Obsessive syndrome: symptoms and treatment. What is obsessive-compulsive syndrome?

To date, three out of a hundred adults and two out of five hundred children are diagnosed with obsessive-compulsive disorder. It is an ailment that requires compulsory treatment. We suggest you familiarize yourself with the symptoms of ACS, the causes of its occurrence, as well as possible options for treatment.

What is ACS?

Obsessive-compulsive syndrome (or disorder) - constantly repeated identical obsessive involuntary thoughts and (or) actions (rituals). This condition is also called the obsessive-compulsive disorder syndrome.

The name of the disorder came from two Latin words:

• Obsession, which in literal translation means siege, blockade, taxation;
• Compulsion - coercion, pressure, self-coercion.

Doctors and scientists began to be interested in the syndrome of compulsive states in the XVII century:

• E. Barton gave a description of the obsessive fear of death in 1621.
• Philip Pinel conducted research in the field of obsession in 1829.
• Ivan Balinsky introduced the definition of "obsessive thoughts" into Russian literature on psychiatry and so on.

According to modern research, obsessive syndrome is characterized as neurosis, that is not a disease in the truest sense of the word.

Obsessive-compulsive syndrome can be schematically depicted as the following sequence of situations: obsessions (obsessive thoughts) - psychological discomfort (anxiety, fears) - compulsions (obsessive actions) - temporary relief, after which everything repeats again.

Types of ACS

Depending on the accompanying symptoms, the obsessional syndrome can be of several types:

1. Obsessive-phobic syndrome. It is characterized by the presence of only obsessive thoughts or anxieties, fears, doubts, which do not lead to any actions in the future. For example, a constant rethinking of situations in the past. It can also manifest as a panic attack.
2. Obsessive-convulsive syndrome - the presence of compulsive action. They can be related to the establishment of a permanent order or the tracking of security. By the time these rituals can take up to several hours daily and take a lot of time. Often, one ritual can be replaced by another.
3. Obsessive-phobic syndrome is accompanied by convulsive, that is, obsessions (thoughts) and actions arise.

ACS, depending on the time of manifestation, can be:

• Episodic;
• Progressive;
• Chronic.

Causes of Obsessive Syndrome

Specialists do not give a clear answer to the reasons for which obsessive syndrome may appear. On this account, there is only the assumption that some biological and psychological factors affect the development of ACS.

Biological reasons:

• heredity;
• Consequences of craniocereberal trauma;
• Complications in the brain after infectious diseases;
• Pathology of the nervous system;
• Violation of the normal functioning of neurons;
• Decrease in serotonin, norepinephrine or dopamine in the brain.

Psychological reasons:

• Psychotraumatic relationships in the family;
• Strict ideological education (for example, religious);
• Experienced serious stressful situations;
• Stressful work;
• Strong impressionability (for example, acute response to bad news).

Who is subject to ACS?

The big risk of the appearance of an obsessive syndrome in people in a family who have already seen similar cases is hereditary predisposition. That is, if there is a person with a diagnosis of ACS in the family, then the probability that his nearest offspring will have the same neurosis is between three and seven percent.

Also, the following types of personalities are affected by ACS:

• Overly hypochondriacs;
• Wishing everyone to keep under their control;
• People who have suffered various psychological traumas in childhood or whose families have had serious conflicts;
• People who were overprotected in childhood or, on the contrary, received less attention from their parents;
• Suffered various injuries of the brain.

According to statistics, there is no division according to the number of patients with obsessive-compulsive disorder between men and women. But there is a tendency to the fact that neurosis most often begins to manifest in people aged 15 to 25 years.

Symptoms of ACS

Among the main symptoms of the appearance of obsessive-compulsive disorder are the occurrence of anxious thoughts and monotonous daily actions (for example, a constant fear of an incorrect word or a fear of germs, which often forces washing hands). There may also be accompanying signs:

• sleepless nights;
• nightmares;
• Poor appetite or complete loss of it;
• Gloominess;
• Partial or complete detachment from people (social isolation).

Categories of people by types of compulsions

In most cases, people are subject to the following categories according to the types of compulsions (forced compulsive actions):

1. Pure people or those who are afraid of pollution. That is, patients have a constant desire to wash their hands, brush their teeth, change or wash their clothes and so on. Those who are constantly reinsured. Such people are troubled by thoughts about a possible fire, a thief's visit, and so on, so they have to often check whether doors or windows are closed, whether the kettle, oven, stove, iron and so on are turned off and so on.
2. Sinners who doubt. Such people are afraid to be punished by higher forces or law enforcement agencies, even for the fact that something is not done as impeccably as they think.
3. Almost perfectionists. They are obsessed with order and symmetry in everything: clothes, surrounding things and even food.
4. Collectors. People who can not give up things, even if they do not need them, because of fear that something bad will happen or they will need it sometime.

Examples of manifestation of ACS in adults

How is the "obsessive-compulsive syndrome" diagnosed? Symptoms of the disease can occur in every person in their own way.

The most common obsessions are:

• Thoughts of attacking their loved ones;
• For drivers: worry that they will knock a pedestrian off;
• Anxiety about the fact that it is possible to cause accidental harm to someone (for example, to arrange a fire in someone's house, flood, etc.);
• Fear of becoming a pedophile;
• Fear of becoming homosexual;
• The thought that there is no love for the partner, constant doubts about the correctness of his choice;
• Fear of saying or writing by accident something wrong (for example, using inappropriate vocabulary in conversation with the authorities);
• Fear of not living in accordance with religion or morality;
• Anxious thoughts about the occurrence of physiological problems (for example, with breathing, swallowing, clouding in the eyes, and so on);
• Fear of making mistakes in work or assignments;
• Fear of losing material prosperity;
• Fear of getting sick, getting infected with viruses;
• Constant thoughts about happy or unhappy things, words, figures;
• Other.

