obsessive-compulsive disorder (2023)

about the disease

What is OCD?

Rituals, obsessions, and compulsions are something that most people have experienced, but for some, these kinds of thoughts and behaviors take over and completely spiral out of control and become a disease. This disease is called OCD.

OCD is an anxiety disorder in which obsessive thoughts and compulsions become so overwhelming that they become a problem. OCD is an abbreviation for obsessive-compulsive disorder. In Danish it is called obsessive-compulsive disorder or simply OCD.

Obsessions are unwanted thoughts that intrude and are hard to get rid of. And compulsive acts, some people feel compelled to do them over and over again. Often out of fear that something catastrophic will happen, for example, that your mother will get sick if she doesn't hang her clothes in the closet in a very specific order. Or maybe you need to count to 100 before you get on the bus so it doesn't run erratically. It may also be that you repeatedly check that the door is locked before leaving, or that the windows are closed and the stove is off.

When you have OCD, you know full well that the actions are exaggerated and don't make sense. But when the compulsions do take place, there is a temporary sense of relief and calm that is very difficult to resist. To be diagnosed with OCD, the symptoms of the compulsion must cause distress or significantly affect a person's social functioning.

If your symptoms start to keep you from doing the things you normally want or do, talk to your doctor.

Symptoms

What are the symptoms of OCD?

Most people with OCD are aware that their obsessions and compulsions are rampant. But they are ruled by fear. The anxiety is so strong that they often give in to the symptoms of the compulsion to achieve peace in the short term.

Forced actions have a calming effect on the anxiety and discomfort they feel. But the effect only lasts for a short time. Because discomfort and anxiety return quickly. And to get relief, you do the compulsions again. And again. And again. Like in a vicious circle.

OCD exists in all degrees of severity, from mild symptoms where you can live a normal life, to severe debilitating symptoms. Some only have obsessive thoughts, others only compulsive actions. But most have both.

Many have mild obsessive-compulsive symptoms, but this is not the same as having OCD.

Typical signs of OCD

• obsessions
• coercive actions
• Voltage
• Distress
• avoidance behavior

obsessions

Obsessions are unwanted imaginations, intrusions, images, and ideas that come up repeatedly, are unpleasant, perhaps even terrifying, and very difficult to get rid of. Even if the thoughts are unwanted and you rationally walk away from them, and even if they may disagree with your attitudes and feelings.

Typical obsessions are, for example, an exaggerated fear of getting infected or dirty. It could also be an exaggerated fear that something could happen to you or someone you care about. Either because you were careless or did something terrible on purpose.

coercive actions

Compulsions are actions or rituals that you feel you must perform to calm obsessive thoughts and alleviate the anxiety you feel. But only briefly. The will to take action returns quickly and, in the long run, helps to maintain anxiety.

Common compulsions include washing your hands all the time, perhaps up to 100 times a day, or checking the same things over and over again. For example, if the door is locked or if the plates are turned off. They can also be mental rituals where you have to say a prayer or say certain things to yourself, i.e. specific lines inside your head. Other compulsions may be putting things in a certain order or an exaggerated desire to do things correctly or perfectly.

avoidant behavior

If you have OCD, you often spend time avoiding situations that may trigger your compulsive symptoms, such as places or people you avoid.

Many also avoid situations where others might have one. Many are aware of the rituals they have, which is why they prefer to perform rituals in their bedroom when they are alone than in the kitchen.

variants

What is the difference between the different types of OCD?

There are basically two different types of OCD. One type is dominated by obsessive thoughts (obsessions), where intrusions and mental images appear repeatedly, the other type is characterized by forced actions (compulsions), which are rituals that you feel compelled to perform.

In some cases, one type is dominant, but many times you have a combination of the two types.

Development

How does the disease develop?

Most people have OCD when they are children or teenagers. The disease usually begins in childhood, while the diagnosis is not made until adolescence. And often the symptoms continue into adulthood. Symptoms usually develop gradually, but occasionally symptoms appear suddenly, almost overnight.

OCD manifests itself in the same way in children, adolescents and adults, and the obsessions and compulsions are very similar. Often the child will try to hide the symptoms from her because he perceives them as embarrassing, or he may be afraid of being seen as crazy.

For some, OCD becomes a chronic condition and they have difficulty leading a normal life, others have good and bad periods. Dean occasionally has a bout of obsessive-compulsive symptoms, usually during stressful times. For example, when they change jobs, have to take an exam, have a child or other circumstances that impose greater responsibility on them, in good times they can lead a completely normal life.

Getting the correct diagnosis can be of great importance. Because it can provide insight and understanding of the difficulties you are having. Both for the person with OCD and for the environment. And it's important to get the right treatment.

life with

What is life like with OCD?

Obsessions and compulsions are unpleasant and time consuming. They can make it a big problem to just walk out the door if you have to repeatedly check that you have turned off the water or the door is locked.

Many people don't know they have OCD. They may think that they have some kind of flaw and that they just need to "put themselves in order." And many are so embarrassed that they don't tell others about their symptoms and try to hide them. This means that other people may perceive them as a bit weird. And that means many people with OCD don't get the right diagnosis and therefore the right help.

Obsessions and compulsions can make it so difficult to be with others that you isolate yourself. They can interrupt daily routines, work and family life, or completely normal social activities. It may also be that the person avoids certain situations, places, or people because it can trigger obsessive thoughts and compulsive actions, and that the disorder also prevents them from doing what the person in question wants.

