Obsessive Compulsive Disorder

Obsessive-compulsive disorder (OCD) is characterised by obsessive-compulsive thoughts and/or coercive actions that the affected person must constantly repeat without being able to control the number or intensity. These acts of coercion can trigger fear. The coercive actions and thoughts are intrusive, the affected person has little or no control over them. The activities are usually not experienced as meaningful.

It is very difficult for those affected to defend themselves against them. After the implementation of the compulsions there is only a temporary relief, which is replaced by fears, feelings of guilt and shame, which in turn can trigger the compulsive thoughts and actions. About 1% of the population is affected by an obsessive-compulsive disorder.

Typical compulsivity symptoms are:

• Fear of infection (obsessive hand washing).
• Fear that something bad could happen to someone or to yourself (hours of imagining disaster scenarios).
• Unwanted/forbidden thoughts (sexuality, religion).
• To have to put things in certain order.
• To collect things that are unnecessary.
• Constantly having to check and control certain things or processes.

Everyone knows such situations: You go on holiday and on the motorway you suddenly get the thought: 'Have I turned off the gas/light? Is the stove still burning? Have I locked the apartment?'?' Normally you can stop these thoughts at some point with a rational thought (or check: you call the neighbour and ask him to check it). One basically orders oneself to stop thinking: 'Now it’s enough with these ideas'.

With an obsessive-compulsive disorder this is not so easy. One cannot ignore or control these thoughts. The thoughts or actions follow their own inner logic. One experiences them as one’s own thoughts, but they do what they want. A control or regulation is only possible with great exertion, and only for a short time.

The quality of life of those affected is often severely restricted and all action revolves around the symptoms of coercion or attempts to prevent them. Ultimately, this leads to an obstruction of important areas of life such as work, study and family.

If you make the following observations very often and have been tortured them for some time, then it would make sense to seek medical assistance:

• Do you wash or clean a lot?
• Do you check a lot?
• Do you have torturous thoughts that you want to get rid of but cannot?
• Do you need a lot of time for everyday activities?
• Do you worry about order and symmetry?

Again: everyone has thoughts and tendencies in everyday life that are perfectionist or ritualistic. The extent (how much, how often, how strongly is the normal course of life affected, how much can I still regulate the thoughts) and the impossibility of using these tendencies flexibly, makes the problem.

Counselling and therapy options

After a proper diagnosis by the psychiatric specialist, the dual strategy of medication (antidepressants) and psychotherapy (behavioural therapy) proves its worth.). In psychotherapy, for example, certain stimulus-reaction couplings are gradually unlearned or overlaid with other activities. The effectiveness of this method, especially in coercive actions, is about 65-75%.  Psychotherapy should include relapse prophylaxis with so-called booster sessions, i.e. refreshing and strengthening strategies. For many people affected, it is advisable and helpful to go to a self-help group. An inpatient stay is important if suicidal thoughts are present and in the case of serious neglect of areas of life.

In Passau, in-patient treatment would be possible at the district hospital. (Wörthstraße 5, 94032 Passau).

It is important to trust the specialist staff during the process. A diagnosis of 'obsessive-compulsive disorder' cannot be made in a five-minute conversation. It is equally important to talk openly with family and close friends. Close relatives can be helpful in the daily implementation of strategies developed in psychotherapy – and last but not least: you can confide in your loved ones and no longer have to try to hide!

All therapies need time and patience – but in many cases it is worth it!