Obsessive-compulsive neurosis - symptoms and treatment

One of the most common psychological disorders today is neurosis.
This disease can be a constant concern or be episodic, but in any case, neurosis greatly complicates a person’s life. If you do not seek qualified medical help in a timely manner, this disorder can lead to the development of more complex mental illnesses. Neuroses are reversible psychogenic disorders that arise due to internal or external conflicts, emotional or mental stress, as well as under the influence of situations that can cause mental trauma in a person. Obsessive-compulsive neurosis occupies a special place among neurotic disorders. Many experts also call it obsessive-compulsive disorder (OCD), but some doctors separate the two pathologies.

Why is this happening? The fact is that in Russian medicine, for a long time, obsessive-compulsive disorder and OCD were indeed considered different diagnoses. But the international classification of diseases ICD-10 used today does not contain such a disease as obsessive-compulsive disorder; this list of diseases only mentions obsessive-compulsive disorder. That is why recently these two formulations have begun to be used as a definition of the same mental pathology.

A person in this state suffers from intrusive, disturbing or frightening thoughts that arise involuntarily. The main difference between this disease and schizophrenia is that the patient is aware of his problems. He tries to get rid of anxiety through obsessive and tiresome actions. Only a qualified psychotherapist who has experience working with patients who suffer from this form of mental disorder can cure obsessive-compulsive disorder.

Causes of obsessive thoughts and fears

Obsessive-compulsive disorder (OCD), or obsessive-compulsive disorder (OCD), is an anxiety disorder in which the sufferer experiences annoying thoughts and actions.
A person is not able to resist them, so he often does strange things, gets nervous and worries a lot. Among the main causes of the syndrome of obsessive movements and ideas:

• Hereditary predisposition . If one of your relatives had OCD, then the child may also get sick.
• Organic pathologies . It has been found that patients with OCD have characteristic changes in the subcortical structures of the brain and the frontal cortex.
• Experienced psychological trauma . Usually people begin to fear what happened to them or someone they know.
• Disturbances in the production of serotonin in the brain, which leads to the progression of dangerous neurochemical disorders.

External and intrapersonal conflicts, frequent stress, deep belief in the supernatural, inadequately low self-esteem, psychological and physical fatigue increase the likelihood of developing the disease.

During the period of preparation for the treatment of obsessive disorders, it is not always possible to establish the cause of the pathology. This significantly complicates the tasks of doctors drawing up a correction scheme.

Diagnosis of OCD

According to the International Classification of Diseases (ICD-10), to make a diagnosis, it is important that obsessions and/or compulsions have been observed with noticeable frequency for at least two consecutive weeks and are accompanied by a state of distress. Symptoms must have the following characteristics:

• The patient's thoughts or impulses are his own, not caused by external factors.
• There is at least one thought or action that the patient tries unsuccessfully to resist.
• The thought of performing a compulsive action is in itself unpleasant (merely reducing tension or anxiety is not considered pleasant in this sense).
• Thoughts, images, or impulses repeat themselves in a stereotypical manner.

When diagnosing OCD, it is important to separate its symptoms from those of other diseases. Obsessions and compulsions can develop during exacerbations of schizophrenia, as well as with Tourette's syndrome. Problems similar to OCD may also be characteristic of obsessive-compulsive personality disorder. But if people with OCD realize that their obsessive actions are irrational, and they themselves experience discomfort from them, for a person with a personality disorder, the obsessive desire for accuracy is perceived as a manifestation of perfectionism and brings him pleasure.

COST OF TREATMENT FOR MENTAL DISEASES

The duration of treatment in a hospital is from 14 to 90 days, depending on the severity of the disease.
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How to get rid of obsessive thoughts

Stopping obsessive thoughts

Most studies confirm that attempts to stop negative thoughts do not bring the expected results; on the contrary, they intensify obsessions. Therefore, you should focus on rethinking your obsessive thoughts, changing cognitive strategies, and reducing anxiety.

Raise awareness

Thoughts and behavior do not arise by chance. They are the result of deeply ingrained thought patterns or triggers that may or may not be conscious. Being aware of these triggers helps people better manage their reactions. Common triggers include:

• Stress
• Reflections on an event that happened in the past
• Significant life changes (graduation, marriage, birth of a child)
• Receiving bad news (job loss, death of a loved one)
• Sudden and unexpected changes

Changing Thinking Patterns

Most intrusive thoughts are rooted in faulty thinking patterns. Although thoughts may seem realistic and reasonable, all thoughts are always subjective and, accordingly, conclusions are too. Cognitive-behavioral psychotherapy turned out to be the most effective in correcting them .

Coping with fears and anxieties

Behind every obsessive thought lies a strong fear. Fears vary, but they are often based on feelings of loss, abandonment, or general insecurity. These fears are not always completely irrational. Often behind them lies a certain amount of truth, which a person exaggerates so that fear and anxiety become the only reality for him, requiring complete concentration on the threat.

It is worth noting that fear is necessary for all people as an important component of survival; it is what forces people to be alert and active in their environment. Therefore, the goal is not to reduce fear, but to get used to it, figuratively speaking, “train the fear muscle.” Exposure psychotherapy (prevention of exposure and reaction) copes most successfully with this task Please note that it should be used strictly under the supervision of a professional psychotherapist or medical psychologist in order to avoid unforeseen negative effects. This is believed to be the most effective way to reduce the frequency and intensity of intrusive thoughts.

Additionally, mindfulness and acceptance psychotherapy, desensitization, relaxation methods on the recommendation of a psychotherapist or medical psychologist, and other methods can be used.

