that considers arguments for and against, even in the simplest actions. Moreover, some obsessive thoughts are directly related to the action taken earlier - did I turn off the stove, did I close the apartment, and so on. Other considerations also apply to complete strangers - I'm driving and I can knock down 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 heavy thoughts accompany compulsive actions - the patient repeats stereotyped 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 are still a number of outlined symptoms and complexes, among which there 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, and so on. On top of that, anxiety is a common companion of OCD sufferers. Some rituals alleviate the feeling of anxiety somewhat, but in other cases it can be quite the opposite. In some patients, this occurs in a "scripted" psychologically motivated response to a stimulus and symptom of OCD, but in other cases, patients have episodes of relapses of depression that occur independently of each other.

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

• Doubts (in the correctness of their actions);
• Flashbacks (intrusive memories of something unpleasant, repeating over and over again);
• Attractions;
• Actions;
• Representation;
• fears;
• Antipathy;
• Fears.

Now let's go through each of the types of sensory obsessions.

Obsessive doubts are intrusively arising, contrary to the mind and will of the patient, insecurities that are accompanied during decision-making and the performance of any actions. The contents of doubts are varied, ranging from household fears (whether the door is closed, whether water, gas and electricity are turned off, etc.) and ending with doubts that are related to work (whether the report was correctly calculated, whether the signature was on the last document, etc.). Despite the fact that a person with OCD checks the action several times, the obsession does not go away.
Psychologists refer to obsessive memories as those that have a stubborn, painful character. Sad, shameful events for the patient, which were accompanied by feelings of guilt and shame, have such an effect. Coping with such thoughts is not easy - a patient with OCD cannot suppress them in himself simply by an effort of will.

Obsessions are urges that “require” a person to perform some dangerous, terrible, terrible actions. Often, the patient cannot get rid of such a desire. For example, the patient is seized 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 vivid vision of the actions taken;
• There are images of absurd, improbable situations and their result.

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

Obsessions are when patients do things that were against their will, despite their best efforts to "not do it." Obsessive thoughts pull a person to do a fantasy until it is realized. And some of them are simply not noticed by a person. Obsessive actions are incredibly painful, especially in those cases when the people around them see their result.

To obsessive fears (phobias), experts rank the following: fear of heights, too wide streets; the onset of sudden death. It also happens that people are afraid to be in confined / open spaces. And even more common cases - a phobia to get sick with 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 are.

Hypochondriacal - a person experiences an obsessive fear of getting sick 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 go through doctors of the appropriate authorities. 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 senseless medication.

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

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

The next type of obsessions are affectively neutral. They are expressed in the form of memories of terms, formulations, neutral events; the 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 the fear of harming others and oneself. Patients who experience contrast obsessions often complain of an irresistible urge to shout a curse in the company of other people, to add endings, to repeat after others, adding a touch of malice, irony, and so on. At the same time, people experience fear of losing control over themselves, and, as a result, the possible commission of 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). The group of contrasting (aggressive) obsessions often includes obsessions of a sexual nature.

Obsessions of pollution. Experts in this group include:

• Fear of "getting dirty" (with earth, urine, feces and other impurities);
• Fear of getting dirty with human secretions (for example, sperm);
• 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 is never shown “outside”, remaining at the preclinical stage of development for many years, manifesting itself only in personal hygiene features (changing underwear or washing hands, refusing to touch doorknobs, etc.), or in the order of conduct household (careful processing of food before cooking, etc.).
Such phobias do not have a very strong effect (or do not affect at all) on the life of the patient, and also remain out of the attention of other people. But in the clinical picture, “mysophobia” is considered as a severe obsession, where the gradually becoming more complex “protective rites” come to the fore: sterility in the bathroom, perfect cleanliness in the apartment (floor washing several times a day, etc.).

Staying on the street of people who suffer from this type of disease is necessarily accompanied by the wearing of long, careful "protecting" the open integuments of the body, which must be "washed after the street." In the later stages of developing a severe obsession, people stop going outside, and even outside the "perfectly clean room". To avoid dangerous contacts with the "infected", the patient is protected from all other people. Misophobia is also considered the fear of getting sick with some kind of 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, the OCD patient develops protective reactions in the form of compulsions.

A notable place in the series of obsessions is occupied by obsessional actions, which have the appearance of specific movement disorders. Some of them develop in childhood - for example, tics, which, unlike natural abnormalities, 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, natural gestures for all.

