Compulsions - depending on their severity - have a considerable impact on the daily lives of those affected. An example: The patient washes their hands intensively several times in a row. He repeats this behavior every hour. If he does not give in to the impulse to wash, he becomes restless and anxious. His thoughts revolve around washing his hands.
From a medical point of view, obsessive-compulsive disorder is characterized by the following symptoms:
- Obsessive thoughts belong to the category of content-related thought disorders. The same thoughts keep coming back to those affected. They also recognize them as nonsensical, but are unable to influence or stop the thought process. They brood, have doubts or have to keep repeating certain thoughts. Obsessive thoughts also include a compulsion to count. Patients have to count certain objects over and over again, such as the stairs in the hallway or the bananas in the supermarket.
- Compulsive impulses: Those affected feel the urge to perform a certain action. However, as these actions are usually of an aggressive or sexual nature, they are not usually put into practice. However, those affected are always afraid that they will give in to this compulsive impulse and actually carry out the corresponding action.
- Compulsive acts: Those affected feel compelled by an inner impulse to perform precisely defined actions. For example, they have to constantly wash their hands or check several times before leaving the house that all electrical appliances are switched off. If they fail to perform these actions, they feel a strong inner restlessness or even anxiety.
Physical symptoms also occur as a result of the compulsive behavior. For example, patients with a washing compulsion often develop eczema. The skin becomes inflamed due to frequent hand washing and the use of aggressive cleaning agents.
Common themes of compulsions are
- Fear of poisoning,
- illness,
- striving for order,
- aggression and
- sexuality.
Between one and two percent of the population develop OCD in the course of their lives.
People with obsessive-compulsive disorder often suffer from other psychological complaints. The compulsions put a strain on the patient, which is why around ten to fifteen percent also develop depressive symptoms. Anxiety disorders or obsessive-compulsive personality disorders also accompany OCD.
When the patient consults a doctor, he or she will ask about the patient's exact medical history in a detailed interview, the so-called anamnesis. If the obsessive thoughts, compulsive actions or compulsive impulses interfere with the patient's life to a considerable extent, a diagnosis of obsessive-compulsive disorder can be made.
Still normal or already obsessive?
You love order and cleanliness. Those around you are amused or complain about your eagerness to clean. Are you wondering whether your behavior has taken on obsessive-compulsive traits?
The renowned Springer publishing house offers a short self-test on the Ärztezeitung website. It consists of five questions that give you a rough orientation. Please note: The test is in no way a substitute for a visit to the doctor.
As with many mental illnesses, the causes of obsessive-compulsive disorder are not yet fully understood. However, it appears to be a multifactorial process, meaning that several factors are involved in its development. Researchers therefore speak of a bio-psycho-social model of development.
Genetic predisposition plays a decisive role in the development of the disease. Various studies have shown that a certain genetic constellation can increase the risk of developing the disease. There is also a higher incidence of the disease within affected families. However, this does not mean that the disease is directly inherited. Even with a corresponding genetic predisposition, OCD does not necessarily have to break out.
There are also various theories from the field of biology that are dedicated to the development of obsessive-compulsive disorder. According to the serotonin hypothesis, obsessive thoughts and compulsive actions are based on a disturbed serotonin metabolism. The neurotransmitter dopamine also appears to play a role. There is also evidence that certain regions of the brain, the so-called basal ganglia, are dysfunctional in people with obsessive-compulsive disorder.
In recent years, it has emerged that obsessive-compulsive symptoms can be caused by infections with streptococci or other bacteria in childhood. In addition to these biological and immunological factors, the person's emotions and learning experiences are also relevant. Patients are usually unable to cope well with unpleasant emotions and develop other support mechanisms. According to representatives of behavioral psychology, however, compulsions are simply learned and can be corrected through appropriate therapy.
Both medication and psychotherapeutic procedures can be considered as treatment options. Doctors achieve the best results with so-called combination therapy. This involves combining medication and psychotherapy. Selective serotonin reuptake inhibitors (SSRIs) are primarily prescribed for obsessive-compulsive disorder. They bring the serotonin metabolism in the brain back into balance.
In cognitive behavioral therapy, patients actively deal with their compulsions with the help of the therapist. They learn to cope with anxiety and stress and practise alternative strategies to avoid giving in to their compulsions. The treatment guideline for obsessive-compulsive disorder - developed by the German Society for Psychiatry and Psychotherapy, Psychosomatics and Neurology (DGPPN) - shows that the effectiveness of cognitive behavioral therapy is well documented.
Anyone searching the internet for self-help strategies will inevitably come across dubious offers. The Deutsche Gesellschaft für Zwangserkrankungen e.V. (German Society for Obsessive-Compulsive Disorders) warns on its website against dubious treatment offers, especially in relation to compulsions.
How can you recognize such offers?
You should be wary of the following criteria:
- The method is praised as the only effective one.
- Conventional medical therapies are considered ineffective.
- Critical questions are not answered.
- Promises such as "free of xxx in three days" or "overcome xxx quickly and easily".
- High fees
Alternative practitioners and naturopathy: Is this recommendable?
Modern therapeutic approaches such as behavioral therapy offer well-founded methods to combat compulsions. Alternative methods, such as acupuncture or naturopathy, can be used as a supplement in individual cases.
Treatment by a reputable alternative practitioner can help to alleviate the side effects of psychotropic drugs. ATTENTION: In any case, you must discuss the alternative treatment with your doctor in advance. The alternative practitioner must also be aware of the conventional medical therapy. Otherwise there is a risk of undesirable interactions.
Naturopathy or medicines with the suffix "natural" are regarded as gentle methods with no side effects. However, their effectiveness and some side effects or intolerances should not be underestimated.
The chances of success vary. In around half of all cases, the disease can be cured or at least contained to such an extent that patients can lead a largely normal life. The earlier and more consistently the OCD is treated, the better the prognosis.
The Bundesverband der Angehörigen psychisch erkrankter Menschen e.V. (Federal Association of Relatives of People with Mental Illness ) offers relatives comprehensive information and help. The offer ranges from brochures for initial orientation to personal e-mail 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 will also find all the important information and receive personal advice.