In this case, individual psychotherapy is often aimed at:

• creating a favorable space for processing psychological trauma, life difficulties and stressors,
• stabilization of the emotional background, development of adequate healthy emotional reactions,
• identifying individual triggers of obsessive thoughts,
• changing reactions to other sources of stress (relationships, work, self-esteem problems, depression, anxiety disorders) that may contribute to maladaptive thinking,
• developing and implementing healthier coping skills,
• increasing self-esteem and building a working model of keeping it at a healthy level;
• changing and practicing a new way of thinking,
• providing a supportive space to process past traumas
• in more complex cases, psychotherapy will be aimed at treating other concomitant mental disorders (anxiety disorder, depression, eating disorder, PTSD, etc.).

Psychotherapy methods are selected individually in each specific case, taking into account symptoms, concomitant disorders, individual characteristics of a person with obsessions, and are recommended at the first psychotherapeutic consultation.

Drug treatment

Pharmacological treatment may temporarily reduce symptoms, but non-pharmacological psychotherapy or a combination of these approaches must be used to achieve long-term remission. A psychotherapist may prescribe antidepressants, anxiolytics, antipsychotics, antipsychotics or other drugs, depending on each specific case. Self-medication is unacceptable, as is the prescription of medications by other specialists (even with medical education) in order to avoid unaccounted negative side effects and aggravation of health problems.

Stages

Doctors distinguish three stages of development of the disease:

• The first one . Fear and negative thoughts arise only when a person is directly confronted with a traumatic situation.
• Second . The worries are becoming more and more frequent. The patient often has thoughts that something bad will happen to him or that he needs to do something urgently.
• Third . The patient is unable to get rid of bad thoughts on his own. They constantly pester him, which makes a normal lifestyle and productive work activity impossible.

OCD is most easily corrected at the first stage. In advanced cases, doctors have to put in much more effort to help the person.

Signs of obsessional neurosis

Among the signs characteristic of the disorder:

• obsessive fears that have no good reason;
• harassing thoughts and judgments;
• obsessions;
• actions of the same type, reminiscent of a ritual.

Patients with OCD may be afraid of getting infected with something, meeting someone, or not liking someone. Many of them have a painful form of perfectionism. Then a person tries to achieve ideal order and cleanliness in everything. The most common “rituals” are checking whether the front door is closed, whether the gas stove or lights are turned off. A sick person may wash their hands too often or look out the window.

Patients often come up with very unusual rituals - for example, they squat three times before putting on their shoes, or turn around their axis several times before entering the apartment. This behavior seems very strange to others.

Symptoms of obsessive-compulsive disorder

Obsessions, or intrusive thoughts

Obsessions are recurring thoughts, images, or urges that cause anxiety, worry, shame, or disgust. They arise uncontrollably, and patients cannot drive them away through logical arguments. A person with OCD tries to suppress such obsessions by “interrupting” them with other thoughts or actions. Typical obsessive thoughts in OCD are the fear of contamination, the need for symmetry or precision, certain immoral ideas or impulses that are alien to the personality of the patient himself. Obsessions can be triggered by any events that somehow indirectly remind of their object - for example, an extraneous cough, contact with a “non-sterile” object (handrails, door handles, etc.)

Compulsions, or obsessive actions

To combat obsessions, OCD patients perform defensive, repetitive actions (compulsions). Compulsions are similar to peculiar rituals that “prevent” the embodiment of negative thoughts and fears. Washing hands too often, wiping objects, constantly checking electrical appliances, repeating words, counting. For example, to make sure that the door is locked, a person with OCD needs to pull the door handle a specific number of times (and count the times). After such a ritual, the patient feels relief for a while, but then the obsessive thoughts return, and everything repeats again and again. In severe cases, compulsions can take up a huge amount of the patient's time, interfering with daily activities. A patient with OCD describes his condition as follows:

I've always had a terrible fear of bacteria, to the point where I washed my hands dozens of times a day, but I didn't think it had anything to do with OCD. Then it became unbearable for me to be at home in the same clothes in which I went out, I could not eat bread in the place where I grabbed it with my hands, I carefully examined all the dishes before using them. It began to take up more and more time and attention and interfered with my life.

At the same time, compulsions are often accompanied by a feeling of depression and melancholy, because a person with OCD does not lose the awareness that such actions are irrational and meaningless.

What are obsessions and compulsions?

Most often, obsessive thoughts and fears are centered around certain topics. The most common of them are cleanliness and sterility, perfectionism, loss of control, religiosity, and forbidden sexual acts. The rituals that “protect” a person with OCD from these thoughts and “prevent” fears can vary. Most often, the nature of the obsession determines a certain type of compulsion.

It has been noticed that the stronger the patient’s desire to resist obsessive thoughts, the more clearly the obsessive-compulsive neurosis manifests itself. The efforts not only do not give the desired result, they further aggravate the problem - the obsessions return in an even more pronounced form.

When such conditions occur, it is very important not to try to cope with the problem on your own - only a doctor can provide effective professional assistance.

Symptoms of obsessive disorders

People who suffer from OCD complain of:

• intrusive thoughts that occur too often;
• internal experiences;
• increased level of aggression;
• worries about loved ones;
• fear of possible events;
• inability to resist obsessions;
• inability to relax;
• insomnia.

Psychologists have noticed that people of a melancholic temperament, who are suspicious, worry about trifles and take any problems very seriously, are more likely to experience the disorder. They are unsettled by any stress or conflict.

Dealing with the disorder

The basis of treatment for obsessive-compulsive neurosis is psychotherapy. It is very important to carry out deep work with the patient’s psyche in order to achieve positive dynamics. A psychotherapist helps you overcome:

• depressive ideas;
• pessimism;
• anxiety;
• obsessive thoughts.

To achieve this, she conducts group, individual and cognitive behavioral therapy sessions. In some cases, music therapy and art therapy are used. If the case is advanced, additional medications are used.