People with obsessive-compulsive disorder (OCD) feel the need to free themselves from anxiety by carrying out rituals or repeating activities to prevent frightening phenomena from occurring. Usually they are aware of the absurdity of their behavior and are ashamed.
Precision, perfectionism or compulsive obsession?
When you look at children's games, some rituals come to my mind: "If I arrive at the end of the street without setting foot on the joints of the sidewalk, I will get a good note on my sheet of paper. »» As an adults, we have not always abandoned these habits. We sometimes organize rituals to ward off fate: "If I wear this jewel, my interview will go well." It is our participation in superstition, which is not pathological as long as it does not harm our daily life. ""
Being a perfectionist, obsessed with the organization or very demanding does not necessarily mean being compulsive. These behaviors are often used to improve your own image and contribute to professional success. There is nothing pathological to that, as long as the time spent in these activities is reasonable and as long as behavior does not cause anxiety, suffering or prejudice to social and emotional life.
What is compulsive obsessive disorder?
Obsessive compulsive disorder, also known as TOC, is a form of anxiety disorder. People with OCD are obsessed with troubled thoughts that are difficult to ignore, parasitize their mind and cause a strong feeling of guilt.
We sometimes sometimes have disturbing ideas, but we know how to reject them as being unreasonable. The person affected by TOC interprets these intrusive thoughts and considers them as signs of an imminent misfortune. A person suffering from obsessive-compulsive disorder is exhausted to fight against these dark thoughts and the fear and guilt they provoke: this is called obsession. She is aware that these recurring ideas are unfounded and disproportionate, but that her attempts to counter them generate an unacceptable level of anxiety. The most common obsessions are dirt, the fear of committing acts of violence, the fear of scandalous behavior.
Faced with these obsessions, repetitive actions or compulsions are a way to escape fear. The sick person feels obliged to accomplish certain rituals to prevent frightening phenomena from occurring. However, it is aware that it is ridiculous. Little by little, the brain learns that this little mania quickly relieves anxiety, but this respite is only short -lived. This ritual is repeated more and more often and is transformed into an obsessive compulsive disorder, a trap living in secret and shame.
If, for any reason, an external element makes impossible the execution of the ritual, anxiety reaches an unbearable level. Rituals can last several hours a day, disturbing daily life and preventing access to normal social and professional life. They often lead the person affected to live a life of secret and shame, which ends up leading to exhaustion and depression.
What are the symptoms of different OCS?
Rituals to calm anxiety can take several forms: verification rituals (constant verification of locks or gas closure, household appliances disconnected from the power supply, out of course); rehearsal rituals (cross and cross doors, repeated gestures, repeat a word or a number); Order and order rituals or avoidance rituals (you never take a specific path, you never touch a specific object).
Phobic obsessions
The person is afraid to simply invoke an object or a situation, even if he is not present (as opposed to a phobia). The most common obsession of this type is the fear of getting dirty, of being infected with germs or contaminated by radiation, toxic waste or household products. These obsessions are accompanied by excessive washing and cleaning rituals: wash your hands several times a day or shower several times, depending on rules that may seem strange, like taking and putting soap twelve times before use.
Obsessions on the point of errors or omissions
It is, for example, the constant and haunting fear of forgetting to do something, to do a bad job, to lose an article, to be mistaken in a letter. Obsessive thoughts focus on morality, religion, the idea of what is right
Impulsive obsessions
People are afraid of committing a criminal, perverse, sacrilege or absurd act, or to kill involuntarily, for example by crossing a pedestrian with their car.
Collector obsessions
They cause an excessive need to accumulate unexpected or completely useless objects. In some serious cases, the apartment can be completely covered with trash.
Obsessions of order and symmetry
The patient believes that a serious event can arrive at a loved one or himself, if certain elements are not perfectly arranged or positioned in a certain way.
What can happen in the event of an untreated OCD?
An untreated OCD causes a depression in more than half of the cases. They can also cause a social phobia Associated with shame on the symptoms of the disease and the fear of the judgment of others.
It is possible to live with a OCD, which can be periodic or permanent. Sometimes this disorder decreases with age.
What causes a OCD?
TOC seems to have multiple origin: genetics, biological and psychological. Genetic sensitivity has been demonstrated in particular by studies carried out on patients with identical twins: 60% of them also had an obsessive-compulsive disorder. Research on brain function has shown that people with TOC are undergoing changes in nervous activity in certain areas of the brain.
Psychoanalysts say that obsessive compulsive disorder is an expression of the psyche defense mechanism against manifestations of unconscious aggression. This defense then takes the form of great mental rigidity and numerous prohibitions.
Who is the TOCs?
