Obsessive thoughts: What to do if you have increased anxiety
Anxiety - the natural reaction of the psyche in a situation of obscurity, and even outwardly imperturbable people from time to time are tormented by disturbing thoughts. The brain, in order to unload, launches its own anti-anxiety campaign: the subconscious invents small rituals, the execution of which allows you to switch. When such a defense mechanism fails, experts talk about the signs of obsessive-compulsive disorder (OCD) - while anxiety becomes a constant companion of life, and “saving” actions turn into an endless liquidation of the threat. We talked with a psychotherapist, a candidate of medical sciences and a member of the Association of cognitive-behavioral therapy Dmitry Kovpak about what lies behind the symptoms of OCD, how to deal with it, and why perfectionists should be on the alert.
strong beliefs or deep emotions, such as fear, so they are difficult to manage. To compensate for itchy anxiety, a person performs compulsions — forced rituals that supposedly can prevent what he fears.
A classic example of obsessive-compulsive disorder is often called obsession with cleanliness, including hands, which seem to collect the largest amount of surrounding dirt. The annoying idea that bacteria and viruses enter the body, lead to an infection or an incurable disease, terrifies a person, pushing him to wash his hands many times a day and process them with an antibacterial gel. True, hypochondria does not necessarily indicate OCD - it can be one of the symptoms and an independent form of anxiety. In OCD, obsessive thoughts do not always revolve around potential diseases - sometimes they are associated with the fear of harming oneself or others, with unwanted and frightening sexual images, with the desire to perform tasks ideally and with other obsessions.
Confidence in one’s own “magical” thinking becomes also a strong motivation to perform rituals. It may seem to a patient with OCD that if he only imagines a car hit someone close, it will definitely happen. In order to get things going well and nothing terrible has happened, a person comes up with and in some way performs intricate actions, compulsions - they perform the role of magical "guarding" rituals. This may be, for example, the folding of objects on the table in color or size or an attempt to walk on the joints between the tiles, so that something terrible did not happen.
So that nothing terrible happens, a person invents and performs intricate actions in a certain way, compulsions - they perform the role of magical "preserving" rituals.
“I constantly perform compulsions, mental and physical,” says Olga. “I am afraid of almost everything, any thing may seem dangerous to my relatives. When such a thought comes, I most often rework what I did: I go back a few steps back, and then I go forward, I re-enter the door, press a button, send a letter. I also want to count repetitions and objects all the time. They should be four, eight, nine or ten - the rest are bad for me. True, bad and good numbers may vary depending on the competition retired fears. The same thing with color: there is good, there is bad. I don’t buy clothes of bad color and with the wrong number of buttons. It’s difficult to buy things because it’s difficult to choose what matches my superstitions. There are days when I didn’t perform a compulsion, and I feel like “dirty”, that is, I can’t do anything important - on that day I really can’t work. As a result, I give my best friends and relatives shower gels I do not buy new things. Sometimes I feel ashamed that I look like a ragged bank - and shame forces me to go to the store and buy something new; usually these are very cheap things that I won’t be sorry to throw away or not to wear when they seem “dirty” as a result of obsessive thoughts. "
"I had various obsessions - Anton shares his experience. - Strange images came constantly: during walks, while communicating with loved ones, while I was alone. I remember how wildly I was afraid to commit some ridiculous act: get up and yelling at my work colleagues, beating up the chefs of the restaurant I worked at, hitting my mom. I began to feel constrained in communicating with other people. I felt that something was wrong with me and I couldn’t tell about it - because everyone will think that I am sick. " Today, the OCR medical classification refers to neurotic conditions, although until recently it was defined as a mental illness. This illness, as Dmitry Kovpak specifies, is radically different, for example, from schizophrenia by awareness: a person understands that not everything is all right with him, he is critical about the problem, is trying to deal with it.
according to some data, up to 4% of children and adolescents face the disorder; Older people are no exception. The fact that not everyone applies for help also affects the indicators, although in many respects OCD reduces the quality of life, and its impact on a person’s social skills is comparable to the harm from depression and alcohol dependence.
Often a disease occurs and develops in those who live with other diseases, such as depression or bipolar disorder. The tendency toward perfectionism, which is also known for its negative side, may also become a backdrop for the development of OCD. Obsessive-compulsive disorder in itself does not develop into a more serious disease and does not lead to loss of mind, despite the fears of many patients. However, it also happens that OCD is not a diagnosis, but a symptom within a completely different kind of diseases. But to determine the difference in this case is only possible for the doctor: self-diagnosis will not lead to anything, except for nervous breakdowns and new anxious thoughts.
"Obsessive," strong "rituals came to me when I began to lose weight actively at fourteen," Lyudmila said. "It was such a hell of a neurotic cocktail: anorexia, nervous exhaustion, and OCD. There were several basic rituals: I could look in the mirror before as long as I didn’t like my facial expression (it sounds weird and a bit creepy), lay socks before going to bed at a specific angle from the bed, move a chair or curtains in a certain way. It was necessary to say goodbye to the house when you leave somewhere - otherwise "Offended" Six years have passed since then, with anorexia, I said goodbye to sixteen years, with the rest of the eating disorders - a little later. Now I have almost two years of more or less adequate life behind my back - except for nightmares that sometimes come off and OCD " .
