What is Obsessive Compulsive Disorder + Symptoms and Treatment

Obsessive-compulsive disorder is a mental illness that is classified as an anxiety disorder, such as phobias or anxiety states. It is characterised by the presence of obsessions and compulsions.

OCD is the second most common disorder after depression and occurs more frequently than, for example, panic disorder or schizophrenia.

Obsessions are defined as recurrent thoughts or ideas that are bothersome and cause anxiety or discomfort.

Obsession = obsessive, compulsive, intrusive thought, morbidly fixed idea
Obsessive = compulsive, insistent, intrusive
Obsessive = insistent, compulsive

An individual afflicted with such a disorder tries to suppress and ignore these thoughts by replacing them with other thoughts or actions.

The second component is compulsions, which are defined as stereotypically repetitive behaviors and actions in which the individual feels compelled to perform them constantly.

Compulsions = the senseless performance of certain movements that the sufferer cannot resist

Compulsions are intended to eliminate anxiety and fear. The individual assumes that if performed, they will serve as a prevention against what he or she fears, such as death, illness, or other misfortunes.

Obsessions and compulsions cause significant discomfort and disruption in various social and occupational activities. They cannot explain the symptoms of another mental disorder, nor can they be attributed to the physiological impact of another substance such as a drug or other medication.

OCD has many faces, but the style and way of thinking and behaving is very similar in people who suffer from it. As far as gender is concerned, women are more likely to be affected by this disorder in adulthood, unlike men, who are more likely to develop it in childhood.

Obsessive-compulsive disorder affects one in 50 people. It affects about 2-4% of the population, equally in men or women. It appears on average at the age of 19.5 years.

Basic types of obsessive compulsive disorder

There are different types of obsessive compulsive disorder.

The table lists the forms of OCD

Prevalence in children

As mentioned above, obsessive-compulsive disorder also occurs in children. The first symptoms of the disorder can appear as early as around the age of 7. However, it is most pronounced during puberty.

Children who worry unnecessarily or who cannot accept criticism and find it difficult to cope with are particularly at risk. Parents, on the other hand, are also involved, because they criticise excessively and want to turn the child into a perfectionist. The child's self-esteem consequently declines.

What are the manifestations of this disorder in children?

The most common obsessions include:

• disturbing sounds or words
• fear of disease, viruses and germs
• happy and unhappy numbers
• religious obsessions
• fear of dirt and contamination
• sexual or aggressive thoughts
• need for order and symmetry

Manifestations of compulsions:

• Frequent hand washing, showering, brushing teeth
• counting rituals
• touching
• gathering and collecting unnecessary things
• repetitive rituals, e.g. going in and out of the house, etc.
• checking rituals, e.g. whether the door is locked, whether he has finished his schoolwork, etc.

Children often hide these problems and behaviours very well, especially from their parents. Most parents are completely unaware of their problem for several months.

Sometimes it happens that the children start to involve the parents in the rituals themselves. The child does something and the parent has to repeat it. If this does not happen, the child has a tantrum, panic and worry.

Parents should especially notice dry, cracked hands on their children, which is caused by excessive hand hygiene. Also, rapidly disappearing soap. Long periods of time spent on homework when they still do poorly in school.

Children suffering from this disorder are constantly worried about something bad happening. Therefore, they are constantly checking on their family members and loved ones. They also have an unrelenting fear of illness.

The definite cause of this disease is unknown. Several factors are involved in the onset and development of the disease.

The main cause is a problem with the transmission of information through serotonin, a substance that helps to transmit nerve signals in the brain, thereby affecting feelings of happiness, well-being, sleep and body position.

Genetic predisposition is a very important factor, as is the influence of upbringing and the environment in which the child grows up. A lack of a sense of security and an overly critical upbringing lead to feelings of insecurity.

If a child has a genetic predisposition to develop OCD, this upbringing may contribute to the development of the illness. A stressful lifestyle also promotes the development of the illness.

