Obsessive-compulsive disorder

When something becomes a compulsion

Certain routines are part of our everyday life: For example, brushing our teeth after getting up or washing our hands after going to the toilet. Rituals are also widespread: Reading before we go to sleep, or checking that all the windows are closed before we leave the house. These things give us a certain structure and reliability. But what happens when such behaviors take over and even determine our daily lives?
For some people, this is exactly the case: they can't help but perform certain actions over and over again, because they feel a great, inner tension if they don't do it. Before they do, they can't sleep, leave the house, or relax. For some people, compulsions cause them to feel severely restricted in their daily lives, while others feel affected by multiple, smaller compulsions: the manifestations vary greatly – but are grouped together under obsessive-compulsive disorder.
Those affected often suffer greatly and find it difficult to ignore the compulsion. In addition, they do not like to talk about it because they are afraid of being seen as "abnormal". In fact, obsessive-compulsive disorder is a mental illness that they themselves cannot control. It is important to seek advice in such situations as a person affected and to react with understanding as a friend or family member in order to be able to combat this disorder.

Overview

Obsessive-compulsive disorders can be very different, but they are all characterized by so-called obsessive thoughts or compulsive actions.

Obsessive thoughts are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.
Compulsive actions are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.

Basically, any thought or action can become compulsive. However, there are certain compulsions that occur in a wide range of people and are particularly common:

Obsessive-compulsive disorders can be very different, but they are all characterized by so-called obsessive thoughts or compulsive actions.
Obsessive thoughts are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.
Compulsive actions, on the other hand, are concrete behaviors or rituals that the affected persons "must" perform again and again. These actions are usually involuntary and, in retrospect, seem excessive or pointless to the affected person. In the moment itself, however, it feels to them as if they absolutely must perform these actions in order to prevent dire consequences or „disasters". When they suppress the compulsion, feelings of fear, disgust, emptiness, or guilt often surface in the sufferer.

 

Basically, any thought or action can become compulsive. However, there are certain compulsions that occur in a wide range of people and are particularly common:

Washing and cleaning compulsions

Affected persons feel fear or disgust of dirt and grime, of germs and other "sources of infection". Therefore, they wash their hands frequently and especially several times very thoroughly or take showers more often than usual. Sometimes they also clean certain things in the household in an exaggerated manner, even if no contamination is visible at all. These washing procedures – whether on their own body or in the environment – take up a lot of time and can lead to skin damage. In addition, they often give rise to conflicts, because those affected severely restrict themselves in their daily lives or, for example, occupy the bathroom for exceptionally long periods when living with others.

Control compulsions

In this case, affected persons repeatedly check certain things – such as electrical appliances and locks – even though they already know that everything is in order. They do this out of fear that something bad might happen: Someone might break into the home if all the locks aren't meticulously locked, or an electrical appliance might catch fire if it hasn't been checked before. People have a strong fear of making mistakes for which they could be blamed. That's why they try to avoid such mistakes through increased control.

Collection and storage compulsions

Affected people collect various things, usually without having a real use for them. The possession of these things brings them inner peace and satisfies the idea of collecting. Separation from these objects, on the other hand, is very difficult for those affected.

Aggressive, religious or sexual obsessive thoughts

These obsessive thoughts are a special kind, because in all cases they contradict the values of the affected person and yet impose themselves penetratingly. For example, malicious impulses and the desire to hurt other people may suddenly appear – thoughts that torment the affected persons because they do not want to and feel this desire to be morally wrong. However, the content of such thoughts can also be sexual or religious.

Other compulsions

There are many more compulsions, but compared to the other compulsions they occur less frequently. For example, the compulsion to arrange things in an exaggeratedly symmetrical and precise manner (order compulsion), to repeat actions several times and to perform them anew until something has "really succeeded" (repetition compulsion) or the compulsion to count certain things in everyday life - no matter how many there are (counting compulsion).

