Today, three out of a hundred adults and two out of five hundred children are diagnosed with obsessive-compulsive disorder syndrome. This is an ailment that requires compulsory treatment. We suggest that you familiarize yourself with the symptoms of ACS, the causes of its occurrence, as well as possible treatment options.
What is ACS?
Obsessive-compulsive syndrome (or disorder) - constantly repeating identical obsessive involuntary thoughts and (or) actions (rituals). This condition is also called an obsessive condition syndrome.
The name of the disorder comes from two Latin words:
- obsession, which literally means siege, blockade, taxation;
- compulsion - compulsion, pressure, self-enforcement.
Doctors and scientists began to become interested in the syndrome of obsessive states in the XVII century:
- E. Barton described the obsessive fear of death in 1621.
- Philippe Pinel did research on obsession in 1829.
- Ivan Balinsky introduced the definition of “obsessive thoughts” into Russian psychiatric literature, and so on.
According to modern research, obsessive syndrome is characterized as a neurosis, that is, it is not a disease in the literal sense of the word.
Obsessive-compulsive syndrome can be schematically depicted as the following sequence of situations: obsessions (obsessive thoughts) - psychological discomfort (anxiety, fears) - compulsions (obsessive actions) - temporary relief, after which everything is repeated again.
Types of ACS
Depending on the accompanying symptoms, there are several types of obsessive syndrome:
- Obsessive-phobic syndrome. It is characterized by the presence of only obsessive thoughts or anxieties, fears, doubts, which do not lead to any further actions. For example, the constant rethinking of situations in the past. It can also manifest as a panic attack.
- Obsessive-convulsive syndrome - the presence of compulsive action. They can be related to maintaining a constant order or monitoring security. In time, these rituals can take up to several hours daily and take a lot of time. Often one ritual can be replaced by another.
- Obsessive-phobic syndrome is accompanied by convulsive, that is, obsessive ideas (thoughts) and actions arise.
ACS depending on the time of manifestation can be:
- episodic;
- progressive;
- chronic.
Causes of Obsessive Syndrome
Experts do not give a clear answer to why the obsessive syndrome may appear. In this regard, there is only the assumption that some biological and psychological factors affect the development of ACS.
Biological reasons:
- heredity;
- consequences of traumatic brain injury;
- complications in the brain after infectious diseases;
- pathology of the nervous system;
- violation of the normal functioning of neurons;
- decreased levels of serotonin, norepinephrine, or dopamine in the brain.
Psychological reasons:
- psycho-traumatic relationships in the family;
- strict ideological education (for example, religious);
- experienced severe stressful situations;
- stressful work;
- high sensitivity (for example, an acute response to bad news).
Who is exposed to ACS?
A great risk of the occurrence of obsessive syndrome in people in the family who have already met similar cases is a hereditary predisposition. That is, if a family has a person with a diagnosis of ACS, then the likelihood that his immediate offspring will have the same neurosis is from three to seven percent.
The following types of personalities are also subject to ACS:
- too suspicious people;
- Those who want to keep everything under control;
- people who have suffered various psychological traumas in childhood or in whose families serious conflicts have occurred;
- people who were too patronized in childhood or, conversely, who received less attention from their parents;
- having suffered various brain injuries.
According to statistics, there is no separation according to the number of patients with the syndrome of obsessive states between men and women. But there is a tendency that neurosis most often begins to manifest itself in people aged 15 to 25 years.
Symptoms of ACS
Among the main symptoms of the occurrence of obsessive-compulsive disorder are the appearance of anxious thoughts and monotonous daily actions (for example, constant fear of an incorrectly spoken word or fear of germs, which forces you to wash your hands often). Accompanying signs may also appear:
- sleepless nights;
- nightmares;
- poor appetite or its complete loss;
- sullenness;
- partial or complete detachment from people (social isolation).
Categories of people by type of compulsions
In most cases, people are subject to the following categories according to the types of compulsions (forced compulsive actions):
- Chistyuli or those who are afraid of pollution. That is, patients have a constant desire to wash their hands, brush their teeth, change or wash clothes, and so on. Those who are constantly reinsured. Such people are worried about thoughts of a possible fire, a thief’s visit and the like, so they often have to check if doors or windows are closed, the kettle, oven, stove, iron and so on are turned off.
- Sinners who doubt. Such people are afraid to be punished by higher authorities or law enforcement agencies even for the fact that something is done not as flawlessly as they themselves think.
- Almost perfectionists. They are obsessed with order and symmetry in everything: clothing, surrounding things and even food.
- Pickers. People who can’t refuse things, even if they don’t need them, because of fear that something bad will happen or they will still need them someday.
Examples of ACS in adults
How to diagnose obsessive-compulsive syndrome? Symptoms of the disease can occur in each person in their own way.
The most common obsessions are:
- thoughts of attacking your loved ones;
- for drivers: concern that they will hit a pedestrian;
- anxiety about the possibility of accidentally harming someone (for example, setting up a fire in someone’s house, flood, and so on);
- fear of becoming a pedophile;
- fear of becoming homosexual;
- thoughts that there is no love for a partner, constant doubts about the correctness of his choice;
- the fear of saying or writing by chance something is not right (for example, using inappropriate vocabulary in a conversation with superiors);
- fear of living not in accordance with religion or morality;
- disturbing thoughts about the occurrence of physiological problems (for example, with breathing, swallowing, blurred eyes, and so on);
- fear of making mistakes in work or assignments;
- fear of losing material well-being;
- fear of getting sick, getting infected with viruses;
- constant thoughts about happy or unhappy things, words, numbers;
- another.
