Conditions Obsessive-compulsive disorder

Almost everyone occasionally does something they know is actually excessive and not at all necessary. For instance, checking twice before a trip to make sure the stove is actually turned off. However, there are people who perform such behaviors compulsively. Compulsively means that when they perform the behavior, they feel uncomfortable or under pressure, or become afraid.

This type of compulsion can become so strong that, over time, it comes to dominate a person’s entire life. There are many different forms of obsessive-compulsive disorder. For instance, some people constantly wash their hands. Others constantly have to count things, clean their apartment, or play the same thought over and over in their mind. Whatever ritual someone has developed, people with obsessive-compulsive disorder are unable to stop doing it.

An obsessive-compulsive disorder expresses itself in the form of obsessive thoughts and compulsive behaviors.

Obsessive thoughts are unwanted and constantly recurring, debilitating thoughts that push their way into the forefront of a person’s mind. Typical obsessive thoughts include agonizing worries about having forgotten something or becoming infected with germs. Some people also have an obsessive fear of behaving inappropriately or harming themselves or others.

Compulsive behaviors or acts are described as rituals that people with an obsessive-compulsive disorder frequently repeat. The aim of these rituals is to make the debilitating obsessive thoughts go away and become calm again.

For example, people who develop a washing or cleaning compulsion are afraid of dirt and the transmission of diseases. This leads them to constantly wash their hands or clean their home.

People with compulsive orderliness are convinced that objects on a desk, on shelves or in the home as a whole must be located in a certain place facing a certain way. People with compulsive hoarding cannot throw anything away. It can reach the point where they can no longer even dispose of their trash. A compulsion to count is also typical: Those who are affected find temporary relief, for instance, by repeatedly counting up to 20. When people with obsessive-compulsive disorder try to suppress these behaviors, they become restless, tense, and filled with anxiety.

Many people who have obsessive thoughts and compulsive behaviors realize themselves that they are excessive or meaningless. However, they find that willing themselves to go against their compulsions doesn’t help eliminate these thoughts or behaviors. This often leads to feelings of powerlessness, which intensifies their anxiety. Some people even fear that they will “go mad”.

It is likely that people develop an obsessive-compulsive disorder due to a combination of several factors, which presumably include a history of OCD in the family (i.e., genetic predisposition), physical factors and external circumstances.

For example, an obsessive-compulsive disorder may develop as a result of a trauma or severe life crisis. Some people with OCD have experienced severe childhood trauma, for example due to repeated abuse or the death of parents.

Certain personality traits may also favor the development of an obsessive-compulsive disorder. Some people with obsessive-compulsive disorders have a strong sense of responsibility and are especially conscientious. They are sometimes very afraid of making mistakes.

However, the causes can vary from person to person.

It is estimated that up to 3 percent of people in Germany will develop an obsessive-compulsive disorder at some point in their lives. Obsessive-compulsive disorders often develop in childhood or adolescence. However, they can, in principle, develop at any stage of life.

An obsessive-compulsive disorder develops over time rather than suddenly. Many people with compulsions only gradually realize that their rituals are taking more and more time and energy. An advanced obsessive-compulsive disorder may lead to problems in a person’s job, private life or relationship. For many people with OCD, their entire lives eventually become controlled by compulsions and rituals.

Everyone who develops an obsessive-compulsive disorder does so in a distinctly different way. The symptoms can temporarily abate only to intensify again. Some people can also go weeks or months without symptoms. In addition, the type of compulsions they experience can change over time.

If left untreated, an obsessive-compulsive disorder often becomes chronic. Some people require professional help in order to deal effectively with their compulsions and to cope with everyday life.

In adulthood, obsessive-compulsive disorders are often less persistent than in children and adolescents. If obsessive-compulsive disorder remains untreated, 4 out of 10 adolescents will feel better after five years. However, many people need professional help to get their compulsions under control.

An obsessive-compulsive disorder is sometimes not so easy to distinguish from another disorder with similar symptoms. For example, a person who constantly worries about the future may also have a generalized anxiety disorder.

