OCD – intrusive thoughts, causes, symptoms, diagnosis. How to treat OCD?

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Many of us happened to wonder if we turned off the iron before leaving the house. For some, such intrusive thoughts are a daily nuisance. OCD is a disorder that affects one in 50 people. It manifests itself with obsessive thoughts in a specific area and expresses itself with compulsions whose task is to relieve tension.

What is obsessive compulsive disorder? A person suffering from it has intrusive, unsettling thoughts, and the almost ritualistic actions performed in this connection, driven by fear, are supposed to release emotions. It happens that a specific gesture or saying a given word is to “protect” the patient or his relatives from an undesirable situation.

What distinguishes OCD from psychosis is realistic thinking. The point is that the patient is aware of the pointlessness of action and the irrationality of thoughts. However, he cannot resist them due to mounting anxiety or tension. In psychosis, in turn, the patient loses the distinction between what is reality and what is a figment of the imagination. The paradox of OCD is also the fact that the more the patient wants to silence the symptoms, the more forcefully they manifest themselves.

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OCD – types

There are a number of different areas around which OCD is concentrated. The most popular are:

1. morbid order, disgust with dirt and disorder, intrusive cleaning, cleaning items, constant washing of hands and body,
2. symmetry – pathological arrangement of objects symmetrically or “to the edge”, suffering and fear in obsessive compulsive disorder, when objects are positioned asymmetrically,
3. doubts, despite checking several times whether, for example, the iron is turned off, the need to constantly confirm that everything is fine,
4. counting (steps, steps, trees, paving slabs),
5. aggression in obsessive-compulsive disorder – manifested in thoughts about unjustified harm to someone, but rarely turns into deeds (compulsions).

For example, religious obsessions are less common, when the sick person prays obsessively because they fear punishment for their sins. The disorder also oscillates around intimate topics. Sometimes there is, for example, a homosexual obsessive compulsive disorder.

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The first symptoms of obsessive compulsive disorder can be noticed in early adolescence, at the age of 7–13. Then the problem more often affects boys. The second moment of manifestation of the disorder is between the ages of 20 and 25, when OCD affects both men and women equally.

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Obsessive thoughts in OCD fall into the following categories:

1. pushy uncertainty – the patient is constantly wondering whether he turned off the taps, turned off the iron, closed the door or washed his hands thoroughly, despite the fact that he checked it several times,
2. intrusive thoughts that run counter to the opinions of others, often blasphemous, intensifying at inappropriate times (e.g. in a church, during a professional meeting),
3. intrusive impulses – willingness to do something inappropriate, publicly compromising, willingness to make a gesture of aggression towards people who are actually neutral to the sick person, willingness to do something risky; in obsessive-compulsive disorder, such thoughts are not realized,
4. luminationsthat is, meaningless, pseudo-philosophical, long-lasting analysis of a single topic, deprived of the internal possibility of taking any position or making a decision,
5. obsessive fear of disorder, dirtas well as insistent thoughts about keeping perfect order, proper arrangement of objects or symmetry.

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The obsessive-compulsive obsessive-compulsive neurosis is additionally manifested by certain intrusive activities. They are also considered by the patient to be pointless and embarrassing, but at the same time unavoidable. Belong to them:

1. pushy checking that the taps are tightened, the iron turned off, etc., as a response to intrusive uncertainty,
2. obsession with washing objects, surfaces and themselves, recurring and unhappily arranging objects and tidying up rooms,
3. the compulsion to collect and store useless items – this type of obsessive-compulsive disorder is commonly called the hoarding syndrome,
4. performing meaningless complex activities that may resemble strange rituals (e.g. walking over the threshold on one leg while clapping your hands) to avert disasters and misfortunes that in reality would most likely not have happened anyway.

There are several other additional symptoms associated with OCD:

1. symptoms of anxiety disorders,
2. symptoms of depression resulting from failure to treat obsessive compulsive disorder (a patient who does not undergo treatment is exposed to suffering, disturbed functioning in society, a sense of helplessness, which may lead to lower mood and even depression in obsessive compulsive disorder),
3. derealization and depersonalization, i.e. the patient’s periodic feeling that he or she functions in an unreal world and that his thoughts, or even parts of the body, belong to someone else,
4. nervous tics – involuntary, recurring movements or making sounds that are difficult to control (grimaces, blinking, grunting, etc.)
5. fear of sharp objects, hiding and avoiding them (ajchmophobia),
6. fear of germs (baccylophobia) or fear of dirt (mizophobia), constant washing, avoiding contact with dirt.

