The obsessive compulsive disorder (OCD) is the most serious and disabling anxiety disorder. In these people there is what is known as thought-action fusion: they equate thoughts to actions.
People who have anxiety disorders and need hospitalization often have this disorder, as do those who need psychosurgery. If you have it, in addition to the typical symptoms of this disorder, you may experience panic attacks, generalized anxiety or major depression.
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Obsessions are meaningless intrusive images or thoughts that you try to avoid or eliminate. The most commons are:
Actions or thoughts that are used to suppress obsessions. They are believed to decrease stress or prevent a negative event. Also, they may be magical or illogical, unrelated to the obsession. Compulsions can be:
Many people with OCD continually wash their hands or do check-ups, which gives them a sense of security and control. The checks help them avoid imaginary disasters. They can be logical - such as checking that the door or gas has not been left open - or illogical - such as counting to 100 to avoid a disaster-.
Depending on the type of obsession, there are more one or other types of compulsions:
It is possible that the tendency to develop compulsive thinking anxiety may have the same biological and psychological precursors as anxiety in general.
For it to develop, it will be necessary for a person to have certain biological and psychological factors.
First, repetitive thoughts may be regulated by the hypothetical brain circuit. People with OCD are more likely to have first-degree relatives who also have the same disorder.
In cases where OCD develops during adolescence, there is a stronger relationship of genetic factors than in cases where it develops in adulthood.
For evolutionary psychology, moderate versions of OCD could have evolutionary advantages. For example, health, hygiene or enemy checks.
One hypothesis is that people with OCD learn that some thoughts are unacceptable or dangerous because they could actually happen. They can develop thought-action fusion, excessive responsibility or feelings of guilt during childhood.
The rapid onset of OCD in children and adolescents could be caused by a syndrome connected to Group A streptococcal infections (PANDAS) or caused by immune reactions to other pathogens (PANS).
Brain studies of people with OCD have shown that they have different activity patterns than people without OCD. The different function of a particular region, the striatum, could be causing the disorder.
Differences in other parts of the brain and dysregulation of neurotransmitters, especially serotonin and dopamine, may also contribute to OCD.
Independent studies have found unusual dopamine and serotonin activity in various brain regions of people with OCD: dopaminergic hyperfunction in the prefrontal cortex and dopaminergic hypofunction in the basal ganglia.
Glutamate dysregulation has also been studied recently, although its role in the disorder is not well understood..
B) At some point in the course of the disorder, the person has recognized that these obsessions or compulsions are excessive or irrational. Note: this point is not applicable in children.
C) Obsessions or compulsions cause significant clinical discomfort, represent a waste of time (they involve more than one hour a day) or interfere markedly with the individual's daily routine, work relationships or social life.
D) If there is another disorder, the content of the obsessions or compulsions is not limited to it (for example, worries about food in an eating disorder).
E) The disorder is not due to the direct physiological effects of a substance or a general medical condition.
Specify if:
With little awareness of illness: if during most of the time of the current episode, the individual does not recognize that the obsessions or compulsions are excessive or irrational.
OCD is often confused with obsessive compulsive personality disorder (OCD). Their main differences are:
On the other hand, OCD is different from behaviors such as gambling addiction or eating disorders. People with these disorders experience some pleasure from doing these activities, while people with OCD feel no pleasure.
OCD affects 2.3% of people at some point in their lives.
Symptoms usually occur before age 35, and half of people develop the disorder before age 20..
Behavioral therapy, cognitive behavioral therapy, and medication are the first-line treatments for OCD.
Exposure with response prevention is used in these therapies. It is a technique by which the person is systematically exposed to stimuli until they become accustomed.
To do this, any maneuver that is related to the execution of the external or cognitive ritual will be blocked. At first the block will be done for short periods of time and then for progressively longer periods.
For this technique to work, the person has to collaborate and take responsibility for:
There are several modalities:
Within the cognitive treatment, specific interventions would be carried out in:
Finally, it is advisable to work on relapse prevention, teaching the steps to follow in case of one:
Medication as treatment includes selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants, particularly clomipramine. SSRIs are a second line of treatment for people with moderate or severe impairment.
Atypical antipsychotics such as quetiapine have also been helpful in treating OCD alongside SSRIs. However, these drugs are poorly tolerated and have metabolic side effects. None of the atypical antipsychotics appear to be helpful when used alone.
Electroconvulsive therapy (ECT) has been found to be effective in some severe and refractory cases.
Surgery can be used as a last resort in people who do not improve with other treatments. In this procedure, a surgical lesion is made in the cingulate cortex. In one study, 30% of participants benefited from the procedure.
Cognitive behavioral therapy can be effective in reducing OCD rituals in children and adolescents. Family participation, observing and reporting, is a key component for successful treatment.
Although the causes of OCD in younger ages can range from abnormalities to psychological concerns, stressful events such as bullying or deaths in close family members can contribute to developing OCD..
When you have obsessive thoughts, try to focus your attention on something else. You can exercise, go for a walk, listen to music, read, play a video game, make a call ...
The important thing is to do something you enjoy for 10-15 minutes to forget the obsession and prevent the compulsive response.
When you start to have an obsession, write down all your thoughts or compulsions. Keep writing until the obsession stops, even if you keep writing the same things.
Writing will help you see how repetitive your obsessions are, and will even help them lose their power..
By anticipating the urge to perform the compulsions before they arise, you can alleviate them. If, for example, your compulsion is to check that the door has been closed, try to be attentive when you close the door and pay attention.
Create a mental note from an image or affirm "the door is closed" or "you can see that the door is closed".
When the urge to check if the door is closed arises, it will be easy for you to think that it is simply an obsessive thought, because you will remember that you have closed the door.
Instead of trying to suppress obsessions or compulsions, develop the habit of programming them.
Pick one or two 10-minute periods each day that you dedicate to obsessions. Choose the time and place, so that they are not close to bedtime.
During the worry period, focus only on obsessions, urges, or negative thoughts. Don't try to correct them.
At the end of your period, relax, let the obsessive thoughts go, and go back to doing your daily activities. When thoughts come back to you during the day, postpone them to your worry period..
Although stress does not cause OCD, a stressful event can lead to heritable OCD or make obsessive-compulsive behaviors more severe. Techniques such as yoga, deep breathing, progressive muscle relaxation, or meditation can reduce anxiety symptoms.
Try to practice a technique for 15-30 minutes a day. Here you can learn some of them.
Complex carbohydrates such as whole grains, fruits and vegetables stabilize blood sugar and increase serotonin, a neurotransmitter with calming effects.
Exercise reduces anxiety and helps control OCD symptoms by focusing attention elsewhere when obsessive thoughts and compulsions arise.
Try to do aerobic exercise for at least 30 minutes a day.
Alcohol temporarily reduces anxiety and worries, although it increases them when not consumed.
The same goes for tobacco: although they seem relaxing, they are a powerful stimulant, leading to higher levels of anxiety..
Anxiety and worry can lead to insomnia and vice versa. When you are rested, it is easier to maintain emotional balance, key to coping with anxiety.
Visit this article for some tips on how to sleep better.
If a family member or friend has OCD, the most important thing is to educate yourself about the disorder. Share that knowledge with that person and make him see that he can get help. Simply seeing that the disorder is treatable can boost your motivation..
Also, you can follow these tips:
People with OCD may have additional problems:
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