As you can see, obsessive-compulsive disorders are multifaceted, and there are many more than we have described. Therefore, it is important to take seriously actions or thoughts that occur against one's will and over and over again and are unpleasant for the person. Such obsessive-compulsive disorders can be well treated. However, for this, it is important to take the first step and talk about it instead of feeling ashamed. Talk to someone you trust. This can be a friend or family member. If you would rather talk first to someone you don't know who is a professional in the psychological field, you can go to one of the many possible drop-in centers. If you observe one or more of the following symptoms in yourself or a loved one, you should take them seriously and act directly:
  • Certain behaviors occur repeatedly at an increased rate – such as washing hands or checking locks. Sometimes these actions do not make sense in the situation – if the person in these cases already has freshly washed hands or the lock has already been checked twice. The affected person is afraid that something bad will happen if they do not perform these actions.
  • Frequent, exaggerated thoughts that are difficult or impossible to suppress and that are perceived as unpleasant.
  • The affected person's everyday life is severely restricted by obsessive-compulsive disorder: For example, she or he avoids events because she or he does not want to use a public toilet, or does not invite anyone to her or his home because of the compulsive collecting. These restrictions are often not recognizable at first glance, so one should be careful if the described actions or thoughts reduce a person's enjoyment of life and they suffer as a result.
As you can see, obsessive-compulsive disorders are multifaceted, and there are many more than we have described. Therefore, it is important to take seriously actions or thoughts that occur against one's will and over and over again and are unpleasant for the person. Such obsessive-compulsive disorders can be well treated. However, for this, it is important to take the first step and talk about it instead of feeling ashamed. Talk to someone you trust. This can be a friend or family member. If you would rather talk first to someone you don't know who is a professional in the psychological field, you can go to one of the many possible drop-in centers. If you observe one or more of the following symptoms in yourself or a loved one, you should take them seriously and act directly:
  • Certain behaviors occur repeatedly at an increased rate – such as washing hands or checking locks. Sometimes these actions do not make sense in the situation – if the person in these cases already has freshly washed hands or the lock has already been checked twice. The affected person is afraid that something bad will happen if they do not perform these actions.
  • Frequent, exaggerated thoughts that are difficult or impossible to suppress and that are perceived as unpleasant.
  • The affected person's everyday life is severely restricted by obsessive-compulsive disorder: For example, she or he avoids events because she or he does not want to use a public toilet, or does not invite anyone to her or his home because of the compulsive collecting. These restrictions are often not recognizable at first glance, so one should be careful if the described actions or thoughts reduce a person's enjoyment of life and they suffer as a result.

It is not yet clear why obsessive-compulsive disorder occurs. In any case, however, it is a psychological, means a mental illness, which can enormously restrict the lives of those affected. An obsessive-compulsive disorder is also not a trained behavior caused by "bad habits" or the like. Many different factors can play a role in the development of compulsions. In some cases, causes for the development can be found in particularly stressful or formative life events, or a connection with the circumstances of the person affected can be inferred.

In the brain, nerve cells communicate via so-called messenger substances, which are precisely coordinated to function so well. In obsessive-compulsive disorders, however, there is an imbalance of these messenger substances, and this alters the communication between the cells in the brain. Exactly which messenger substances are affected and in what way has not yet been clearly investigated. In addition, this connection can also be differently pronounced from compulsion to compulsion and vary from individual to individual.

The course of obsessive-compulsive disorder is also very diverse, which is why it is difficult to describe exactly what happens in obsessive-compulsive disorder. The symptoms can also change over time. For example, the symptoms may become weaker overall or new thoughts and actions may be added while others disappear. The content of the compulsions also varies greatly and can change over time. In general, however, it can be said that obsessive-compulsive disorders can interfere with the daily lives of those affected at an early stage: When compulsive actions or thoughts take precedence over other activities and lead, for example, to neglecting duties and needs in everyday social, professional or school life.

Es kann passieren, dass Betroffene ungerne über ihre Zwänge reden, da sie sich nicht verstanden fühlen und sich für ihr „abnormales“ Verhalten schämen. Als angehörige Person ist es dann wichtig, sehr einfühlsam und verständnisvoll zu sein. Es sollte ein sicherer Raum geschaffen werden, in dem die betroffene Person offen über ihre Gedanken und Handlungen sprechen kann, ohne verurteilt zu werden. Das kann dabei helfen, betroffenen Personen eine mögliche Psychotherapie näher zu bringen, da sie mehr und mehr dazu bereit sind, sich anderen anzuvertrauen und über ihre Erkrankung zu sprechen.