Usually, patients who suffer from a tic may shake their heads for no reason (as if checking if they have a hat), make some senseless hand movements (check the time on a wristwatch without one), blink their eyes (as if in them rubbish fell).

Along with such obsessions, pathological actions develop, such as spitting, biting lips, grinding teeth, and so on. They differ from obsessions that arise for objective reasons in that they do not cause feelings of guilt, experiences that are alien, painful to a person. Neurotic states, which are characterized only by obsessive tics, as a rule, have a favorable outcome for the patient. Most often appearing at school age, tics go away by the end of puberty. True, there are such 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 persists, and long-term stabilization of a person's mental health is quite possible.

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

More severe, complex forms of OCD, such as infection phobias, fear of sharp objects, aggressive obsessions, as well as the numerous rituals that follow, on the contrary, can be very resistant to any treatment, go into a chronic form with frequent relapses. In this case, despite the fact that the patient is undergoing active therapy. Further worsening of these symptoms leads to the fact that the clinical picture of the disease becomes more and more difficult.

Diagnosis of obsessive-compulsive disorder

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 intrusive thoughts of harm. However, it is important to know that OCD is treatable! Therefore, anyone who suffers from intrusive thoughts should consult an experienced psychotherapist who specializes in the treatment of OCD.

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

The complex lingering obsessions that characterize OCD also need to be distinguished from schizophrenia. Unlike its manifestations, obsessions are usually accompanied by a growing sense of anxiety, significant systematization and expansion of the circle of obsessive associations, which acquire the character of "special significance". 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 making a differential diagnosis arise in Gilles de la Tourette's syndrome, in which generalized disorders predominate.

Nervous tics, in this case, are localized in the neck, face, jaws, and are accompanied by grimaces, tongue protrusion, etc. In such cases, the syndrome can be excluded based on the fact that it is characterized by roughness of movements, various motor disorders, and as well as more complex mental disorders.

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

Genetic Causes of OCD

It is worth emphasizing that when OCD occurs, studies have 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.

The study of this problem in adult twins showed that this disorder is moderately hereditary. True, they could not identify the gene that is responsible for the occurrence of OCD. However, the most prerequisites for this are genes - 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 the nervous structures. And as we wrote above, a neurotransmitter is required for the transmission of impulses in neurons. There are studies that clearly state hSERT mutation 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 transfer another substance - the neurotransmitter glutamate.

autoimmune reaction

What is the autoimmune response to obsessions? In addition, the occurrence of obsessive-compulsive disorder 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 streptococcal infection, but as a result of taking prophylactic antibiotics that fight infection. Various forms of obsessive-compulsive disorder can also occur as a result of the reaction of the immune system to pathogens.

Brain malfunction

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

• thalamus;
• Striped body;
• Orbitofrontal cortex;
• Caudate nucleus;
• Anterior cingulate gyrus;
• Basal ganglia.

In the results of brain scans of OCD patients, it was found that the disease affects the functionality of the chain connection between departments. Such a circuit that regulates instinctive behavioral aspects (aggression, bodily secretions, sexuality); starts the corresponding behavior, in the normal state it can “turn off”. That is, a person once washing his hands, will not do it again, in the near future. And move on to something else. However, in patients who suffer from OCD, this circuit cannot "switch off" immediately, and the signals are ignored, which causes a breakdown in "communication" between departments. The 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 violation is associated with problems in the biochemistry of the brain.

Behavioral psychology. What are the reasons for obsession?

According to the postulates of one of the laws of behavioral psychology: the repetition of the same action makes it easier to reproduce it 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, it plays the role of a “protective ritual” in order to “drive away” obsessive thoughts / actions. Such activities temporarily reduce fear, anxiety, anger, and so on, but the paradox is that it is the “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, alas, leads to an increase in OCD symptoms. People who are under great stress for a long time are most often subject to pathological changes: for example, they start working in a new place, end an exhausted relationship, and suffer from constant overwork. For example, if a person previously calmly used public toilets, then at “one fine moment” the patient may develop a phobia of “infection” from unclean toilet seats, because of which one can catch a “disease”. Further, a similar association may appear to other objects in social life - public sinks, cafes, restaurants, and so on.