It is estimated that 2% to 3% of the population is affected by an obsessive-compulsive disorder. Two thirds of patients suffer from the appearance of the disease before the age of 25, sometimes in early childhood. While the proportion of men and women in the adult group is almost the same (52% of women), boys are more likely to be affected than girls in adolescence.
Obsessive-compulsive disorder is the fourth most frequent psychological disorder in terms of frequency, after phobias, addictions and depression.
Some personality traits seem to be present in people predisposed to this disorder: an exaggerated sense of responsibilities, an inability to tolerate uncertainty, a tendency to overestimate the importance of the opinions of others and the need to control them, for example.
How is TOC diagnostic?
The presence of obsessions, compulsions or a combination of the two is not sufficient to make a diagnosis of OCD. If obsessions and compulsions take more than an hour a day and interfere significantly with work, social activities and relationships, then OCD can be present. The time spent performing rituals is an indicator of the severity of the disease. Obsessions must be repetitive, persistent, intrusive and evoke obvious anxiety or distress, even in the absence of the dreaded object or situation. Compulsions are irresistible, but they are only relatively effective in relieving anxiety.
The delay between the appearance of the disease and the diagnosis is often long, as people with OC tend to hide their symptoms as long as possible. They organize their lives so that their compulsion is invisible, even for those who are close to them.
The treatment of obsessive-compulsive disorder implies the use of psychotherapy techniques and possibly antidepressants. The purpose of psychotherapy is to maintain social and emotional life, despite the possible persistence of certain symptoms after the end of treatment
Is psychotherapy effective in the treatment of TOC?
Behavioral therapy is often used to treat OCD. For forty to fifty sessions, the person with TOC is deliberately confronted with situations that cause anxiety, first mentally and then in everyday life. The person is strongly encouraged to develop other measures to control their anxiety.
Cognitive therapy can be started at the same time. He helps the patient to reinterpret his invasive thoughts more objectively, bringing out their irrational and unjustified side. These therapies are often effective. However, the disappearance of OCD can sometimes lead to the appearance of another symptom of anxiety (e.g. phobia, panic crisis).
Psychoanalysis and analytical inspiration psychotherapy, which require longer investment, are not very effective in relieving short -term symptoms. However, they can help discover the source of the conflict behind these disorders and thus lead to lasting well-being.
What drugs are used to treat symptoms?
Antidepressants are the main drugs used and would be effective in around 60% of cases. Often the symptoms decrease without the intensity disappearing completely.
Two types of antidepressants are used: some serotonin reuptake inhibitors (SRI) and the imipramine clomipramine antidepressant (Anafranil and its generics).
Antidepressants seem to be more effective with obsessive thoughts than with compulsive thoughts. The doses used are often higher than for the treatment of depression.
Sometimes treatment may not be effective up to two months. This should not discourage patients from continuing their treatment. Stopping treatment must be progressive and spread over several months.
CBD in compulsive obsessive disorders syndrome
People with OCD, report that the severity of their symptoms has been reduced by about half of it consume cannabis, according to a study by Washington State University.
The researchers analyzed the computer data of people who identified themselves as having an obsessive-compulsive disorder, a condition characterized by intrusive and persistent thoughts and repetitive behaviors such as compulsive verification of the door closure. After using cannabis, consumers have indicated that it decreases their symptoms by 60%, invasive or unwanted thoughts by 49%and anxiety by 52%.
A study, published in the Disorders Journal of Affective, revealed that larger doses of cannabis with higher concentrations of CBD or cannabidiol were associated with a reduction in compulsion.
"The overall results indicate that cannabidiol can have a positive short -term effect on OCD, but not in the very long term," said Carrie Cuttler, author of the study, assistant professor of psychology in WSU. "For me, the results of the CBD are promising because the cannabidiol molecule is not psychotropic and does not generate dependence. It is an area that would really benefit from clinical research on changes in compulsions, and anxiety with anxiety with Pure CBD. "
The current TOC treatments included behavioral therapy is often used to treat OCD, in which people 'irrational thought on their behavior is directly questioned, and in medication, certain inhibitors of serotonin reuptake (SRI) and the Antidepressant. Although these treatments have beneficial effects for many patients, they do not heal the disorder and do not work for all people with OCD.
"We are trying to learn more about the relationship between CBD consumption and TOC because it is an area that is really underestimated," said Dakota Mauzay, doctoral student in the laboratory of Cuttler and first author of the article.
In addition to their own research, the researchers found only one other study on the subject: a small clinical trial with 12 patients who found a reduction in the symptoms of OCD after the consumption of legal cannabis, but it is was not much more than the reduction associated with placebo.
Other research, in particular clinical studies on the CBD cannabis component, could demonstrate a therapeutic potential for people with OCD.
Sources:
Toc, Health insurance, 06/2018
Psy well-being guide, Vidal, 2008