It can happen that affected persons are reluctant to talk about their compulsions because they do not feel understood and are ashamed of their "abnormal" behavior. As a carer, it is then important to be very empathetic and understanding. A safe space should be created where the affected person can talk openly about her our his thoughts and actions without being judged. This can help bring affected individuals closer to possible psychotherapy, as they become more willing to confide in others and talk about their condition.

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

What does an obsessive-compulsive disorder feel like?

Obsessive-compulsive disorders can be very different, but they are all characterized by so-called obsessive thoughts or compulsive actions.

Obsessive thoughts are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.
Compulsive actions are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.

Basically, any thought or action can become compulsive. However, there are certain compulsions that occur in a wide range of people and are particularly common:

Obsessive-compulsive disorders can be very different, but they are all characterized by so-called obsessive thoughts or compulsive actions.
Obsessive thoughts are images, impulses or thoughts that repeatedly and very suddenly come to the mind of the affected person, and which he or she cannot easily ignore or suppress. These thoughts do not have to coincide with one's own opinion, but impose themselves on the affected person – often it even happens that the affected person her- or himself finds these thoughts repulsive or frightening.
Compulsive actions, on the other hand, are concrete behaviors or rituals that the affected persons "must" perform again and again. These actions are usually involuntary and, in retrospect, seem excessive or pointless to the affected person. In the moment itself, however, it feels to them as if they absolutely must perform these actions in order to prevent dire consequences or „disasters". When they suppress the compulsion, feelings of fear, disgust, emptiness, or guilt often surface in the sufferer.

 

Basically, any thought or action can become compulsive. However, there are certain compulsions that occur in a wide range of people and are particularly common:

Washing and cleaning compulsions

Affected persons feel fear or disgust of dirt and grime, of germs and other "sources of infection". Therefore, they wash their hands frequently and especially several times very thoroughly or take showers more often than usual. Sometimes they also clean certain things in the household in an exaggerated manner, even if no contamination is visible at all. These washing procedures – whether on their own body or in the environment – take up a lot of time and can lead to skin damage. In addition, they often give rise to conflicts, because those affected severely restrict themselves in their daily lives or, for example, occupy the bathroom for exceptionally long periods when living with others.

Control compulsions

In this case, affected persons repeatedly check certain things – such as electrical appliances and locks – even though they already know that everything is in order. They do this out of fear that something bad might happen: Someone might break into the home if all the locks aren't meticulously locked, or an electrical appliance might catch fire if it hasn't been checked before. People have a strong fear of making mistakes for which they could be blamed. That's why they try to avoid such mistakes through increased control.

Collection and storage compulsions

Affected people collect various things, usually without having a real use for them. The possession of these things brings them inner peace and satisfies the idea of collecting. Separation from these objects, on the other hand, is very difficult for those affected.

Aggressive, religious or sexual obsessive thoughts

These obsessive thoughts are a special kind, because in all cases they contradict the values of the affected person and yet impose themselves penetratingly. For example, malicious impulses and the desire to hurt other people may suddenly appear – thoughts that torment the affected persons because they do not want to and feel this desire to be morally wrong. However, the content of such thoughts can also be sexual or religious.

Other compulsions

There are many more compulsions, but compared to the other compulsions they occur less frequently. For example, the compulsion to arrange things in an exaggeratedly symmetrical and precise manner (order compulsion), to repeat actions several times and to perform them anew until something has "really succeeded" (repetition compulsion) or the compulsion to count certain things in everyday life - no matter how many there are (counting compulsion).