Soon, a person who develops OCD begins to perform "protective rituals" - dusting door handles, trying to avoid public toilets, and much more. Instead of overcoming his fear, convincing himself of the illogicality of obsession, a person becomes more and more subject to a 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 compulsions in thoughts and actions several times a day, much more than people with a healthy mind. And unlike the latter, patients with obsessive-compulsive disorder exaggerate the importance of the thoughts that come to their mind.
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 moms don't pay attention to stupid thoughts, attributing it to stress. But people who suffer from illness begin to exaggerate the importance of the thoughts and actions that come to their mind.

The woman begins to think, to realize that she is an "enemy" for the child. And this causes him fear, anxiety, and other negative thoughts. For the child, mommy begins to experience shame, mixed feelings of disgust and guilt. Fear of one's own thoughts leads to attempts to neutralize the "root causes". And more often than not, mothers begin to avoid situations during which they have such thoughts. For example, they stop feeding their baby, give him insufficient time, and develop their own "protective rituals."

And as we wrote above, the emergence of "rituals" help the violation in behavior to "get stuck" in the human psyche, to repeat this "ritual". It turns out that the cause of OCD is the perception 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 as early as childhood. Among those:

• An 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 is fully responsible 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 the detrimental processes of obsession in people who are genetically susceptible to this disease. Studies have shown that neurosis in more than half of the cases occurs precisely because of the influence of the environment.

In addition, statistics show that patients who suffer from obsessions have experienced a traumatic event in their lives 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;
• Maltreatment of an adult or child, past abuse;
• Death of a family member;
• Changing of the living place;
• relationship problems;
• Changes at work/school.

What amplifies OCD?

What helps obsessive-compulsive disorder get "stronger"? In order to cure OCD, knowing the exact causes of the disorder is not so important. The doctor needs to understand the underlying mechanisms that support the progress of the disease. Overcoming these will be the key to resolving the problem in the mental health of a person.

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

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

Avoidance and "protective rituals" initially work - a person reassures himself at the thought that if he hadn't checked, a catastrophe could have happened. But in the long run - such actions bring only a feeling of anxiety, which feeds the obsessive syndrome.

Belief in the materiality of thoughts

A person who suffers from obsessions overestimates his capabilities, his influence on the world. And as a result, he begins to believe that his bad thoughts can make a “catastrophe” in the world. Whereas if you turn "magic spells", "rituals" - this can be avoided. Thus, a patient with a developing mental disorder feels more comfortable. As if from the conducted "spells" there is control over what is happening. And bad things will not 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.

Too much focus on your thoughts

It is important to understand that obsessions and doubts, which are often absurd and contrary to what a person really does and thinks, appear in every individual. The problem is that people who don't have OCD simply don't attach any importance to stupid thoughts, while a person with neurosis takes their thoughts too seriously.

In the 1970s, a number of experiments were conducted where healthy people and patients with OCD were asked to list their thoughts. And the researchers were surprised - the obsessive thoughts of both categories were practically the same!

Thoughts are the deepest fears of the individual. For example, any mother always worries 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 OCD sufferers is that painful thoughts occur much more often in the latter. And this is 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 are visited, the worse it affects the psychological balance of the patient. Healthy people often ignore them, do not attach importance to them.

Fear of uncertainty

Another important aspect is that the OCD patient overestimates the danger / underestimates their ability to cope with it. Most people with obsessions feel they need to be 100% sure that nothing bad will happen. For them, "protective rituals" are akin to an insurance policy. And the more often they perform such magic spells, the more they will receive "security", certainty in the future. But in fact, such efforts only lead to the emergence of neurosis.

Desire to make everything "perfect"

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

“fixate” on a particular thought/action

As people say, "fear has big eyes." Here's how a person with OCD neurosis can "twist" themselves:

• Low tolerance for disappointment. At the same time, 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 one.

With obsession, a person "winds" himself to a state of anxiety, and then tries to suppress this feeling by performing obsessive actions.

Treatment for OCD

Can obsessive-compulsive disorder be cured? In about 2/3 of OCD cases, improvements occur within a year. If the disease lasts more than a year, then during its course, doctors will be able to track fluctuations - when periods of exacerbation “change” with periods of improvement that last several months, and sometimes several years. The doctor can put 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 are incredibly persistent. Studies have shown that the 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 that includes a number of symptoms and forms, the principles of treatment for them are similar. The most reliable way to recover from OCD is 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 medicines is strictly prohibited!

