Why could someone compulsively clean their house?
Obsessive Compulsive Disorder: Description
Obsessive compulsive disorder, OCD disease is a serious mental disorder that puts a lot of strain on those affected. Charles Darwin and Martin Luther are said to have suffered from obsessive-compulsive disorder. Obsessive-compulsive disorder encompasses a wide range of behavioral and other psychological characteristics. For example, the person concerned is persecuted by obsessive thoughts or is under pressure to have to carry out certain actions again and again in a ritualized form. This can be the compulsion to wash according to a certain scheme or to count things. Others have the compulsive idea of committing an act of violence or sexually undesirable acts.
You can find more information on the signs and treatment of compulsory washing in the article Compulsory washing.
Obsessive-compulsive disorder is an outdated term for obsessive-compulsive disorder. The obsessional neurosis definition indicates that people who are obsessive-compulsive - in contrast to people with a psychosis - do not lose touch with reality. They know that their obsessions and compulsions are irrational, but they still cannot turn you off.
The thoughts and actions are called compulsion because those affected try to fight them. The inner resistance to refraining from actions or thoughts costs a lot of strength and creates ever increasing tension and fear. Only when they give in to the compulsions and perform the particular ritual, or get external confirmation that their fears and worries are unfounded, does the pressure decrease. Similar to addicts, a kind of habituation effect occurs over time: the ritual usually becomes more and more complex and protracted until it brings the desired relaxation. The constraints therefore take up more and more time and energy.
A bit of coercion is normal
There is a bit of compulsiveness in everyone - superstitious ideas are just as much a part of it as harmless rituals. Some otherwise rational people feel a little uneasy when they are supposed to sign an important contract on Friday the 13th.
The transition from normal behavior to OCD is fluid. Some people may just feel compelled to double-check that the stove is switched off before going to sleep - even if they haven't cooked at all. Others, on the other hand, have to perform a washing ritual lasting several hours before they can leave the house. In principle, an obsessive-compulsive disorder is only considered to be given if the person concerned suffers from it himself or is massively restricted in his everyday life.
How many are affected?
People with obsessive-compulsive disorder are often ashamed of their irrational behavior. The number of unreported cases is therefore high. Experts estimate that about one to three percent of the population will experience OCD at some point in their lives. Men are more likely to have control compulsions, whereas women are more likely to suffer from washing or cleaning compulsions. In addition to obsessive-compulsive disorder, there are usually other mental disorders such as depression or anxiety disorders.
Compulsion to control
You can find out how compulsory control expresses itself and how it is treated in the article compulsory control.
Compulsions in children
Obsessive-compulsive disorder often begins in childhood or adolescence. Around half of those affected show the first symptoms of obsessive-compulsive disorder before the age of 15. Children and adolescents often try to keep these constraints a secret. Boys are more often affected than girls. The compulsions often manifest themselves massively in life crises or conflict situations. Obsessive-compulsive disorder in children, like adults, is treated with cognitive behavioral therapy. If the compulsions are strong, drugs, especially selective serotonin reuptake inhibitors (e.g. fluoxetine), can also be used in children.
Obsessive-compulsive disorder: symptoms
The main characteristic of obsessive-compulsive disorder is having recurring obsessions or compulsions. Often these symptoms also occur together. The obsessions and compulsive actions create a strong internal tension and are mostly associated with fear.
Eight tips against nail biting
No more nibbling!At the desk, in the subway, on the couch - for nail bitters it doesn't matter where they are, they can nibble their nails anywhere. Children and adolescents are predominantly affected by the nervous habit, but some adults cannot get rid of it either. Since this is not entirely harmless - it can cause wounds, inflammation, bleeding and malformations - it is worth stopping. Eight tips to help you succeed.
Keep your nails shortShort nails offer less surface to bite. Therefore, keep your nails as short as possible by trimming them regularly. It is best to file them in addition so that there are no corners and edges that could tempt you to nibble.
Apply bitter nail polishFortunately, the industry is responding to your problems: There are now many different suppliers who offer chew-stop nail polish. In many cases it tastes so disgusting that you don't feel like nibbling any more. Try it out!
Hide your nailsIf you don't want to use nail polish, there are other ways to cover your nails: stick tape, plasters or stickers on them, have artificial nails done or hide them in gloves - this is very easy, especially outside in winter.
Treat yourself to manicuresGet a Manicure Regular: If you are spending money on beautiful nails, you will likely want to get them and the chances of nibbling will decrease. Even more expensive, fancy nail polish that you apply carefully can help.
Replace your habitNail biting is not a nice habit. Perhaps you can manage to replace it with another one that will distract you from nibbling. For example, you could always put lotion on your hands, knead a stress ball, or play with a chestnut when you really want to chew. In addition, chewing gum may help you bite your nails less.