Stress and an unhealthy lifestyle are risk factors for developing it.

Most often it is a constant checking of certain things, whether it is a locked door or the stove being turned off. Repeating the same actions and constantly counting (e.g. stairs).

There is also very often a fear of getting dirty, so hand hygiene is very common.

Nonsensical words or phrases are repeated in the patient's head. If he does not do what his thoughts tell him to do, he feels very tense or anxious. He feels that something bad will happen if he does not do it.

The thoughts can often be magical in nature.

Main symptoms:

• behavioural changes (behavioural disorders)
• Exhaustion
• anxiety
• meticulousness (perfectionism)
• concentration disorders (attention disorders, concentration disorders)
• shyness
• preference for routine activities
• inability to think rationally
• nervousness
• restlessness
• increased activity (hyperactivity)

The diagnosis is made solely by the psychiatrist on the basis of the patient's history (interview). The doctor focuses on the presence of obsessive and compulsive thoughts and rituals, specifically whether they interfere with everyday life.

He finds out how long the patient has had the symptoms. He examines the disruption of daily activities and also the level of anxiety. Very often the Zohar-Fineberg obsessive-compulsive screening is used, which includes 5 questions.

These are questions such as:

• Do you wash often or do you wash frequently?
• Do you often check things, situations?
• Do you have any thoughts that bother you that you would like to get rid of but can't?
• Does it take you a long time to stop your normal activities?
• Do you worry or dwell too often on orderliness and symmetry?

After completing this test, which can be done not only by the psychiatrist himself, but also, for example, by a nurse or other doctor, we can come to the following conclusion.

If the patient has one positive answer, he or she is immediately referred to a specialist for a more detailed and detailed examination followed by a final diagnosis.

In practice, it takes on average 7 years from the onset of symptoms before a patient seeks treatment. This is true even if the symptoms are so severe that they significantly affect social and work activities.

In practice, we also find that some people suffer only from intrusive thoughts without subsequent compulsions. They do not take any action to forget the intrusive ideas.

The compulsions may be less noticeable: counting numbers and things, repeating certain words, praying (for any little thing).

However, the thoughts are often of a threatening nature, such as the need to hurt someone or to commit a violent sexual act. Experiencing anxiety also brings with it physical manifestations. The sufferers experience:

• changes in heart rate or blood pressure
• increased muscle tension
• excessive sweating
• trembling of the limbs
• diarrhoea

How to prevent relapses?

In OCD, relapse (a return even after complete cure) can happen very often. After stopping medication, relapse is quite common.

Up to 80% of individuals are at risk of relapse if they stop medication prematurely. Therefore, treatment should be continued for some time after the symptoms have disappeared.

However, relapse can be manifested by the reappearance of obsessions, compulsions, anxiety and tension.

What is life like after recovery?

If the individual has successfully recovered, he or she should continue to try to avoid stressful situations and to be mindful of his or her behaviour.

Education by medical personnel about how the disorder itself arises and how the person can learn to live with the bothersome thoughts and feelings is also very important.

It is essential that the individual learns to perform various relaxation techniques. Also, there are alternating phases of improvement and deterioration in this disorder.

A complete cure of the disorder is very rare and less likely. However, an individual affected by this disorder can still lead a full life.

With therapy and prevention, he or she can learn to accept his or her illness for what it is and to control his or her actions and thoughts.

What should a person suffering from OCD know?

There is absolutely no reason to be ashamed of this disorder. It is important to realize that obsessions and compulsions are the result of an illness that is out of control and not the result of a weak will!

In total, about 100 million people in the world suffer from this disorder, so surely no one is alone.

Individuals should always be open about their thoughts and feelings, even with their doctor, although sometimes this may not always be comfortable for obvious reasons.

Treatment is long-term, taking several months to years. That is why patience is particularly important.

The most effective treatment is a combination of pharmacotherapy and cognitive behavioural therapy. This therapy in particular requires your courage, perseverance and systematicity.