Some have good and bad periods. They may have a flare of obsessive-compulsive symptoms, usually during stressful times. The rest of the time, they can lead a normal life. Others have only mild symptoms and lead a normal daily life. If severely affected, OCD can be debilitating and destroy your ability to function at school, work, and with your family if left untreated.

In children, the condition can mean they have trouble concentrating at school or just following a movie. For example, because they count or say the lines in their head, and without you realizing it.

Treatment

What treatment exists for OCD?

If left untreated, OCD can become a chronic disorder. With treatment, the symptoms can be reduced or, in the best of cases, disappear completely.

The first option for treating OCD is psychotherapy in the form of cognitive behavioral therapy.¹.If the therapy is insufficient, the therapy can be combined with medication.

Psychoeducation - knowing OCD

As part of treatment, some learn about their OCD. Knowing your disease to better deal with it is also called psychoeducation. Psychoeducation can be a separate course or part of a therapy course.

Psychotherapy

Cognitive behavioral therapies are the main treatment for OCD. In therapy, the therapist works with defiance anxiety, disaster thoughts, and compulsions. The goal is to reduce the anxiety that triggers the compulsions and the compulsions, which in turn lead to more anxiety.

Carefully and at your own pace, you expose yourself to situations and things that trigger the compulsive symptoms, but without performing the compulsive acts. That way, you train yourself to resist instead of letting anxiety take over. The therapy can be done individually, in a group or as a family, if you are a child or a young person.

Medical treatment

OCD can also be treated with medication. For example, antidepressant medication in the form of so-called SSRI preparations. Other times, some slightly older preparations (TCA). In particularly severe cases, adults can also be treated with antipsychotic medications.²It is rare that medication can completely eliminate OCD.³.

Fuentes

1. National Board of Health, 2016: National Clinical Guidelines for the Treatment of Obsessive-Compulsive Disorder (OCD)

2. National Board of Health, 2016: National Clinical Guidelines for the Treatment of Obsessive-Compulsive Disorder (OCD)

3. Central Jutland Region, 2014: Information on OCD in adults. The disease, treatment and prevention. Central Jutland Region Psychiatry.

good advice for you

You can do it by yourself

Many are ashamed of their symptoms and try to hide them. And that's a shame. Because OCD can be treated. If you have OCD symptoms, it's crucial to seek help. And it's important that you get in on time.

Good advice to tame your OCD

• Know your OCD.

• Find out what you can do to change your patterns.

• Be honest with your therapist. How to get the best treatment.

• Take care and avoid stress.

• Be patient. It takes time to change ingrained patterns and habits.

for relatives

You can do it as a relative.

It can be difficult to understand that the person suffering from OCD cannot simply "get together" and stop the compulsions. And it can be unpleasant and frustrating to witness the suffering of someone you care about. But try to avoid showing your anger and frustration as this can make your symptoms worse.

As a family member, you can make a big difference by being there and caring and helping encourage people to seek help.

Good advice for you who are a family member.

• help to get help

• know the disease

• Don't scold and avoid saying things like 'get a hold of yourself' or 'relax'

• Take care of yourself and stick to what gives you energy and profit. And possibly talk to other people in the same situation.

• Do not adapt your own behavior to the disorder. Helps maintain anxiety and only intensifies compulsive symptoms

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Distribution

How many people have OCD?

Population studies show that just over 2% have had OCD at some point in their lives.

The disease usually appears in childhood or adolescence. There are about the same number of men and women who suffer from OCD, but the symptoms usually appear earlier in men.

About a quarter of men who develop OCD are diagnosed before the age of 10, while most women develop the condition in their teens.⁴.

Fuentes

4. Ruscio, A. et al. (2010): The epidemiology of obsessive-compulsive disorder in the National Comorbidity Survey

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reasons

What causes and therefore causes OCD?

There is no simple explanation for why some people develop OCD. The disease occurs in a complex interaction between various biological, social and psychological factors.

There is a higher risk of developing OCD if someone in your family has it. Research also suggests that there is a genetic or hereditary link between OCD and bipolar disorder. There is also an increased risk of getting OCD if there is bipolar disorder in the family.⁵.

Studies also suggest that there is an increased risk of OCD among children whose mothers are older and have birth complications. And an increased risk among addicts. Studies also suggest that there may be a link between traumatic or stressful events and the development of OCD.⁶.

Fuentes

5.Pallanti, S. et al., 2011: Comorbidity of obsessive-compulsive disorder: clinical evaluation and therapeutic implications. Frontiers in Psychiatry 2.

6. Brander, G. et al., 2016: Systematic review of environmental risk factors for obsessive-compulsive disorder: a proposed roadmap from association to causation. Neuroscience and Biobehavioral Reviews 65.

Multiple diagnoses at the same time

What diseases can occur along with OCD?

Many people with OCD also have other mental disorders, for example, symptoms of depression, other anxiety disorders, and bipolar disorder. The incidence is significantly higher than in the general population.⁷.

In children and young people with OCD, there is also an excess of Tourette syndrome. And girls in puberty can have eating disorders at the same time as OCD⁸Obsessive-compulsive symptoms are also found in other mental illnesses, for example, schizotypy.

Fuentes

9. Pallanti, S. et al., 2011: Comorbid obsessive-compulsive disorder: clinical evaluation and therapeutic implications. Frontiers in Psychiatry 2.

10. Gerlach, J., 2008: Angstbogen: symptoms, causes and treatment of anxiety, Psykiatrifondens Forlag