If symptoms similar to psychological disorders appear, it is necessary to contact the specialists of the psychoneurological dispensary or any other institutions of this profile to establish a competent 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 - for a long time there has been no “registration of the mentally ill”, 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 worsening is followed by improvement. The pronounced suffering of a person with neurosis, it would seem, requires radical action, but 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, the treatment of the latter will "erase" the symptoms of obsession, which makes it difficult to adequately treat.

Any therapy aimed at curing obsessions should begin with consultations, where the doctor proves to the patient that this is not “crazy”. Those suffering from this or that disorder often try to involve healthy family members in their “rituals”, so relatives should not make indulgences. But it’s also not worth it too harshly - this way you can aggravate the patient’s condition.

Antidepressants for OCD

Currently, the following pharmacological drugs are used in OCD:

• Anxiolytics of the benzodiazepine series;
• 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, reduce symptoms, but they should not be used for more than a few 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 small antipsychotics. Atypical antipsychotics, such as risperidone, quetiapine, olanzapine and others, serve as the basis in therapy against the disease, where ritualized obsessions and negative symptoms are formative.

It is important to understand that any comorbid depression is treated with antidepressants at an acceptable dosage. There is evidence that, for example, the tricyclic antidepressant clomipramine has a specific effect on the symptoms of obsession. True, the test results showed that the effect of this drug is insignificant, and appears in patients with distinct signs of depression.

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

Help from a psychologist for OCD

What are the features of psychotherapy in the treatment of OCD? One of the fundamental tasks for effective treatment of the patient is to establish a 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 to "introduce" the confidence that regular visits, taking medications in prescribed doses, and following all the doctor's recommendations are the key to effective treatment. Moreover, the faith in recovery must be supported by the relatives of the patient.

If a patient suffering from OCD has formed "protective rituals", then the doctor needs to form for the patient the conditions under which he tries to perform 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 ceases to carry out 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 experts practice the "thought-stopping" method, but its effect has not been proven.

Can OCD be permanently cured?

We have previously written that a nervous breakdown has an oscillating development, which is accompanied by an alternation of “improvement-deterioration”. And regardless of what measures for treatment were taken by doctors. Until a pronounced recovery period, 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, improve intra-family relationships. If marital problems cause the progression of OCD, then the spouses are shown joint therapy with a psychologist.

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

Rehabilitation will help to set up the right interaction in society. Patients receive vocational training in the skills that are required in everyday life. Psychotherapy will help those patients who experience a sense of their own inferiority to feel better, treat themselves adequately, and gain confidence in their own strengths.

All these methods, if used in combination with drug therapy, will help increase the effectiveness of treatment. But, they cannot replace drugs in full. It is important to emphasize that the method of psychotherapy does not always bear fruit: in some patients with obsessions, deterioration is observed, since the “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 result of past 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 is often referred to 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. Given 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, as vivid symptoms may be due to schizophrenia or bipolar personality disorder. This disorder occurs equally in both men and women.

Obsessive compulsive disorder can develop at any age, but it peaks in puberty and adulthood. The number of children with such a diagnosis is inexorably growing, which is associated with improper upbringing, social and economic troubles, the unwillingness of peers to support each other for some reason, an insufficient level of trust between the parent-child link, where a teenager does not share his experiences.

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

• specific personality traits. Before the onset of the disease, most people with neurosis have anxiety, suspiciousness, low self-esteem and increased demands on themselves and others. Which, inexorably, leads to an intrapersonal conflict, undermining the already weak psycho-emotional background;
• genetic predisposition;
• chronic stress;
• Physical and mental strain;
• Frequent conflicts.

Sometimes neurosis occurs with VVD (vegetovascular dystonia), although, to be more precise, fluctuations in pressure, body temperature, chilliness and sweating of the extremities occur most often as a result of dystonia, and not VVD is the initial neurosis.

Any, even insignificant, bad event can be the last straw in the formation of a neurosis. A striking example is the increased working capacity of a person, the successful completion of all tasks and duties 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. Had it happened a day or two before, a person would not have paid attention to it. But over time, energy reserves are depleted and rest and tranquility are vital to recharge them.

Clinical picture

Obsessive-compulsive disorder has three components, which are more or less pronounced, depending on the person's perception of the stress factor (in some cases there is a combined form):

• phobic experiences;
• Obsession with actions (compulsions);
• Obsession with thoughts (obsessions).