How to treat the disorder
Experts still can not unambiguously explain why OCD develops. On this score, there are many hypotheses, but none of them have so far any rigorous evidence. The genetic factor, of course, is taken into account: the probability of OCD inheritance from immediate relatives can be from 7 to 15%. Sometimes they see the reason in a decrease in the level of serotonin, the “hormone of happiness,” but this theory has not received enough evidence.
Since it is customary to treat OCD as a neurosis, it is treated accordingly, often using cognitive-behavioral therapy. It allows you to determine the causes of anxiety, to understand where the internal conflict originated, followed by obsessions and compulsions. Having dealt with the source of OCD, the psychotherapist helps a person to see the irrationality of fears and their contradiction between reality and life experience. One of the tasks of a specialist at this stage is to change the negative attitude to the symptoms to neutral, to teach the patient to accept and experience his fear, and not to avoid him, resuming the vicious circle of obsessions and compulsions. For this, an exposure (immersion) technique can be used, in which the state of anxiety is artificially intensified to the limit, and the patient is not allowed to perform his usual compulsions. Having reached the peak, anxiety unexpectedly disappears.
Anton recalls that at first he received the psychotherapist's proposal to try the exposition with apprehension. "Of course, I was scared, I was afraid that I would get worse from this. I was afraid of obsessive images and thoughts, I got used to run away from them - and then I had to face them face to face. It was a bit disturbing my picture of the world. Once I decided to try compulsive obsessions. I started by presenting in paints how I hurt myself. Of course, during the exercise I noticed an increased anxiety. I became scared. But the more I sank into my fears, the easier it was for me It became. Constantly reinforcing negative thoughts, I finished . That they caused fewer discomfort They come quietly - but leave can just as easily. "
The interlocutor's violent reaction, especially accusations of insanity and reproach, can cause pain to an OCD person and further increase the anxiety.
True, psychotherapy is a long and difficult way to treat obsessions. More often in the case of OCD, a course of antidepressants is prescribed - they inhibit arousal and cause anxiety to recede. But, according to Dmitry Kovpak, this method does not work as well as we would like. In most cases, the patient, though to a lesser extent, still has to perform rituals. In addition, there is no guarantee that anxiety will not escalate again after some time. At the same time, psychotherapy and antidepressants do not exclude each other. The options may be different: you can combine the sessions with a specialist with antidepressants or use psychotherapy first, and then fix the effect with medications.
“I went to a specialist when I entered the university and moved to Moscow,” says Lyudmila. “Then there was some terrible stress, enormous difficulties with the team and personal life. I ran to a psychotherapist because of depression, but it turned out I was also a long-time OCD. The doctor called me a classic neurotic and wrote out tranquilizers and antidepressants. By the end of the course, everything had almost passed - but after about six months I found myself saying goodbye to the house again, apologizing to the walls when I hit them, and commit another as if funny, but very No annoying nonsense. As a new ritual, we added checking closed and unclosed doors in each room, bringing the mess on the table into a specific geometric shape, etc. I don’t think that there are more compulsions - there are always about the same number - but they have definitely become more harmless In general, the attacks of OCD are wavy and always combined with stress. When the next wave rolls in, I first go shopping, do manicures, hair masks and other simple things from self-care - it helps to calm down. And then my program is meditation, breathing exercises, stretching exercises, different variations of yoga, always culminating in shavasana. This is incredibly helpful. I think this way oxygen gets better to the muscles and the head, cortisol becomes smaller, endorphins get bigger, stress goes away, and OCD hides behind the wall until the next time. "
draws anxious imagination. But the violent reaction of the interlocutor, especially accusations of insanity and reproach, can cause pain to a person with OCD and add to the anxiety. If you notice that a loved one has signs of frustration, it is important to understand that he is not guilty of this, and provide proper support, avoiding accusations.
“I started telling friends about OCD when I was twenty-one,” says Olga. “In general, everyone doesn’t care. I can’t say that my relatives support me and I’m not sure that I need it. As I said, shame can To defeat OCD for a while, shame is more important and more unpleasant than fear. So for me, the best help is when people scold me for my shoals, and they don’t say: “Well, you have OCD, it’s good that you came, and don’t give a damn about a gift.” The only thing nobody knows about is that OCD is in every movement of mine, that this disorder determines my whole life I cannot tell about it because it is inexplicable. It is impossible to understand how a person can be so selfish and passionate about himself that even milk chooses in a store according to its own scheme. "
People with OCD are hostages of their own subconscious, sometimes it may seem to them that they are doomed and nothing will help. But, fortunately, the existence of the disorder and its manifestations has recently been said more and more. Clearly expressed examples of people with obsessive-compulsive disorder - Leonardo DiCaprio's characters in Aviator and Jack Nicholson in Better Never, and the autobiographical character of Lena Dunham in the TV series Girls. Bloggers also do not hide the way people live with OCD. Relatively recently, Intrusive Thoughts ("Obsessive Thoughts") has appeared, where you can find useful information about symptoms, treatment, and the course of the disorder.
And yet, if a person is not yet ready to take action, do not force him to treatment: the effectiveness of therapy, according to Dmitry Kovpak, depends on how much the patient is involved in the process. It should be understood that a person with OCD will have to spend on treatment almost as much strength and energy as it takes on his experiences and symptoms. It requires tremendous dedication and continuous work on oneself — which for many people with OCD means literally becoming a different person.
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