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Obsessive-compulsive disorder

Causes & Symptoms

What are Obsessive Compulsive Disorder?

Obsessive-compulsive disorder is one of the most common mental illnesses in adulthood. There are obsessive-compulsive disorders in which obsessive-compulsive thoughts are in the foreground and those in which compulsive actions are the main part of the symptoms.

Obsessive-compulsive thoughts force themselves on those affected and constantly occupy them in the same way. These thoughts are almost always threatening or distressing. Trying to suppress the thoughts is usually unsuccessful.

Compulsive acts or rituals are not perceived as pleasant, nor do they serve to perform useful tasks. Affected people often experience it as a prevention against an objectively improbable event that could harm them or in which they themselves could cause harm. In general, patients experience this behavior as pointless and therefore keep trying to counteract it. Fear, tension, or disgust are usually constant and intensify when trying to suppress these actions.

Obsessive Compulsive Disorder - Causes: How do compulsions arise?

In order for an obsessive-compulsive disorder to develop, several components usually have to come together. Are risk factors
  • Inheritance
    Various research projects have found an increased incidence of obsessive-compulsive disorders and anxiety disorders in relatives of those affected. If one or both parents have obsessive-compulsive disorder, the risk of developing obsessive-compulsive disorder is increased in the children. A similar picture emerges with twins. However, since many members of stressed families also remain healthy, the genetic connection is assessed to be rather low. It is also unclear to what extent the children take over compulsions from their parents through model learning.
  • Neurobiological factors
    In those affected, certain areas of the brain are hyperactive. Among other things, these areas are assigned to special filter systems for information processing and influenced by the messenger substance serotonin. Successful therapy of compulsions leads to normalization of the hyperactivity of these brain regions. Compulsions to collect (hoarding of intrinsically worthless objects) also occur more frequently, but can also exist independently of obsessive-compulsive disorders. Compulsive-related disorders include compulsive scratching of the skin and compulsive pulling of hair.
  • Parenting styles
    If high expectations of independence and responsibility are set early on, mistakes are assessed very critically and successes are little recognized, sensitive children can become insecure. They then react more cautiously and fearfully to demands and in interpersonal contact. An increased striving for security can be the result. They try to avoid mistakes and criticism through perfectionism. Even if parents repeatedly warn their children of dangers and protect them excessively, this can lead to persistent uncertainty. However, parenting styles are never solely responsible for the disease.
  • Formative events in the life story
    If extraordinary stress occurs in the course of life (for example physical or sexual violence, emotional neglect, the early death of a parent), people who are already insecure can feel overwhelmed. The obsessive-compulsive symptoms are then used as a proxy to regain control of a situation that seems to be impossible to cope with.
  • Personality traits
    People who absolutely want to avoid mistakes often check again. High levels of anxiety and low self-esteem also require more security and can thus lead to compulsions. Pronounced shyness and poor assertiveness are also risk factors.
  • Triggers for the onset or worsening of obsessive-compulsive disorder or for a relapse
    There are often emotionally stressful life events associated with intense, negative emotions. This includes drastic stresses in partnership and family, the transition to a new phase of life or a persistent occupational overload situation. These events do not necessarily have to be the cause of the obsessive-compulsive disorder. However, you can activate an existing vulnerability (predisposition), even if the constraints were successfully overcome at an earlier point in time.

Obsessive Compulsive Disorder Symptoms: What Are The Symptoms?

Obsessive-compulsive disorder feel a strong inner urge to think or do things that they themselves - at least at the beginning of the symptoms - consider nonsensical or exaggerated. The attempt to defend oneself against this urge is mostly unsuccessful or even leads to an increase in thoughts and impulses. Stressful thoughts and feared catastrophes keep pushing their way into consciousness and trigger massive unrest, tension or disgust. Although the mind knows that the thoughts and fears are nonsensical or exaggerated, the feeling of threat cannot be calmed. It can only be reduced through ritualized countermeasures with compulsive acts or mental rituals. This can sometimes take up to hours and affect the entire daily routine.

The insight into the absurdity of thoughts and actions is often associated with shame. As a result, many sufferers try to hide their symptoms from friends and family.

Symptoms of all obsessive-compulsive disorder

All constraints have a threat side and a defense side. Example:
A thought experienced as uncontrollable signals a threat:
“If you don't check again, something bad will happen”.
This thought is neutralized by an obsession, for example by repeatedly checking the stove.
The tricky thing is that the fears cannot be allayed with a one-time inspection. It takes multiple, time-consuming checks and rituals or reinsurance to reassure you. As a rule, this increases the uncertainty of those affected.

Symptoms of washing and control compulsions

In the case of compulsory washing, those affected fear infection or harm to themselves or other people through contact with dangerous substances or pathogens. The fear and feelings of disgust caused by the unpleasant performances can supposedly only be alleviated by extensive cleaning rituals.

People who suffer from an obsession with control are constantly afraid of causing disasters. They fear that they have caused a fire, flood or break-in through negligence. Others have the thought of running over someone without realizing it. You therefore drive the route several times or call the police.

Symptoms of other obsessive-compulsive disorder

Some patients are driven by their fears to follow magical rituals or rules to avert misfortune from loved ones. You have to do things in a very specific order and with a given frequency, for example you must not step on the joints. Others develop reinsurance and repeat pressures.

More symptoms

Obsessive-compulsive disorder often coexists with other disorders, such as
  • depression
  • Panic disorder
  • Social phobia
  • Personality disorders
  • Body Dysmorphic Disorder (being overly concerned with one's own appearance)
  • Attention Deficit Disorder (ADHD)
  • Post Traumatic Stress Disorder (PTSD)
  • eating disorder

Diagnosis

Diagnosis: This is how an obsessive-compulsive disorder is diagnosed

To be diagnosed with Obsessive Compulsive Disorder, the obsessive-compulsive act or thought must have occurred on most days for at least two weeks. The compulsions must be experienced as excruciating or interfere with your normal activity.

Standardized interviews or questionnaires enable us to precisely determine the severity of your obsessive-compulsive disorder. We proceed very sensitively in the diagnostic discussions and give you enough time and space so that you can develop the trust you need in us.