Disease of Delusion or Doubt/ Obsessive-Compulsive Disorder
"Football
obsession is always on him." "He is very fond of shoes".
"He must be lying". We use these words for people who repeat certain
habits or actions, even though others do not understand the reason for their
behavior. Usually, this habit is not a problem and in some cases it can be
helpful. May be. But, the urge to do something over and over or over and over
again can become painfully overwhelming.
If :
You keep
having painful thoughts in your mind, even though you try not to let them enter
your mind.
or
You have a
recurring urge to touch something over and over, count things over and over
again, or do something over and over again, such as washing your hands over and
over again.
So you may
have obsessive-compulsive disorder (OCD).
Symptoms
(Ayesha)
"I am afraid that I will get some disease from others I spend hours
cleaning my house with bleach to kill germs, and wash my hands several times a
day. I try not to go out of the house for any work. When my husband and
children come home, I take off their shoes before entering the house. I ask
them in detail where they went to find out if they went to any dirty place like
hospital etc. I make them change their clothes immediately after coming home
and take a good bath. I also realize that these illusions of mine are silly. My
family is fed up with this habit, but I have been doing it for so long that I
can't stop myself anymore.
Symptoms
of OCD:
Obsessive
compulsive disorder has two main types of symptoms.
1.
Delusional thoughts. (Obsessions)
2. Tasks
that the patient finds himself forced to do over and over again. (completions)
Obsessions
Patients
have recurring thoughts, delusions, doubts, and whispers that persist for
hours. These delusions are usually very painful because they are violent or
sexual in nature and the patient knows they are delusional. The patient tries
to stop them from coming to his mind again and again or to shake them out of
his mind, but these thoughts do not leave his mind. The patient knows that
these are his own thoughts, but they keep coming into his mind against his
will. Sometimes people have repeated thoughts of killing or cursing someone.
Although people do not understand these thoughts and do not follow them, but
these thoughts are very painful Sometimes patients have thoughts throughout the
day that they are contaminated with germs or dirt or that they will get a
serious illness such as cancer or AIDS.
Compulsions
(doing the same thing over and over for no reason)
Many
patients with this disease repeat certain actions countless times, for example,
some people wash their hands for an hour, or check fifty-fifty times that the
door has not been left open. Often patients know that they have done something
and it is pointless and useless to do it again, for example, the hands are
clean or the door is open, but they have a strong urge to do it again and if
they Don't do it again and try to stop it, panic sets in. Sometimes patients do
such things repeatedly because they feel that if they don't do it, some big
trouble will come to them or their family.
How
common is OCD?
About two
percent of people are affected by this disease at some point in their life. The
rate of this disease is equal in men and women.
How
severe can OCD be?
If OCD is
severe enough, it becomes almost impossible to hold a regular job, spend
quality time with family, or take an interest in family affairs If the patient
tries to involve family members in their compulsions, they may become upset and
angry.
Are
people with OCD crazy?
People who
suffer from OCD are mentally sound, but many times they hesitate to express
their illness lest people think they are crazy. Although patients are worried
that they may lose control of themselves due to this disease, but in reality it
does not happen.
At what
age does OCD start?
OCD usually
begins in adolescence or early twenties. Symptoms sometimes start, sometimes go
away on their own and then come back, but patients usually don't seek help
until many years after the onset of the disease.
What
happens if OCD is not treated?
If the
disease is mild, many people get better without treatment. If the disease is moderate
or severe, this usually does not happen, although symptoms sometimes improve
temporarily. Some people's disease gets progressively worse over time, while
some people's symptoms worsen with depression or anxiety. People generally
benefit from treatment.
Why does
OCD occur?
Genes
OCD tends to
run in some people, so sometimes it runs in more than one family member.
Mental Pressure
(Stress)
About
one-third of people who develop OCD develop it after stressful situations and
events.
Change In
Life
When someone
suddenly has more responsibilities, such as becoming an adult, having a baby,
or getting a new job, the risk of developing OCD symptoms increases.
Mental Change
We don't
know for sure, but according to researchers, if someone has OCD for more than a
short period of time, there is a malfunction in the process of a chemical
serotonin in the brain.
Personality
People who
are very neat, tidy and do everything according to a certain rule and high
standard are more likely to develop OCD. These traits are beneficial in normal
life, but can lead to OCD if they become excessive.
Dhing/Way
Of Thinking
Almost all
of us have the odd thought at some point, "What if I get in front of that
car, I don't hurt my child." Most of us shake those thoughts away and Do
not pay attention to But some people are so bound by morality in their thoughts
that they think that such thoughts should not come. Such people worry that such
thoughts may not occur again, and those who worry tend to have more of these
thoughts.
Why
doesn't OCD go away?
Sometimes
the efforts that OCD sufferers make to reduce their symptoms increase their
thoughts, such as:
Trying to push the obsessions out of the mind
and trying not to let the thoughts come to mind. This effort usually increases
the thoughts.
Repeated
compulsions, repeated checking of tasks, or repeated seeking of reassurance
from people temporarily relieves the anxiety, but it reinforces the patient's
belief that they Doing things prevents something bad from happening, so next
time do those things again and againThe pressure increases.Bringing
"right" thoughts to the mind to eliminate "bad thoughts".
If you do, leave it and wait until your panic subsides.
Help
Yourself
Face your
obsessions. This may sound strange to you, but it makes it easier to control
your thoughts. Record your obsessions spoken and listen to them over and over
again, or write them down and read them over and over again. You have to do
this regularly for about half an hour daily until your anxiety subsides.
Try to stop
the compulsions but don't try to stop the obsessions.
