Obsessive-compulsive disorder is strongly linked to anxiety. One common symptom is excessive hygiene.
Continuing washing hands, checking things or fear of getting sick. The corona pandemic has made life difficult for many OCD sufferers.
Mild and intermittent compulsions and actions are common. However, about 1–3 percent of Finns suffer from the actual obsessive-compulsive disorder. The number of people suffering from the disorder has not increased, but the corona pandemic has intensified the symptoms of many, says Husi's psychiatry line manager and psychologist Jan-Henry Stenberg. Hus is responsible for organizing specialized medical care in the Uusimaa region.
According to Stenberg, the effects of the pandemic can be seen especially in compulsive symptoms that concern washing, cleanliness and the fear of viruses or bacteria, but also in other symptoms, as obsessive-compulsive disorder is strongly linked to anxiety.
“Some of the patients had moderately mild symptoms before the pandemic, but the pressure caused by the fear of getting sick and the restrictions increased anxiety and the need to alleviate this anxiety with compulsive rituals,” Stenberg describes.
Did an electrical appliance get left on?
Obsessive-compulsive disorder involves compulsive thoughts, compulsive actions, or both. Compulsive activities can be, for example, arranging or checking things or washing hands or surfaces – a person may wash dozens of times a day or check whether electrical appliances are turned off so often that it takes an unreasonably long time to leave the house.
Compulsive thoughts are thoughts that compulsorily come to mind, foreign thoughts that can be related to anything. For example, a person may have images in his mind of someone close to him dying, and with obsessive-compulsive symptoms he tries to deny the realization of this fear.
“The person understands at the level of reason that rituals do not negate the worst fears, but still does them. The most troublesome are sexual or violent thoughts, such as what if I hurt my child or am a pedophile. Such things are really oppressive, and one does not easily dare to seek help for them, even if it is especially important to seek help for them,” states Stenberg.
Hereditary factors play a role
Professor Emeritus of the University of Tampere Jukka Hintikan according to OCD, a more imperceptible form of symptoms can also be associated with it: internal compulsions. A person may have a compelling need, for example, to count to ten every time he does a certain thing.
According to Hintika, heredity plays a significant role in the onset of OCD. The younger the disorder begins, the more genetic predisposition there is.
“Prescribing these drugs should be part of the basic skills of every general practitioner.”
For example, experiences of insecurity and a strong need for control may also influence the onset of the disorder.
“Rarely, however, has there been any terribly dramatic abnormality in the growth environment of a child or young person suffering from obsessive-compulsive disorder. I would say that the disease is a set of symptoms arising from many different reasons, the risks and background factors of which are known, but based on them it is not possible to predict who will eventually develop the disorder,” says Hintikka.
According to Stenberg, obsessive-compulsive disorder is typically diagnosed in childhood or adolescence or between the ages of 20 and 30. After this, getting sick is clearly less common.
Sometimes the disease breaks out in a particularly stressful life situation, such as with pregnancy or becoming a mother.
Medication and psychotherapy
Help for obsessive-compulsive disorder should be sought as soon as the illness starts to make it difficult to function in everyday life, says Hintikka.
“When the symptoms become chronic and become an ingrained part of life, it becomes difficult to get rid of them.”
For the treatment of mild symptoms, Hintikka recommends Mielenterveystalo.fi self-care program for obsessive-compulsive disorder found on the website.
Professional help emphasizes two main lines: medication and various therapies. For obsessive-compulsive disorder, SSRI mood medications are used, which were once developed to treat depression, but which have also been found to be helpful for obsessive-compulsive symptoms.
“In my opinion, prescribing these medications should be part of the basic skills of every general practitioner, and the threshold for trying medication should not be high.”
According to Hintika, online therapy, various short psychotherapies and longer psychotherapy are used for obsessive-compulsive disorder, and particularly good results have been obtained with cognitive psychotherapy. In therapy work, the importance of exposure is emphasized: it is important for a person to learn to change their own behavior and tolerate situations that produce symptoms.
The younger the patient, the more important the role of the family and close network.
“Sometimes the interaction in families has become such that the family seems to support the existence of symptoms – for example, checking things on behalf of the patient in order to save time. This is no help at all.”
According to Hintika, some patients get enough help from medication alone, some from therapy alone, and some need both at the same time. In the treatment of obsessive-compulsive disorder, the most important goal is not the absence of symptoms, but the treatment primarily aims to alleviate the symptoms and thereby make a person's everyday life easier.
When the most difficult symptoms ease, a person often gets an extended circle of life, and the harm associated with the remaining symptoms is also alleviated.
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