Identify the triggersVarious causes can trigger or worsen nail biting. For example, a hangnail - the detached but still stuck part of a fingernail or the skin around the fingernail - can encourage nibbling. Psychological factors such as stress or fear also often play a role. Find out in which situations you chew the most. Just knowing can help sometimes.
Fight the causesIf knowing the triggers alone isn't enough to keep you from chewing, do something about the causes. If hangnails are the main problem, you can always carry small scissors or files with you to remove them. If there are psychological causes behind biting your nail, it is best to consult a psychologist who will talk to you about your problems.
Always a finger lessSome doctors suggest that gradual weaning is easier. They recommend gradually identifying more and more fingers that you no longer nibble on. You can either exclude one finger after the other or always pair of fingers, for example first the two thumbs, then the two index fingers, .... The goal, of course, is not to bite any more fingers at the end of the day.
- By Dr Varinka Voigt
Compulsive acts are irrational acts that those affected carry out. Often it is about averting a possible disaster. The content of the actions does not have to be rationally related to the fears. For example, a mother may fear that something bad will happen to her children if she forgets to turn off the lights. So, fearing for her children, she constantly checks the light switch.
Frequent forms of compulsive behavior are, among other things, compulsory cleaning and compulsory order. When cleaning is compulsory, those affected have to clean the apartment or objects again and again. Order constraints go hand in hand with an obsessive desire for uniformity and symmetry. For example, the pens on the desk may have to be aligned exactly parallel or the shirts folded to exactly the same size. Deviating from this requirement is unbearable for those affected.
Many also suffer from an obsession with number and repetition, in which they feel compelled to perform certain actions with a certain frequency. If those affected make a mistake in their rituals or have the impression that they were not thorough enough, they have to start all over again. Due to the increasing complexity of the rituals, an obsession can take several hours to complete.
Whether it is an obsessive thought or a compulsive act - those affected are well aware of the absurdity of their thinking and behavior and they are ashamed of it. You try again and again to oppose the coercion with resistance, but this only succeeds for a short time and with great effort.
Obsessive thoughts are expressed in the form of intrusive ideas, conceptions or impulses. They often have violent, sexual, or blasphemous content. For more information on signs and treatment for obsessive-compulsive thoughts, see the Obsessive-compulsive thought post.
Obsessive-compulsive disorder: causes and risk factors
How obsessive-compulsive disorder develops is not yet clear. Family examinations and twin studies show that - as with most mental illnesses - there is a hereditary predisposition to the obsessive-compulsive disorder. For it to break out, however, other factors must be added. These include, for example, experiences in childhood that have led to a person being more insecure and having a stronger need for control. OCD is usually preceded by a particularly stressful experience or life crisis. With the help of the compulsive ritual, the affected person regains the lost feeling of security. The external uncertainty is balanced out by an internal structure. But this security is deceptive: if the ritual is not carried out, fear comes back with power. In the long term, it becomes stronger and stronger - this in turn increases the obsessive-compulsive disorder - a vicious circle.
Overactive lobe of the brain
It is now known that the frontal lobes of the brain are overactive in people with obsessive-compulsive disorder. Among other things, it also controls the so-called basal ganglia - these are brain structures that are responsible for motor processes. This hypothesis is supported by the fact that people whose basal ganglia are affected by tumors or head injuries often develop obsessive-compulsive disorder. In addition, the serotonin levels in the brain appear to be disturbed in people with obsessive-compulsive disorder. Many patients are helped by drugs that increase serotonin levels.
In the interplay with the personality and the biological requirements, the upbringing can contribute to the development of obsessive-compulsive disorder. Children who are more anxious are made more insecure by their parents' overprotective behavior. They learn from their parents to avoid threatening situations instead of facing them. Parents who are very critical of their children or who have perfectionist demands can also promote obsessive-compulsive disorder.
Obsessive-compulsive disorder is often triggered by stressful events. Any overstrain creates the desire for control. However, when the person is unable to cope with the situation, obsessions and compulsions serve as a distraction. On the other hand, obsessive thoughts and actions give people who are anxious and have an increased need for security the illusion of being able to control events that are basically uncontrollable. For example, they hope to avert accidents through certain rituals.
Obsessive Compulsive Disorder: Investigations and Diagnosis
Those affected are often ashamed of their compulsions because they perceive them as nonsensical. They find it difficult to confide in a psychologist or doctor. People should be aware, however, that the strange thoughts and actions are part of an obsessive-compulsive disorder and that many people struggle with the same or similar compulsions. Above all, compulsions usually don't go away on their own. It is therefore important to answer the doctor or psychologist openly and honestly so that they can recognize and treat the OCD.