Among the common obsessions are listed as follows:

• Constant cleaning and observance of a certain order of things;
• Frequent hand washing;
• Security check (locked locks, electrical appliances, gas, water and so on off);
• Often repeating the same set of numbers, words or phrases in order to avoid bad events;
• Constant check of the results of their work;
• Constant counting of steps.

Examples of manifestation of ACS in children

Children are subject to obsessive-compulsive syndrome much less often than adults. But the symptoms of manifestation are similar, only with the correction for age:

• Fear of being in a shelter;
• Fear of falling behind and losing parents;
• Anxiety for evaluation, which develops into obsessions;
• Frequent washing of hands, cleaning of teeth;
• Complexes in front of peers, overgrown in obsessive syndrome and so on.

Statement of the diagnosis of ACS

Diagnosis of the obsessive-compulsive syndrome is to identify those most intrusive thoughts and actions that have taken place over a long period of time (at least half a month) and are accompanied by depression or depression.

Among the characteristics of obsessive symptoms for the diagnosis are the following:

• At least one thought or action is present in the patient, and he resists them;
• The idea of fulfilling motivation, the patient does not bring any joy;
• Repetition of obsession delivers anxiety.

The complexity of the diagnosis is that it is often difficult to separate the obsessive-depressive syndrome from simple ACS, since their symptoms occur almost simultaneously. When it is difficult to determine which of them appeared earlier, then it is considered to be the primary depression depression.

It will help to identify the diagnosis of "obsessive-compulsive syndrome" test. As a rule, it contains a number of questions related to the type and duration of actions and thoughts typical of a patient with ACS. For example:

• The amount of time spent each day to think about obsessive thoughts (possible answers: not at all, a couple of hours, more than 6 hours, and so on);
• The amount of time spent each day to perform obsessive actions (similar answers, as well as the first question);
• Feelings from obsessive thoughts or actions (possible answers: no, strong, moderate, etc.);
• Whether you control obsessive thoughts / actions (possible answers: yes, no, insignificant, and so on);
• Whether you experience problems with hand washing / showering / cleaning your teeth / dressing / washing clothes / putting things in order / carrying out garbage and so on (possible answers: yes, like everything, no, do not want to do it, constant traction and the like);
• How much time do you spend on the shower, brushing your teeth / hairstyle / dressing / cleaning / taking out garbage and so on (possible answers: like everything, twice as many, several times larger and the like).

To more accurately diagnose and determine the severity of the disorder, this list of questions can be much larger.

The results depend on the number of points scored. More often than more, the higher the probability of obsessive-compulsive syndrome.

Obsessive-compulsive syndrome - treatment

For help in the treatment of ACS, you should contact a psychiatrist who not only helps in the precise diagnosis, but also can identify the dominant type of obsessive disorder.

And how can you overcome obsessive syndrome in general? Treatment of ACS consists of a number of psychological therapeutic measures. Medications here are receding into the background, and often they are only able to support the result achieved by the doctor.

As a rule, tricyclic and tetracyclic antidepressants are used (for example, "Melipramin", "Mianserin" and others), as well as anticonvulsants.

If there are metabolic disorders that are necessary for the normal operation of neurons in the brain, the doctor prescribes special medications for the treatment of neurosis. For example, "Fluvoxamine", "Paroxetine" and so on.

As a therapy, hypnosis and psychoanalysis do not work. In the treatment of obsessive-compulsive disorder, cognitive-behavioral approaches are used that are more effective.

The goal of this therapy is to help the patient stop focusing on obsessive thoughts and ideas, gradually drowning them out. The principle of work is the following: the patient should focus not on anxiety, but on refusal to perform the ritual. Thus, the patient is experiencing discomfort no longer from the obsession, but from the result of inaction. The brain switches from one problem to another, after a few such approaches, the urge to perform obsessive actions subsides.

Among other known methods of therapy, besides cognitive-behavioral, in practice, the technique of "stopping thought" is also used. Patient at the time of the obsession or action is recommended to mentally say to himself "Stop!" And analyze everything from the outside, trying to answer such questions:

1. How strong is the probability that this will happen in reality?
2. Do obsessive thoughts interfere with normal life and how much?
3. How great is the feeling of inner discomfort?
4. Will it become much easier to live without obsessions and compulsions?
5. Will you be happier without obsessions and rituals?

The list of questions can be continued. The main thing is that their goal is to analyze the situation from all sides.

It is also possible that the psychologist will decide to apply another treatment method as an alternative or as an additional help. It already depends on the specific case and its severity. For example, it can be family or group psychotherapy.

Self-help with ACS

Even if you have the best psychotherapist in the world, you need to make the effort yourself. Not so few doctors - one of them, Jeffrey Schwartz, a very famous researcher of the ACS, - note that independent work on one's own condition is very important.

For this you need:

• To study all possible sources about obsessive frustration: books, medical journals, articles on the Internet. Take as much information as possible on the neurosis.
• Practice the skills that your therapist has taught you. That is, try to suppress obsessive ideas and compulsive behavior on your own.
• Keep in touch with family and friends. Avoid social isolation, as it only exacerbates the obsessional syndrome.

And most importantly, learn to relax. Study at least the basics of relaxation. Apply meditation, yoga or other methods. They will help reduce the effect of symptoms of obsessive disorder and the frequency of their appearance.