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

With neglected neurosis, contrasting obsessions are a frequent companion. These are terrible and incomparable thoughts or images that significantly reduce the quality of human life.

Contrasting obsessions take two forms:

• Thoughts of harming another person;
• The desire to "punish" oneself through suicide or physical abuse.

In both cases, the negative stream of thought ends with self-accusation and denial of what is happening. The man is ashamed of himself, but he cannot do anything about it. There is a theory that people who have a tendency to perversion suffer from obsessive-compulsive disorder. It is not known whether it is completely reliable, but, of course, it also 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 an appointment with specialists every time he gets sick, and he will perceive the hint of going to a psychotherapist as an unwillingness to treat him. Does he consider himself sick? Sick - yes. Mentally, no. In mild forms of neurosis, people themselves often turn to psychologists, as they have criticism of their condition and can interpret changes in their body as pathological, but not from the side of 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 the pathology of the psychiatric profile is the fear of going crazy. Any phobia (fear of enclosed spaces, darkness, heights, etc.) tends to progress. That is, if a person is afraid of heights, with each new debut 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), as a rule, occur after the manifestation of phobias.

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

• Simple compulsions are the performance of certain manipulations at the time of a stressful situation. This includes nail biting, hair straightening, leg twitching. The desire to crumple, tear, straighten something for lack 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, believes that this is a matter of course;
• True compulsions (rituals) have more complex psychological aspects and are directly related to phobic experiences. All actions are aimed at combating your fears and striving to receive the desired peace from this. A striking example would be the constant washing of hands (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 like that, but the frequent use of antibacterial agents not only dries out the skin, but also cracks, which makes it easier for microorganisms to penetrate inside, causing inflammation. That is, the phobia of getting infected with something from unwashed hands leads to the fact that a person becomes ill with this. This also applies to other phobic experiences, and the relief from these rituals is only temporary.

obsessions

Obsessions are less common in practice, but this does not mean that this form is less harmful than the others. Thoughts arise spontaneously and, most often, during rest and before going to bed. Surely, everyone has met with such a phenomenon as “mental chewing gum”. It is an endless stream of thought that aims at self-knowledge and realization. It is possible that many philosophers had in their store of knowledge not only high intelligence, but also obsessive-compulsive disorder itself. Obsessions can be of a short duration, such as playing a song in your head that was on the radio a few hours earlier, 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 obsessions includes an inflating thought process about the future, the meaning of life, and so on. This already speaks of a neglected neurosis, which must be identified and cured before its transformation into depression begins. Memories of even good things cause an irresistible longing in a person, because this will not happen again and will not happen again. Whereas in a person with a normal functioning psyche, such images may have a slight shade of sadness, but they do not depress his general well-being.

Features in children

Obsessive-compulsive disorder in children is not much different from this disorder in adults. The first phobias appear when the child begins to read fairy tales or show cartoons, and parents scare him with all sorts of stories. “If you behave badly, we will give you to that aunt over there”, “a babai comes for bad children”, etc. The psyche of a child is a rather fragile phenomenon, and even such a ridiculous threat for adults can greatly affect it. Being in puberty, schoolchildren begin to skip classes because they are afraid of their teacher. Often there is a phobia in the form of fear of losing their parents. Careless words like “it would be better if you weren’t there”, “but the neighbor has a child ...” affect his mood and feelings. You should not 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 closes in on himself, begins to get nervous, the first rituals appear (nail biting, the inability to sit still in the form of hare legs syndrome, etc.). The condition is exacerbated by obsessive thoughts, often leading to suicide. Therefore, an excuse like "he has a bad temper, will outgrow" should be forgotten once and for all. Any deviation in behavior is not the norm. And instead of reading morals to your child, trying to share life experience and scold 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 exclusion, the diagnosis of neurosis is 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”, “Do you find it difficult to resolve conflict situations”, etc. Accordingly, the more points scored, the more severe the form of neurosis.

Treatment

Therapy of obsessive-compulsive disorder is almost always amenable to drug therapy, but the main role in the treatment, of course, should be played by psychotherapy.

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, the detection of weak personality traits and the proposal of ways to correct them. Good results are obtained by group psychotherapy and auto-training. Sometimes sessions with a psychotherapist are enough to achieve mental well-being. But if the conversations could not help, then only drug therapy is applied.