For the diagnosis of obsessive-compulsive disorder, the therapist uses the ICD-10 classification of mental disorders. The following criteria must apply:
- People have obsessions or compulsions (or both) most days for at least two weeks.
- The obsessive thoughts and actions show the following characteristics:
- those affected know that the thoughts / actions are their own and are not generated by outside influences
- the thoughts / actions repeat themselves continuously, are perceived as unpleasant and recognized as exaggerated or nonsensical
- those affected try to resist the obsessive thoughts or actions
- those affected find the execution of obsessive thoughts or actions uncomfortable
- Those affected suffer from obsessive-compulsive disorder and the enormous amount of time they spend restricts them in their professional and social life.
In an initial conversation, the doctor or therapist will ask questions to determine whether the criteria mentioned apply to the person. The obsessive-compulsive disorder expert might ask the following questions:
- Do you often have unpleasant thoughts that arise?
- Do you feel an inner pressure to carry out certain actions over and over again?
- Do you find these thoughts or actions nonsensical?
- Do you fear that if you don't perform the actions, something bad could happen?
- Do you need a long time for everyday activities?
Obsessive Compulsive Disorder: Treatment
Cognitive behavioral therapy shows the best treatment success. The therapist discusses the concrete procedure with the patient at the beginning of the therapy. One method in cognitive behavioral therapy is exposure exercises, which are considered to be particularly effective. During these exercises, the patient is confronted with the stimulus that normally triggers his compulsive behavior without being allowed to give in to internal pressure. Someone who has an obligation to order, for example, has to bring clutter into their wardrobe and is then not allowed to sort the clothes. The exposure can take place in such a way that the challenges are increased from time to time or the person concerned is confronted with his greatest fear right at the beginning of the therapy.
While the urge to follow the usual ritual seems overwhelming at first, the patient experiences how the pressure slowly eases - even without giving in to the pressure. Through this conscious experience, he regains control over his behavior to a certain extent. At the beginning of obsessive-compulsive disorder therapy, however, it can take several hours for this effect to set in.
In order to cope with obsessive-compulsive thoughts, the patient is asked to allow the uncomfortable thoughts. Because the suppression means that these occur even more frequently. If those affected get involved and deal directly with the thoughts, they can overcome their compulsions.
The behavioral therapist also explains to the patient how compulsions arise and helps him to change unfavorable thought patterns. Methods to reduce stress such as autogenic training, progressive muscle relaxation or mindfulness training also have a supportive effect.
Obsessive Compulsive Disorder: Medication
So-called selective serotonin reuptake inhibitors (SSRI) - a special group of antidepressants - help a large proportion of the OCD. As a rule, they have to be dosed significantly higher than in the treatment of depression. Ingestion reduces the internal tension in most of those affected. The obsessive-compulsive symptoms subside, but usually do not go away completely and return more often after stopping the medication. Accompanying cognitive behavioral therapy is therefore always recommended.
Tips for relatives
Obsessive-compulsive disorder is a burden not only for the patient but also for everyone who lives with them. The time-consuming compulsions are also at the expense of the partner and family. Sometimes they are even asked to submit to coercion, for example by complying with excessive hygiene rules.
The following tips can help to cope with the difficult situation:
- The patient can only control the obsessional ritual to a limited extent and with great effort. The request to pull yourself together or discussions about the pointlessness of doing are therefore of no help. The only thing that really helps is therapy.
- Therefore, encourage your loved one to seek therapeutic help.
- Do not support your sick loved one in their ritual.For example, don't help him check all electrical appliances or count things to calm him down before leaving the house. In the long run, you only stabilize the compulsive behavior.
- Praise them for progress, but don't criticize them if the symptoms get worse again - for example, if the person is under pressure. Such fluctuations in the severity of symptoms are normal.
- Do not allow yourself to be overwhelmed by the coercion of your loved one. Continue to pursue your hobbies, meet friends and try to do something with the obsessive-compulsive disorder as well as he can.
- Give your sick loved one clear boundaries as to what you are willing to accept and what not.
- If you feel exasperated and angry at times - and this is inevitable - make it clear that this relates to the symptoms, not your loved one.
Obsessive-compulsive disorder: disease course and prognosis
Obsessive-compulsive disorder is usually chronic. Symptoms worsen under stress. Nevertheless, with the current state of psychotherapy and certain medications, the chances of an improvement in symptoms have increased significantly. Those who also suffer from depression have a worse prognosis.
In the past, obsessive-compulsive disorder was thought to be hardly treatable. In the meantime, the symptoms can usually be reduced to a tolerable level. The earlier the therapy starts, the better the prognosis.
Long-term studies have shown that the condition of about two thirds of the patients treated has improved or very much improved two to six years after the end of therapy compared to before. A complete cure of the Obsessive-compulsive disorder however, it is very rare.
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