Among the common obsessive actions are as follows:
- constant cleaning and following a certain order of things;
- frequent hand washing;
- safety check (whether the locks are locked, whether the appliances, gas, water and so on are turned off);
- often repeating the same set of numbers, words or phrases to avoid bad events;
- constant check of the results of their work;
- constant counting of steps.
Examples of ACS in children
Children are susceptible to obsessive-compulsive syndrome much less often than adults. But the symptoms of manifestation are similar, only adjusted for age:
- fear of being in a shelter;
- fear of falling behind parents and getting lost;
- anxiety for assessments, which develops into obsessive thoughts;
- frequent hand washing, tooth brushing;
- complexes in front of peers that have grown into obsessive syndrome and so on.
Diagnosis of ACS
Diagnosis of the obsessive-compulsive syndrome is to identify those very obsessive thoughts and actions that have occurred over a long period of time (at least half a month) and are accompanied by a depressed state or depression.
Among the characteristics of obsessive symptoms for diagnosis, the following should be highlighted:
- the patient has at least one thought or action, and he resists them;
- the idea of fulfilling an impulse does not give the patient any joy;
- the repetition of obsessive thoughts is disturbing.
The complexity of the diagnosis lies in the fact that it is often difficult to separate the obsessive-depressive syndrome from simple ACS, as their symptoms occur almost simultaneously. When it is difficult to determine which one appeared earlier, then depression is considered to be the primary disorder.
The test will help to identify the diagnosis of "obsessive-compulsive syndrome". As a rule, it contains a number of questions related to the type and duration of actions and thoughts characteristic of a patient with ACS. For instance:
- the amount of daily time spent thinking about obsessive thoughts (possible answers: not at all, a couple of hours, more than 6 hours, and so on);
- the amount of daily time spent on obsessive actions (similar answers as for the first question);
- sensations from obsessive thoughts or actions (possible answers: none, strong, moderate, etc.);
- Do you control obsessive thoughts / actions (possible answers: yes, no, insignificantly, and so on);
- Do you have problems with washing your hands / taking a shower / brushing your teeth / putting on / washing clothes / cleaning up / taking out garbage and so on (possible answers: yes, like everyone else, no, I don’t want to do this, constant craving, etc.);
- how much time you spend on a shower / brushing your teeth / hairdo / dressing / cleaning / taking out garbage and so on (possible answers: like everything, twice as much; several times more and the like).
For a more accurate diagnosis and determination of the severity of the disorder, this list of questions can be much larger.
Results depend on the number of points scored. Most often, the more there are, the higher the likelihood of obsessive-compulsive syndrome.
Obsessive-compulsive syndrome - treatment
For help in the treatment of ACS, you should contact a psychiatrist who will not only help in the accurate diagnosis, but can also identify the dominant type of obsessive disorder.
And how can you generally defeat obsessive syndrome? Treatment of ACS consists of a series of psychological therapeutic measures. Medicines here recede into the background, and often they are only able to maintain the result achieved by the doctor.
As a rule, tricyclic and tetracyclic antidepressants are used (for example, Melipramine, Mianserin and others), as well as anticonvulsants.
If metabolic disorders that are necessary for the normal functioning of brain neurons are observed, then the doctor prescribes special drugs for the treatment of neurosis. For example, Fluvoxamine, Paroxetine, and so on.
As a therapy, hypnosis and psychoanalysis are not involved. In the treatment of obsessive-compulsive disorder, cognitive-behavioral approaches are used that are more effective.
The goal of this therapy is to help the patient stop focusing on obsessive thoughts and ideas, gradually drowning them out. The principle of operation is as follows: the patient should not focus on anxiety, but on refusing to perform the ritual. Thus, the patient is already experiencing discomfort not from the obsession, but from the result of inaction. The brain switches from one problem to another, after several such approaches, the urge to perform obsessive actions subsides.
Among other known methods of therapy, in addition to cognitive-behavioral, in practice, the method of “stopping thought” is also used. The patient at the time of the appearance of an obsession or action is recommended to mentally say to himself, “Stop!” and analyze everything from the outside, trying to answer these questions:
- How strong is the likelihood that this will actually happen?
- Do obsessive thoughts interfere with normal life and how much?
- How great is the feeling of internal discomfort?
- Will it become much easier without obsessions and compulsions?
- Will you be happier without obsessions and rituals?
The list of questions goes on. The main thing is that their goal is to analyze the situation from all sides.
There is also the possibility that the psychologist decides to apply a different treatment technique as an alternative or as additional assistance. It already depends on the particular case and its severity. For example, it can be family or group psychotherapy.
Self-help with ACS
Even if you have the best psychotherapist in the world, you must make efforts yourself. Not so few doctors - one of them, Jeffrey Schwartz, a very famous researcher of ACS, - note that independent work on his condition is very important.
For this you need:
- Learn yourself all the possible sources of obsessive disorder: books, medical journals, articles on the Internet. Get as much information as possible about neurosis.
- Put into practice the skills your psychotherapist has trained you. That is, try to independently suppress obsessions and compulsive behavior.
- Maintain constant contact with loved ones - family and friends. Avoid social isolation, as it only exacerbates obsessive syndrome.
And most importantly, learn to relax. Learn at least the basics of relaxation. Use meditation, yoga or other methods. They will help reduce the effects of symptoms of obsessive disorder and their incidence.