Medical therapy

Medications are prescribed depending on the severity of the course of neuroses. With a mild form, it is possible to prescribe sedative preparations of plant origin (novo-passitis, 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). In 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 possible. Neuroses are quite common, and their provoking factor is overstrain. 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, take a break, put things off for later. It is much better to dedicate a couple of hours to yourself and then get to work than to finish everything in advance and have a nervous breakdown. For preventive purposes, you can drink a course of light sedatives, especially at those moments in life when they are necessary for emotionally unstable people (session, large project, arrival of the authorities, etc.). If the above methods did not have the desired effect, and the symptoms intensify, preventing you from living, then contact a psychotherapist, take care of your health.

What person does not have thoughts or ideas that will cling to and cannot rest? Obsessive states, which are also called obsessive-compulsive disorder or obsessive-compulsive disorder, are not a disease that must be treated with psychiatrists. It’s just that this condition has its own causes and symptoms of manifestation, which to some extent will interfere with the normal existence of a person who eventually wants to get rid of them.

So, the site of psychiatric help does not call obsessive-compulsive disorders 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 look ridiculous 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, cause fear, anxiety or panic, until finally the necessary actions are taken. The actions that a person has to 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 carry a negative color and seem to be third-party, alien, 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 feels anxiety, fear of the consequences that will arise if he does not take the necessary actions.

What are obsessive states?

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 occur during obsessive states are also called by some psychologists the habits that a person has developed in the process of life. They didn't just happen to him. The emergence of obsessive-compulsive states was preceded by certain social factors.

Examples of ritual actions can be:

1. The desire to wash hands thoroughly in a public toilet, because a person seems to have a lot of germs on them.
2. The desire to double-check if the kettle or iron is turned off.
3. Uncertainty that the person closed the door to the apartment, although he obviously took out the keys and twisted them.

The obsession of thoughts lies in the fact that a person is not sure and cannot reliably remember whether he did the right thing. And since he cannot remember, he has a fear that “the apartment will burn down because the kettle is not turned off,” “he will be robbed by apartment 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 is happening 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 hands.
2. He enters the room to check that the device is off.
3. Pulls on the front door to see if it's closed.

Compulsive states consist of two factors:

1. Thoughts - a person is driven by obsessive thoughts that arise in his head in a certain situation and disturb him until he performs the necessary action, switches his attention or leaves the circumstances of the environment.
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 inherent in 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 should be “perfect”.

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

obsessive-compulsive disorder

For the first time, the obsessive-compulsive disorder syndrome was proposed by the psychiatrist R. Kraft-Ebing, who at one time could not fully explain this phenomenon. He considered 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, the obsessive state disrupts the habitual activity of a person. That is why it is recommended to eliminate this disorder, in whatever form it manifests itself.

Become obsessive in the syndrome:

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

The person becomes and is often disturbed by something. Compulsive states are:

• Abstract obsessions - counting, thoughts, memories, detailing the event.
• Figurative obsessions - when a person has negative emotional experiences.

Causes of Obsessions

Psychologists identify the following causes of obsessive-compulsive disorders:

• Overwork.
• Chronic intoxication of the body.
• Head injury.
• Lack of sleep.
• Infectious diseases.
• Asthenization.
• Mental illness.

Some people with obsessive-compulsive disorders are treated by psychiatrists. However, not every person who has obsessive-compulsive disorders becomes a patient in a psychiatric hospital. Obsessive states are quite inherent in healthy people, however, to some extent weakened by life, physically or emotionally.

Let's try to describe more precisely 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, even more immersed in his thoughts, which tell him what can happen to him.

Obsessive-compulsive disorder symptoms

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

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

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

The obsession of ideas is manifested 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, while 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, counts the number of steps taken.

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

Obsessive doubts are manifested 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 are manifested in the fact that a person constantly returns his thoughts to some event from his past. This event should cause vivid negative experiences inside 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 the fear of heights, which occurs when a person is on a hill or simply imagines how he is on a tall building. With this fear, a person does not fall from a height, but clearly imagines how this will happen, how he will break it on the ground, how scared he will be in flight and hurt when falling.

Obsessive desires or desires are similar to phobias, because a person imagines a picture of what he wants to do. They are presented in the form:

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

Treatment of obsessive-compulsive disorders

The treatment of obsessive-compulsive disorders is carried out in various directions. You can be treated both independently, if a person is still able to control the process, and 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 what causes fear and anxiety in him. He must abandon habitual actions and do what usually causes tension in him. 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. Medications are also prescribed in case of complications.

