Frequently asked questions

There is still no real explanation as to how obsessive-compulsive disorder develops. As with many mental illnesses, a genetic predisposition is one of the triggering factors. However, heredity alone is usually not enough to trigger the onset of the disorder.

Another factor could be a disease of the brain, particularly due to changes in metabolism. However, it is not clear whether these actually cause the disease or merely accompany it. However, it has been shown that they disappear after successful treatment. It is also assumed that psychological factors play a role in OCD. These include upbringing, traumatic childhood experiences, negative later life events and a personality predisposition.

Playing computer games can be addictive, with similar mechanisms to those when taking addictive substances. Winning activates the reward centre in the brain. The desire to relive a feel-good sensation develops. In time, tolerance develops. The dose, in this case the amount of game-playing, must be increased. As with other addictive situations, control is lost. Gaming dominates. School, education, and family are neglected.
Successful games are designed in a way that binds the user. These games last forever. Graphic features change frequently so that there is always something new to discover. Games distribute rewards, but players do not know when. Games that involve team activity generate social bonding. The degree of difficulty is tailored to the player; this leads to winning, which motivates the player to keep playing. Not every phase of intensive play can be qualified as addiction. Since 2019 however, gaming disorder is recognised as a disease by WHO. This designation facilitates diagnosis and treatment.

An intellectual disability is often caused by genetic defects and mutations. In addition, problems before, during and after birth can lead to this, including from premature births or birth traumas. The use of drugs, medicines or alcohol during pregnancy is also a possible trigger. Other causes include brain defects in development and infections. In many cases, however, the exact cause is not known.

Fears and phobias can have very different causes, which in combination can trigger the disease. These include family predisposition, early childhood experiences, traumatic experiences, stressful situations or various personality disorders. Anxiety and phobias can also be caused by organic diseases, for example diseases of the cardiovascular system, the respiratory tract, thyroid disorders or pathological changes in the brain’s nerves.

Sleep disorders have multiple causes. These include physical and mental issues, certain medicines, the sleep environment, lifestyle issues, or certain periods in life. A frequent physical problem is sleep apnoea, consisting of periods of nocturnal breathing arrest. Other common physical causes are restlessness in the legs (restless-legs syndrome), pain syndromes, or cardiovascular disorders. Sleep disturbances can also accompany several mental diseases, such as depression, anxiety, or bipolar disorder.

Other common triggers are noise, shift work, bruxism (teeth grinding), use of drugs or alcohol, sleepwalking, or the special circumstances of pregnancy and menopause. Also, the influence of worry, stress and burdensome events on sleep should not be underestimated.

Not every change in eating behaviour reflects an eating disorder. For instance, decreased food intake can be a reaction to stress or sadness. Pathologically reduced food intake as part of anorexia is characterised by the following:

• Excessive preoccupation with the issue of eating.
• Eating behaviour displays a high level of self-control.
• Count calories incessantly and weigh themselves daily (even more than once).
• They eat slowly.
• They drink plenty of water to fill the stomach.
• They find excuses to avoid eating in the company of others or, when that is inevitable, to avoid eating (“I have eaten already”).
• Severe weight loss.
• Excessive sports activity.
• Consider themselves fat despite obvious underweight.
• Have difficulty concentrating, lose hair and have dry skin, and feel cold.
• Develop lanugo hair (new-born facial hair).

Body-mass index (BMI) shows the relationship between height and weight. The normal range is between 18.5 and 24.9. Values below 18.5 indicate underweight, and values below 14.5 are life-threatening.

Even though the BMI is not the ultimate parameter of health, it is a good indicator of extremes. Severe overweight can also have life-threatening effects, albeit less acute. A BMI of more than 30 indicates severe overweight; this should be reduced.

Obsessive-compulsive personality disorder is a different clinical picture to obsessive-compulsive disorder. In obsessive-compulsive disorder, sufferers experience recurring compulsions to do or think a certain thing. They can hardly resist them, even though they are aware of the futility of the compulsions.

Personality disorders relate to facets of the personality that are intensely pronounced, but at the same time not very helpful for a healthy, unencumbered life. Obsessive-compulsive personality disorder falls under this category. Those affected are driven by exaggerated perfectionism, a desire for control and excessive orderliness. Due to their excessive demands on themselves, they get bogged down and bogged down in many tasks and activities. They are very concerned with order and rules and follow them strictly. As a result, they lose flexibility and quality of life and develop stress and/or other illnesses.

So-called selective serotonin reuptake inhibitors (SSRIs), which are also used for depression, are recommended for the medicinal treatment of obsessive-compulsive disorder. If the desired effect is not achieved, it can be enhanced by adding a low dose of an atypical antipsychotic.

At the time of menopause, women go through a change in their hormonal balance and their fertility. Oestrogen and progesterone (sex hormones) production decreases. This leads on the one hand to shortened deep-sleep phases, and on the other hand to frequent night hot flashes. Both can severely impair sleep.

Internal restlessness and mood swings also develop frequently during menopause. The extensive internal and external changes of this life phase put many women under stress. All these circumstances can lead to sleep disorders. Age also plays a role. The body produces less melatonin sleep hormone and the depth of sleep decreases.