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Czym jest zaburzenie obsesyjno-kompulsywne (OCD)?

Have you ever heard someone casually say that they are “so OCD?” If you have, it’s probably because OCD (obsessive compulsive disorder) is widely misunderstood in today’s society. Many people think if you like to clean your house a lot or have a quirky way of organizing your stuff, you have OCD – but that isn’t true. OCD is a change or disturbance in thought patterns that results in negative emotions and affects a person’s ability to behave normally. In particular, OCD is characterized by:
  • uncontrollable, intrusive thoughts, beliefs, and ideas
  • negative emotions like guilt and anxiety
  • repetitive and ritualistic behaviors or actions

How does your brain usually handle information?

Your brain is like a supercomputer – it constantly receives new data about your experiences and helps you understand it. To do this, different parts of your brain are programmed to handle different aspects of information processing. For example, one area of the brain might manage incoming sensory data, another might sort and prioritize your thoughts, and a third might convert your thoughts into emotional responses. They all interact with one another to control the flow of information throughout the brain. When all of the parts work together properly, you are able to quickly and accurately process information about the world around you.

What happens when things go wrong?

Sometimes the communication system between the different parts of the brain breaks down. When this happens, information isn’t processed correctly and the brain starts to make mistakes when it tries to sort new data or tell the body how to respond. OCD is linked to communication problems between parts of the brain that translate information into thoughts and actions, including the orbitofrontal cortex, caudate nucleus, cingulate gyrus, and the basal ganglia. When these parts of the brain malfunction, inappropriate information is passed through the system and the person becomes overwhelmed by their thoughts and actions.

Symptomy

Individuals who have been diagnosed with OCD experience two main symptoms- obsessions and compulsions.
Obsessions are intrusive and recurring thoughts, ideas, mental images, and beliefs that are often disturbing and cause significant emotional distress or dysfunction. As the person tries to work or go to school, their obsessive thoughts pop up and interfere with their ability to focus. Most of us can let go of an upsetting thought or belief that is bothering us, but a person with OCD is unable to control their obsessions. Some common obsessions include:
  • fear of contamination, germs, or dirt
  • fear of forgetting something (like turning off the stove)
  • fear of hurting yourself or others
  • unwanted thoughts about aggressive or sexual behaviors
  • excessive beliefs about the importance of perfection or symmetry
  • excessive beliefs about morality or religion
  • excessive superstitious beliefs (like the belief that stepping on a sidewalk crack will harm your mother)
Compulsions are behaviors or rituals that a person feels driven to do. Compulsions are often performed in an effort to reduce the anxiety and distress caused by obsessions. For example, an obsessive fear of germs often results in compulsive, repetitive hand washing. Compulsions can involve mental behaviors like repeating a word ten times in your head, or physical behaviors like tapping a desk ten times. They are usually irrational and have no connection or effect on the person’s problem or fears. Some common compulsions include:
  • counting, repeating words, or tapping
  • double-checking things like stove knobs, door locks, and light switches
  • cleaning or washing excessively
  • repeatedly contacting family and friends to confirm their safety and health
  • arranging items in a specific way or putting things in a certain order
  • following a specific routine or ritual
  • keeping items that should be thrown out, like old newspapers or empty containers of milk
Many people with OCD have good insight; they recognize that their obsessions and compulsions are unreasonable or unhelpful, but they still aren’t able to control their thoughts or behaviors. Obsessions and compulsions are especially distressing as they become more complex – some people develop rituals that take up hours of their day, every day. When this happens, the symptoms are considered severe because they have the power to affect most aspects of the person’s life and often interfere with relationships, work, and school.

Risk factors/causes

Most of the time OCD can’t be attributed to a single cause. Instead, they are the result of the interplay between several different risk factors.
  • Genetics: if you have a close family member with OCD, you are more likely to have it yourself.
  • Psychological factors: if you have symptoms of another mental illness, you are more likely to develop OCD. You are especially at risk if you have been diagnosed with an anxiety disorder or a mood disorder, like depression. Certain personality characteristics, like perfectionism, high sense of morality, and high sense of responsibility, are also associated with OCD.
  • Illnesses during childhood: in children, the body’s reaction to an infection with streptococcus (the bacteria that causes strep throat) can cause the sudden development of OCD.
  • Other illnesses or injuries: any time you have a physical illness or an injury to your brain, symptoms of OCD can be triggered. Traumatic brain injuries, certain viruses, and brain tumors have all been linked to the disorder.

How common is OCD?

OCD is one of the most common mental disorders and about 2% of US adults experience OCD at some point during their life. Of those, more than half endure symptoms that are extremely severe and cause significant problems. Men and women are diagnosed with OCD at equal rates, but men are more likely to experience symptoms during childhood. Approximately 25% of all cases of OCD are children under the age of 18, and 1/3 of adults with OCD developed the disorder at a young age.

Is OCD preventable?

Scientists and mental health professionals agree that the initial onset of OCD is not preventable, but that patients may be able to manage their symptoms once they have been diagnosed. To do this, people with OCD should identify any situations or events that could trigger their symptoms and keep a diary of their symptoms so they can immediately seek treatment if their symptoms get worse. They should also continue taking all their medications as prescribed. Sometimes patients stop taking their medications when their symptoms seem to improve or go away, but that is extremely dangerous - 20% of patients stop responding to medications that once worked for them because they stopped taking them as prescribed!

What are some treatments for OCD?

Treatments for OCD usually involve a combination of medication and psychotherapy, based on the specific needs and symptoms of the patient. These treatments work together to improve functioning and decrease symptom severity over time.

Medications

The medications used to treat OCD are called antidepressants. Antidepressants like selective serotonin reuptake inhibitors (SSRI’s) focus on fixing dysfunctional communication between the orbitofrontal cortex, caudate nucleus, cingulate gyrus, and basal ganglia. They do this by increasing the amount of a chemical messenger called serotonin in these parts of the brain, which improves information processing. Antidepressants can usually produce a 40-60% reduction in symptoms of OCD.

Psychotherapy

One of the most effective psychotherapies for OCD is cognitive behavioral therapy (CBT). CBT focuses on identifying and challenging maladaptive thoughts, emotions, beliefs, and behaviors, and then replacing them with more adaptive ones. CBT also exposes patients to the situations that they’re afraid of, and helps them to change their behavior. In doing so, CBT helps patients to cope with obsessions and resist compulsions, and usually produces a 60-80% reduction in symptoms of OCD.

Weź pod uwagę:

Scientists recently found that a gene that causes certain kidney disorders also causes symptoms of OCD. They believe the discovery could help them develop a urine test to identify babies and young children who may be at risk for developing OCD. Their test could eventually be a key part of early intervention and lead to better outcomes among children with a genetic connection to the disorder.

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