Also, a person can try to get rid of obsessive states. You can try, it still won't hurt.

A person is invited to switch his attention to something else. Do not try not to think about what is being forced on you. Just try to be interested in something else, to be distracted by something else.

Turn on a conscious approach to business. In a 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 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 took some role in their occurrence. However, while you are running and afraid, the intrusive thoughts become even deeper and more persistent.

Outcome

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

Compulsive disorder, or obsessive-compulsive disorder (OCD), affects 1 to 3% of people. Predisposition to the disease is largely determined by hereditary factors, but in young children, symptoms are practically not manifested. In most cases, OCD is first diagnosed between the ages of 10 and 30.

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

Frequent hand washing

People with OCD often have an exaggerated fear of infection. The result of a phobia is washing hands too often. At the same time, the process is associated with a number of strange actions. For example, a person lathers his palms a strictly defined number of times or rubs each finger from 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

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 the surrounding objects seem to him not clean enough. If a person washes floors several times a day, is eager to check all surfaces for dust, unnecessarily uses strong disinfectants - this is an alarm signal.

In some people with obsessive-compulsive disorder, the morbid desire for cleanliness is manifested by the fear of touching various objects (for example, the patient refuses to press the buttons in the elevator or opens the door with his elbows so as not to touch them with his hands). Sometimes patients are not able to do their usual activities, seeing the dishes left on the table or crumpled napkins.

The habit of double-checking your actions

Each of us at least once found ourselves in a situation where, after leaving the house, he could not remember whether he locked the front door. This usually happens when we think and get distracted from the actions performed automatically. This kind of distraction is the norm. You can talk about pathology if a person ceases to trust himself and is afraid of the consequences of losing control over a familiar situation.

People with OCD experience this kind of anxiety all the time. To protect themselves and calm down, they form numerous rituals related to rechecking 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 “necessary” number of times, go around the apartment along a strictly defined route, checking that there are no electrical appliances turned on, etc.

Tendency to count

The obsessive-compulsive disorder syndrome can manifest itself as a pathological tendency to count. The patient constantly counts the objects around him: steps in the entrance, steps that he takes on the usual path, cars of a certain color or brand. At the same time, the action itself often has a ritual character or is associated with irrational hopes and fears. For example, a person gains unreasonable confidence in the future good luck if the account "converged", or begins to fear the harmful consequences of not having time to count some objects.

Pathological order requirements

The OCD patient organizes around him a strictly regulated order. 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 an inadequately sharp, painful reaction to any violation of the once and for all worked out layout.

If your relative or friend refuses to sit down at the table after noticing that the fork is at an angle to the plate, throws a rowdy tantrum over shoes placed a few inches further from the sofa than usual, or cuts an apple into perfectly even slices every time, he should seek medical advice.

Excessive fear of trouble

Life's troubles do not please anyone, but usually people solve problems in order of arrival. The OCD sufferer is overly anxious 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 prefers ritual actions that are in no way connected with the essence of the problem, but supposedly capable of influencing the development of events (arrangement of objects in the "correct" order, "happy" counts, etc.).

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

obsessive sexual fantasies

A patient with OCD may be haunted by sexual fantasies of a perverse nature, often directed at people with whom the patient is in constant contact (relatives, colleagues). At the same time, a person feels shame, considers himself "unclean", but cannot get rid of fantasies. Thoughts of obscene or cruel behavior are not realized in practice, but become the cause of internal discomfort, the desire for isolation, refusal to communicate with loved ones.

The tendency to constantly analyze relationships with others

The syndrome of obsessive states changes the patient's idea 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 that.

The habit of rehearsing future actions

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

People with obsessive-compulsive disorder often seek support from family and friends. Anxiety should not be caused by an ordinary request for help, but by repeated appeals with the same problem (usually voiced in the same terms) to all acquaintances in a row - while completely ignoring their reaction and advice.

Constant dissatisfaction with one's appearance

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

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

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

Obsessions and compulsions are diagnostic when they persist for two consecutive weeks. Imaginary fears should cause distinct discomfort, and protective actions - temporary relief. It should be borne in mind that only a psychiatrist can confirm the diagnosis of OCD.

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