Depending on their severity, compulsions can significantly interfere with the daily lives of those affected. For example, a patient may wash their hands thoroughly several times in a row.
He repeats this behavior every hour. If he does not give in to the compulsion to wash his hands, he becomes restless and his anxiety increases. His thoughts revolve around the topic of handwashing.
From a medical perspective, obsessive-compulsive disorder is characterized by the following symptoms:
Obsessive thoughts are a type of thought disorder. Those affected are repeatedly plagued by the same thoughts. They recognize these thoughts as nonsensical but are unable to influence or stop the thought process. They brood, have doubts, or feel compelled to repeat certain thoughts constantly.
Compulsive counting is also a form of obsessive thought. In this case, patients feel compelled to count certain objects over and over again, such as the stairs in the hallway or the bananas at the supermarket.
Compulsive impulses: Those affected feel an urge to perform a specific action. Since these are usually aggressive or sexual acts, they do not act on them.
Those affected are constantly afraid that they will give in to this compulsive impulse and actually carry out the act.
Compulsive behaviors: Those affected feel compelled by an inner impulse to perform precisely defined actions.
They constantly wash their hands or check multiple times before leaving the house to make sure that electrical appliances are turned off. If they fail to perform these actions, they feel intense inner restlessness or even anxiety.
Physical symptoms also arise as a result of the compulsive behavior. For example, patients with a washing compulsion often develop eczema. The skin becomes inflamed due to frequent handwashing and the use of harsh cleaning agents.
Common themes of compulsions include:
- Fear of poisoning
- Illness
- A desire for order
- Aggression and
- Sexuality
Between one and two percent of the population will develop obsessive-compulsive disorder at some point in their lives.
People with obsessive-compulsive disorder often suffer from other mental health issues. The compulsions take a toll on patients, which is why about 10 to 15 percent also develop depressive symptoms.
Anxiety disorders or obsessive-compulsive personality disorders may also co-occur with OCD.
When a patient consults a doctor, the doctor conducts a detailed interview—known as a medical history—to determine the exact course of the illness.
If the obsessive thoughts, compulsive behaviors, or compulsive urges significantly impair the person’s life, a diagnosis of obsessive-compulsive disorder is made.
Still normal or already compulsive?
You love order and cleanliness. The people around you either find it amusing or complain about your zeal for cleaning. Are you wondering if your behavior might have taken on compulsive traits?
The renowned Springer-Verlag offers a short self-test on the Ärzte Zeitung website. It consists of five questions that provide you with a rough guide. Please note: This test is in no way a substitute for a visit to the doctor.
As with many mental illnesses, the causes of obsessive-compulsive disorder (OCD) are not yet fully understood. However, it appears to be a multifactorial condition, meaning that several factors are involved in its development. Researchers therefore refer to a biopsychosocial model of its origin.
Genetic predisposition plays a decisive role in the development of the disorder. Various studies show that a specific genetic combination can increase the risk of developing the disorder.
Furthermore, a clustering of cases within affected families has been observed. However, this does not mean that the disorder is directly hereditary. Even with a corresponding genetic predisposition, OCD does not necessarily have to develop.
In the field of biological research, there are also various theories dedicated to the origins of obsessive-compulsive disorder.
According to the serotonin hypothesis, obsessive thoughts and compulsive behaviors are based on impaired serotonin metabolism. The neurotransmitter dopamine also appears to play a role.
There is also evidence that certain brain regions (basal ganglia) are dysfunctional in people with OCD.
It is also possible that obsessive-compulsive symptoms may arise from infections with streptococci or other bacteria during childhood.
In addition to these biological and immunological factors, the individual’s emotions and life experiences are also relevant.
For example, patients are often unable to cope well with unpleasant emotions and develop alternative coping mechanisms.
According to behavioral psychologists, however, compulsions are simply learned behaviors and can be corrected through appropriate therapy.
Treatment options include both medication and psychotherapeutic approaches. Doctors achieve the best results with what is known as combination therapy.
This approach combines medication and psychotherapy. Selective serotonin reuptake inhibitors (SSRIs) are primarily used to treat obsessive-compulsive disorder. They restore balance to serotonin metabolism in the brain.
In cognitive behavioral therapy, patients actively address their compulsions with the help of their therapist. They learn to tolerate anxiety and stress and practice alternative strategies to avoid giving in to their compulsions.
The German Society for Psychiatry and Psychotherapy, Psychosomatics, and Neurology (DGPPN) has developed treatment guidelines for obsessive-compulsive disorder. These guidelines show that cognitive behavioral therapy is highly effective.
Anyone searching the internet for self-help strategies will inevitably come across dubious offers. The German Society for Obsessive-Compulsive Disorders (Deutsche Gesellschaft für Zwangserkrankungen e.V.) warns on its website against dubious offers for the treatment of compulsions.
How can you recognize such offers?
You should be on your guard if you encounter the following criteria:
- The method is presented as the only effective one.
- Conventional medical therapies are claimed to be ineffective.
- Critical questions go unanswered.
- Promises like “free of xxx in three days” or “overcome xxx quickly and easily.”
- High fees
Alternative practitioners and naturopathy: Is this recommended?
Modern therapeutic approaches, such as behavioral therapy, offer well-established methods for treating compulsions. Alternative methods, such as acupuncture or naturopathy, can be used as complementary treatments in individual cases.
Treatment with a reputable naturopath can help alleviate the side effects of psychiatric medications. CAUTION: In any case, you must discuss the alternative treatment with your doctor in advance.
The naturopath must also be familiar with conventional medical therapy. Otherwise, there is a risk of unwanted interactions.
Naturopathy or medications labeled “natural” are considered gentle, side-effect-free methods. However, their effectiveness—as well as certain side effects or intolerances—should not be underestimated.
The chances of success vary. In about 50% of cases, the disorder is curable or can be alleviated to the point where patients can lead largely normal lives. The earlier and more consistently OCD is treated, the better the prognosis.
The Federal Association of Relatives of People with Mental Illness (Bundesverband der Angehörigen psychisch erkrankter Menschen e.V.) offers comprehensive information and support to family members. Services range from brochures providing initial guidance to personalized email or telephone counseling (“SeeleFon”).
For those affected, there is, for example, the German Society for Obsessive-Compulsive Disorders (Deutsche Gesellschaft für Zwangserkrankungen e.V.). Here, you can also find all the important information and receive personalized counseling.