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OCD – causes

There is no single cause of OCD. Rather, the disorder is a product of many factors – biological, psychological, and social. The former include, among others, the specific structure and functionality of brain structures, genetic factors, and even inheritance. The obsessive compulsive disorder is particularly associated with the disorder of serotonin transmission.

In addition, the occurrence of the disorder may be associated with angina. There is a link between streptococci and OCD. Throat angina with a high fever caused by streptococcus puts survivors at high risk because the bacteria, in addition to the throat, attack the nuclei of the base of the brain. It is their damage that can lead to obsessive compulsive disorder.

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In the psychological realm, there are theories that associate the onset of obsessive-compulsive disorder with childhood psychoactive development, namely the Freudian anal phase (1-3 years of age), when the child becomes aware of excretion control. Improperly carried out by the caregivers, the process of “descent” can lead the child to a state of emotionality defined on the line of fear – aggression and the conflict of personality structures (id, ego, superego), and consequently to the development of an anankastic personality in him.

In addition, the psychological and behavioral basis of the obsessive compulsive disorder may also be the style of upbringing by the caregivers. If he is strict, high demands are placed on the child, and parental sensitivity is limited, the child develops intellect and self-control, but remains emotionally backward. This causes tension in adults and fears of not meeting their expectations, which are reduced by compulsions and magical rituals of obsessive compulsive disorder.

On the other hand, the psychosocial causes of obsessive-compulsive disorder include an increasing pace of life, a multitude of duties and the pressure of deadlines. What is also important is undervaluation and the feeling of unfulfillment, which significantly lowers self-esteem and leads to tensions and fears. It happens, however, that the appearance of obsessive-compulsive neurosis symptoms is associated with physical injuries to the body, for example postpartum trauma.

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OCD – treatment

Can it be cured? The obsessive compulsive disorder can be overcome with an appropriate course of treatment prescribed by a psychiatrist and with the patient’s attitude. How long does obsessive compulsive disorder treatment take? It is assumed that this process may last from several months to several years.

Two paths are practiced in psychiatry. The first is a therapy that requires the patient’s full commitment. Cognitive behavioral therapy and psychodynamic therapy are the most commonly used. OCD is also treated with medications. These are the so-called serotonin reuptake inhibitors, acting on the basal ganglia. Pharmacological treatment should go hand in hand with therapy, because when administered alone, it only alleviates symptoms, but does not eliminate long-term effects.

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Child obsessive compulsive disorder

Childhood is the moment when OCD can manifest for the first time. As much as 40 percent. cases, the symptoms of the disorder recur in adulthood. There are cases of OCD manifestation already in preschool age. However, they focus only on intrusive behavior. Lack of obsessive thoughts may be related to the inability to reflect them in children.

Diagnosing and treating childhood OCD is difficult because some children’s behaviors are either considered quirky or accepted by their parents (e.g., opening the door regularly when the child refuses to touch the handle with his hand). In turn, teenagers are often ashamed or afraid to talk about their obsessions because of their sexual or aggressive nature.

In the case of children, the treatment of obsessive compulsive disorder is most often used without medication. The results are achieved by meetings with a psychologist, including:

1. cognitive behavioral therapy – exposing the child to uncomfortable situations due to the disorder and teaching him how to deal with anxiety and tension,
2. cognitive strategies – help to distance and realistically assess the symptoms of OCD, strengthen motivation and teach how to deal with anxiety,
3. family meetings – parents also take part in order to get acquainted with the child’s problems and learn to properly respond to obsessions and compulsions.

OCD and pregnancy

At the beginning, it is worth mentioning that OCD is not a contraindication to pregnancy. In this case, there is no risk of miscarriage or of any physical abnormalities in the fetus. However, the psyche is an important sphere, because all anxieties and tensions reflect on the mental condition of the child.

A woman treating OCD in pregnancy should first of all discontinue medication. Pharmacological treatment must, however, be replaced by intensive cognitive-behavioral therapy. Managing obsessions and compulsions is the key to a baby’s health and a happy resolution.

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OCD and other diseases

The obsessive compulsive disorder manifests itself with symptoms that are also typical of other disorders and diseases. It is often associated with tic disease, due to the repetition of movements resulting from impaired motor coordination. Such symptoms also include soft neurological symptoms noticeable in ADHD or schizophrenia.

The obsessive compulsive disorder also has its source in damage to the same part of the brain as in Parkinson’s disease, Sydenham’s chorea or Huntington’s chorea. Sometimes it also accompanies certain phobias. For example, social phobia and obsessive compulsive disorder may occur together.