As you can see, obsessive-compulsive disorders are multifaceted, and there are many more than we have described. Therefore, it is important to take seriously actions or thoughts that occur against one's will and over and over again and are unpleasant for the person. Such obsessive-compulsive disorders can be well treated. However, for this, it is important to take the first step and talk about it instead of feeling ashamed. Talk to someone you trust. This can be a friend or family member. If you would rather talk first to someone you don't know who is a professional in the psychological field, you can go to one of the many possible drop-in centers. If you observe one or more of the following symptoms in yourself or a loved one, you should take them seriously and act directly:
  • Certain behaviors occur repeatedly at an increased rate – such as washing hands or checking locks. Sometimes these actions do not make sense in the situation – if the person in these cases already has freshly washed hands or the lock has already been checked twice. The affected person is afraid that something bad will happen if they do not perform these actions.
  • Frequent, exaggerated thoughts that are difficult or impossible to suppress and that are perceived as unpleasant.
  • The affected person's everyday life is severely restricted by obsessive-compulsive disorder: For example, she or he avoids events because she or he does not want to use a public toilet, or does not invite anyone to her or his home because of the compulsive collecting. These restrictions are often not recognizable at first glance, so one should be careful if the described actions or thoughts reduce a person's enjoyment of life and they suffer as a result.
As you can see, obsessive-compulsive disorders are multifaceted, and there are many more than we have described. Therefore, it is important to take seriously actions or thoughts that occur against one's will and over and over again and are unpleasant for the person. Such obsessive-compulsive disorders can be well treated. However, for this, it is important to take the first step and talk about it instead of feeling ashamed. Talk to someone you trust. This can be a friend or family member. If you would rather talk first to someone you don't know who is a professional in the psychological field, you can go to one of the many possible drop-in centers. If you observe one or more of the following symptoms in yourself or a loved one, you should take them seriously and act directly:
  • Certain behaviors occur repeatedly at an increased rate – such as washing hands or checking locks. Sometimes these actions do not make sense in the situation – if the person in these cases already has freshly washed hands or the lock has already been checked twice. The affected person is afraid that something bad will happen if they do not perform these actions.
  • Frequent, exaggerated thoughts that are difficult or impossible to suppress and that are perceived as unpleasant.
  • The affected person's everyday life is severely restricted by obsessive-compulsive disorder: For example, she or he avoids events because she or he does not want to use a public toilet, or does not invite anyone to her or his home because of the compulsive collecting. These restrictions are often not recognizable at first glance, so one should be careful if the described actions or thoughts reduce a person's enjoyment of life and they suffer as a result.
Where does an obsessive-compulsive disorder come from?

It is not yet clear why obsessive-compulsive disorder occurs. In any case, however, it is a psychological, means a mental illness, which can enormously restrict the lives of those affected. An obsessive-compulsive disorder is also not a trained behavior caused by "bad habits" or the like. Many different factors can play a role in the development of compulsions. In some cases, causes for the development can be found in particularly stressful or formative life events, or a connection with the circumstances of the person affected can be inferred.

What happens in obsessive-compulsive disorder?

In the brain, nerve cells communicate via so-called messenger substances, which are precisely coordinated to function so well. In obsessive-compulsive disorders, however, there is an imbalance of these messenger substances, and this alters the communication between the cells in the brain. Exactly which messenger substances are affected and in what way has not yet been clearly investigated. In addition, this connection can also be differently pronounced from compulsion to compulsion and vary from individual to individual.

 

The course of obsessive-compulsive disorder is also very diverse, which is why it is difficult to describe exactly what happens in obsessive-compulsive disorder. The symptoms can also change over time. For example, the symptoms may become weaker overall or new thoughts and actions may be added while others disappear. The content of the compulsions also varies greatly and can change over time. In general, however, it can be said that obsessive-compulsive disorders can interfere with the daily lives of those affected at an early stage: When compulsive actions or thoughts take precedence over other activities and lead, for example, to neglecting duties and needs in everyday social, professional or school life.

Help with obsessive-compulsive disorders

It can happen that affected persons are reluctant to talk about their compulsions because they do not feel understood and are ashamed of their "abnormal" behavior. As a carer, it is then important to be very empathetic and understanding. A safe space should be created where the affected person can talk openly about her our his thoughts and actions without being judged. This can help bring affected individuals closer to possible psychotherapy, as they become more willing to confide in others and talk about their condition.

 

It can happen that affected persons are reluctant to talk about their compulsions because they do not feel understood and are ashamed of their "abnormal" behavior. As a carer, it is then important to be very empathetic and understanding. A safe space should be created where the affected person can talk openly about her our his thoughts and actions without being judged. This can help bring affected individuals closer to possible psychotherapy, as they become more willing to confide in others and talk about their condition.

Who can I talk to?

You have decided to seek help for yourself or someone close, and you ask yourself where to find support? Firstly: You should know that there are many different points of possible contact and various professionals to work with. It is important to first find out which path individually suits best.

This is why a good first step is to talk to your general practitioner. As with a therapist, because of the pledge of secrecy, everything you tell them remains confidential and will not leave the room you are in. Of course, you may also bring a friend of a family member.

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