An obsessive-compulsive disorder may also occur alongside other mental illnesses and problems. Many people with an obsessive-compulsive disorder have depression at the same time. Both illnesses can then make each other more intense.

To get a reliable diagnosis, it is important to arrange an appointment at a medical or psychotherapeutic practice. The consultation will include, in particular, questions about what type of obsessive thoughts and compulsive behaviors are occurring – for example:

• Do you repeatedly get certain thoughts or images in your mind that you try in vain to get rid of?
• What do you do to make these thoughts and images go away?
• Do you feel as though your actions are pointless or excessive?
• Do you have the impression that you have to do certain things repeatedly against your will?

Sometimes, there are also physical signs that may indicate obsessive-compulsive disorder, for example very dry skin in people with a compulsion to wash.

Psychotherapy helps to alleviate obsessive thinking and compulsive behavior to the extent that people can begin to live a normal life again. However, obsessive-compulsive disorders cannot be cured.

The most common type of psychotherapy used for OCD is cognitive behavioral therapy. In Germany, it is provided by behavioral therapists.

Medication may also be an option alongside psychotherapy. Antidepressants are usually prescribed – these are drugs that are normally used to treat depression. These primarily include medications known as selective serotonin reuptake inhibitors (SSRIs). The tricyclic antidepressant clomipramine is another option, although not as a first choice. Doctors may also prescribe these drugs to bridge a waiting period until the person can begin psychotherapy.

In addition to these treatments, there are self-help options, such as sharing experiences with others affected in a self-help group. Some people also find that high-quality information from books or websites helps them cope with their compulsions. Others try to get their symptoms under control using mindfulness exercises, relaxation techniques – such as meditation, autogenic training, breathing exercises – or physical activity.

For severe obsessive-compulsive disorder, repetitive transcranial magnetic stimulation (rTMS) is an option – though only if psychotherapy and medication prove ineffective. During this procedure, magnetic pulses are directed into the brain from the outside. If the compulsions are very severe and persistent, deep brain stimulation is also an option. During this procedure, electrodes are implanted in the brain to stimulate nerve cell activity.

You can read more detailed information about treating an obsessive-compulsive disorder at gesundheitsinformation.de.

An obsessive-compulsive disorder is often debilitating and can be very time-consuming. The compulsions can even become so intense that a normal life is no longer possible. Many people with an obsessive-compulsive disorder feel ashamed of their obsessive thoughts or compulsive acts. As a result, many try to hide their compulsions from others. This can be extremely draining for them.

People with an obsessive-compulsive disorder often wait for a long time before getting help and telling their partner or other loved ones. Some worry that people knowing about their illness could have a negative impact or their career or home life. Following successful treatment, many regret not seeking help sooner.

An obsessive-compulsive disorder also affects the behavior of loved ones. For example, they may feel compelled to follow certain patterns to avoid making the sufferer nervous about what they perceive as a lack of order.

Parents in particular often feel guilty for not noticing their children’s compulsions earlier. However, it is normal for OCD not to be detected by loved ones immediately. There are various reasons for this. For example, some people with an obsessive-compulsive disorder do their utmost to conceal it. Others fail to recognize their own compulsions themselves for a long time or don’t want to accept any help.

However, family and close friends can provide an important source of support, as close relatives, life partners or close friends usually tend to be more understanding than others. If loved ones are included in therapy, it can be easier to face up to fears and compulsions. In the long term, this can also be an important factor for maintaining the success that has been achieved by the end of therapy.

Self-help groups offer people with obsessive-compulsive disorder and their relatives a way of obtaining information and advice, and of sharing personal experiences. This type of communication often helps people to cope better with their compulsive impulses. Some also find it helpful to consult books and websites that provide good, serious information on the topic of obsessive-compulsive disorders.

You will find a database of suitable self-help groups on the website of the National Contact and Information Point For Self-Help (Nationale Kontakt- und Informationsstelle für Selbsthilfe, NAKOS).