Out of control body - Is "obsessive compulsive disorder" really a disease? How to deal with obsessive compulsive disorder?

Author: Xu Wei, Zhongda Hospital Affiliated to Southeast University

Reviewer: Dong Liping, Chief Physician, Subei People's Hospital, Jiangsu Province

1. What is obsessive-compulsive disorder?

Is your brain out of control, with recurring unwanted thoughts or images? Does it cause you mental anxiety and pain?

Do you feel driven to perform specific behaviors or mental activities repeatedly? Perform the following behaviors.

1. Cleaning Repeated washing of hands, bathing, or cleaning of household items, usually for several hours.

2. Check Check and recheck every day that the door is locked, the coffee machine is turned off, the hair dryer is unplugged, etc.

3. Repetition: Inability to stop repeating a name, phrase, or simple activity (e.g., walking through a doorway over and over).

4. Hoarding Having difficulty discarding useless items, such as old newspapers or magazines, bottle caps, or rubber bands.

5. Touching and arranging must be precise and neat, and objects must be placed in a certain order; when climbing stairs, the steps corresponding to the left and right feet must follow the rules of odd and even numbers.

6. Mental Activities Endlessly reviewing conversations, counting or praying, and using special words or phrases.

Figure 1 Copyright image, no permission to reprint

If you experience any of the above symptoms, you may be suffering from obsessive-compulsive disorder.

Some people may have obsessions and/or compulsions at some point in their lives, but this does not mean they have OCD. To make a more accurate diagnosis, it is important to determine whether the cycle of obsessions and/or compulsions is very typical. Usually, obsessions and/or compulsions consume a lot of time (lasting at least 1 hour per day), cause intense distress to the person, or interfere with important activities and relationships.

In addition, obsessive-compulsive symptoms may not be obvious to be observed. Some successful people in society may be silently fighting against obsessive-compulsive disorder and are afraid to let others know. It is difficult for people with obsessive-compulsive disorder to stop self-criticism, and they are always trapped in the identity of perfectionists. Some people with obsessive-compulsive disorder appear to behave normally on the surface, but they are constantly struggling, distressed, and talking to themselves in their hearts.

"I feel like I have obsessive thoughts and compulsive behaviors sometimes, but I think normal people also have these symptoms, just not as severe, right?"

The characteristics of obsessive-compulsive symptoms in normal people are: ① They are short-lived and sometimes present and sometimes absent; ② They are mild and do not affect normal life and work; ③ They do not take the initiative to restrain those obsessive-compulsive symptoms.

The obsessive-compulsive symptoms of patients with OCD are: ① more frequent (more than 1 hour per day on average); ② more intense (seriously affecting study and life); ③ more distressing and anxious (weakening various psychological functions).

As a common mental illness among young people, obsessive-compulsive disorder not only causes patients to suffer from the disease, but also brings great pain to their families. Some families have fallen apart because of obsessive-compulsive disorder.

A real case in the clinic: parents live with their son who suffers from obsessive-compulsive disorder. For the parents, it is a "hellish" feeling. The son controls and interferes with everything in the parents' lives. For example, they must clean or wash vegetables according to the steps he stipulates; they must cut vegetables into a certain shape according to his requirements; they must step into the house with their right foot first, otherwise they must close the door again and step into the house again in the way he requires; items must be placed neatly or in the same direction, otherwise the patient will be very angry; "garbage" such as old newspapers or empty food containers must be piled up; when going out to throw away garbage, the faucet must be kept open, because if you turn on the faucet after returning home after throwing away the garbage, the faucet will be contaminated...

Therefore, it is necessary for the family members of patients with OCD to learn to get along with the patients while actively supporting their treatment.

Obsessive-compulsive disorder is not formed overnight. It takes time to change the patient's relatively fixed thinking, emotional and behavioral coping patterns. Therefore, the doctor should ask the patient, "Do you really want to get better? What kind of life do you want to live?" "In order to live the life you want, are you really ready to make changes to your obsessive-compulsive disorder?" "What can you do now?" After clarifying these questions, take action.

Treatment of obsessive-compulsive disorder

1. Cognitive behavioral therapy

Exposure therapy and ritual (response) prevention therapy are cognitive behavioral therapies that are effective in treating obsessive-compulsive disorder. Exposure therapy involves gradually and repeatedly exposing patients to things (scenes or people) that trigger obsessive thoughts, rituals, or discomfort, while requiring patients not to perform compulsive rituals (ritual prevention therapy). Through repeated exposure therapy, the patient's discomfort or anxiety can gradually disappear, allowing the patient to understand that their compulsive behavior is unnecessary to reduce the discomfort caused by the obsessions. Usually, the therapist and the patient work together to develop an exposure therapy plan, and the treatment should be gradual. Exposure therapy can be performed in the hospital or at home.

2. Medication

Selective serotonin reuptake inhibitors are effective in treating obsessive-compulsive disorder, and physicians can choose them based on the patient's sensitivity to the drug. Other psychiatric drugs may also be effective and should be used as directed by the physician. For patients with mild to moderate obsessive-compulsive symptoms, cognitive behavioral therapy or drug therapy is usually given based on the patient's preference, the patient's cognitive ability and insight level, other comorbid psychiatric disorders, and the availability of treatment. It is recommended that patients with severe obsessive-compulsive symptoms receive both cognitive behavioral therapy and drug therapy.

3. Support from family or caregivers

For patients with OCD who live with family members or caregivers, it is recommended to seek support from family members or caregivers. Family members or caregivers can help patients practice exposure therapy at home.

4. Self-care

Maintaining a healthy lifestyle can help you cope with OCD. In addition, using basic relaxation techniques such as meditation, yoga, visualization, and massage can relieve the stress and anxiety caused by OCD.