Human thought is an incredibly complex phenomenon that we do not yet fully understand and that partly escapes our own control as we experience it. However, when that involuntary part returns to uncontrollable thoughts and drives us to develop involuntary behaviors, we may be dealing with a case of obsessive compulsive disorder (O.C.D.).

What is obsessive-compulsive disorder and what causes it?

Obsessive compulsive disorder is a mental condition characterized by the appearance of involuntary thought patterns and fears that provoke repetitive behaviors. Both phenomena interfere significantly in the person’s life, without the person being able to do anything to stop or control them.

Typically, these patterns are centered around a particular motif, such as fear of germs or fear of clutter and asymmetry.

Their causes are unknown, although biological, genetic and learning factors are being considered.

What is known is that there are certain risk factors that increase the likelihood of suffering from them, such as family history, going through stressful or traumatic events and suffering from other mental health disorders.

What are its symptoms?

The main symptoms of obsessive-compulsive disorder are obsessions (repetitive intrusive thoughts) and compulsions (repetitive and unavoidable behaviors).

Obsessions are repeated, persistent, unwanted thoughts that cause emotional discomfort and have a tendency to intrude when the person is engaged in another activity. For example, it may be a fear of dirt, anxiety about uncertainty, anxiety about asymmetry or disorder, violent thoughts or images about hurting oneself or others, or about sexual or religious issues.

It should be clarified that, in cases where obsessions focus on sexual or violent motives, they do not imply a desire to carry out such actions. In fact, they are often accompanied by extreme revulsion, shame and guilt just for thinking about it.

Compulsions, on the other hand, are ritualized behaviors that attempt to alleviate obsessions or prevent something bad from happening. They can include such things as washing hands or surfaces excessively, constantly checking to see if lights or faucets are off, following strict routines, counting in certain patterns, quietly repeating words or phrases….

In some cases, certain compulsions can end up having an impact on physiological health, such as washing hands to the point of damaging the skin.

How is it treated?

Although obsessive-compulsive disorder is generally considered to be lifelong, in terms of symptomatology it tends to respond well to treatment and can be kept from interfering with daily life. The approach usually combines psychotherapy and pharmacology.

From psychotherapy, a cognitive-behavioral strategy is usually adopted, with methods such as gradual exposure and response prevention (consisting of exposing the patient to the object of an obsession in a controlled manner so that the patient tries to repress the compulsion).

At the same time, it is common to administer antidepressant drugs, such as some selective serotonin reuptake inhibitors (SSRIs).

In the most extreme cases in which the patient is unable to function properly in his or her life and does not respond to conventional treatments, the psychiatrist may resort to intensive outpatient or residential treatment, deep brain stimulation or transcranial magnetic stimulation.

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