If your
thoughts are bothering you religiously, talking to a therapist may help
determine if your thoughts are not caused by OCD.
Treatment
of OCD
Two methods
are used. CBT for OCD
Exposure
and Response Prevention (ERP) and Cognitive Therapy (CT)
Exposure
and Response Prevention (ERP)
This method
of treatment prevents panic and compulsions from reinforcing each other. If a
person stays in a stressful situation for a long time, he gradually gets used
to it and his anxiety decreases In keeping with the same principle, in this
treatment, the patient is exposed to situations in which he has hallucinations,
such as touching a dusty object, but is prevented from complying with his
demands, such as frequent hand washing, when Until his panic subsides It is
better to complete this treatment gradually rather than suddenly.
Make a list
of things that make you very nervous or that you stay away from.
Put the
situations or thoughts that make you the least nervous at the bottom of your
list, and the ones that make you the most nervous at the top.
First face
the situations that make you least nervous and then come to the things that
make you more nervous. Do not move on to the next level until the lower level
is less panicked.
Do this
exercise daily for a week or two. Do this each time until your anxiety is at
least halved from the extreme. Initially it takes half an hour to an hour.
You can
practice these steps with a psychotherapist, but most of the time you will have
to do them on your own. Do this at a pace that you can comfortably handle. Your
anxiety doesn't have to be completely gone every time, just low enough that you
can deal with the situation.- Remember that your anxiety:
It's painful, but it can't hurt you.
It will go away without end.
It will
decrease with regular practice.
There are
two main ways to do this: ERP
Helping
Yourself With Guidance.
You can take
a book, tape, video, DVD or software guide. You can sometimes seek advice and
support from a professional therapist. This method is best if you have mild OCD
and are confident enough to use your own self-help methods.
Individual
or group therapy under the supervision of a psychologist:
This can be
by appointment or over the phone. This usually happens once or twice a week at
first and lasts 45 to 60 minutes.
An Example:
Ahmed could not leave home in time to go to
the office every day, because he had to take care of many things. He used to
worry that the house would not burn down or be stolen if he did not check
everything in the house five times. He had made a list of all the things he had
to see. The list was something like this:
1. Dekchi
(Least Feared)
2. Tea
pot
3. Stove
4. A
window or windows
5. Doors
(most feared)
He started
the treatment from the first stage. Instead of seeing Dekchi many times, he
only saw her once. In the beginning, he was very nervous. He stopped himself
from looking again. He had also agreed that he would not ask his wife to look
at everything and would not ask her to reassure her that the house was safe.
Her fear gradually subsided over two weeks. Then he went to the second stage
(tea pot) and so on. Finally, he left his home
He used to
take care of everything and reach work on time.
Cognitive
Therapy (CT)
Cognitive
therapy is a psychological treatment that tries to make your obsessions less
painful rather than getting rid of them. This is useful if you are troubled by
obsessions but do not have compulsions.
Anti-Depressant
Drugs
SSRI
antidepressant medications reduce obsessions and compulsions. It also works in
people who don't have depression. These can be used alone or in conjunction
with psychotherapy. If there is no benefit after three months of SSRI
treatment, another SSRI or another drug, clomipramine, may be given.
How much
benefit are these methods of treatment?
Exposure
Response Treatment (ERP)
About
three-quarters of people who complete ERP treatment experience substantial
benefit. About a quarter of those who do get better have symptoms that return
after a while and need more treatment.
Medicines
About sixty
percent of people get better with antidepressants. On average, their symptoms
are reduced by about half. Antidepressant medications prevent OCD from coming
back. This effect remains effective for many years after the symptoms have
disappeared About half of people who stop the medication have symptoms return
within the next few months. If cognitive behavior therapy is given along with
medication, the risk of symptoms returning is reduced.
Which
method is best for me? Medication or psychotherapy?
Exposure
response treatment can be taken without specialist advice (in mild cases).
Plenty of people benefit from it, and there are no side effects other than a
little nervousness at first. On the other hand, it requires a lot of motivation
and effort, and the initial panic increases.
CBT and
medication are equally beneficial. CBT alone may also benefit if you have mild
OCD. If your illness is relatively severe, then you may be treated with either
CBT or medication. If your OCD is very severe, a combination of medication and
CBT may work best for you. Be sure to consult your psychiatrist who can provide
you with more information.
What if I
don't benefit from early treatment?
Consult your
psychiatrist againThey may advise you to:
Also be
given. Exposure treatment with cognitive therapy or medication.
Two
antidepressant medicines taken together, such as clomipramine and citalopram.
Other psychological problems such as anxiety,
depression or alcoholism should also be treated.
Anti-psychotic
drugs should also be given along with antidepressants.
Work with
your family to counsel them and try to ease their anxiety.
Will I
need to be hospitalized for treatment?
Hospitalization
is required only when:
You may be
very sick, unable to care for yourself, or have suicidal thoughts.
You have any other serious psychiatric
problems such as an eating disorder, schizophrenia, or very severe depression.
You can't get to the clinic because of
symptoms.
Advice
For Family And Friends Of The Patient
The behavior
of OCD patients is sometimes very disturbing for the family. Try to remember
that he is not intentionally trying to create difficulty for you with his
behavior but is trying to fight the disease.
It may take
some time for the patient to realize that he needs treatment. Encourage him to
read about OCD and talk to a professional.
Educate
Yourself About OCD
You can use
exposure treatment to help change your attitude toward your loved one;
Encourage them to face situations that make them nervous, don't participate in
their compulsions, and don't reassure them over and over that everything is
fine.
Do not worry
that if the patient has violent thoughts, he will act on them. This rarely
happens.
Ask them if
you can go with them to see their psychiatrist