Signs and Symptoms

Many of us engage in small habits that provide comfort, though we could manage without them. For instance, we might have a 'lucky' charm or follow a reassuring ritual. However, for individuals with obsessive-compulsive disorder (OCD), these behaviors become more intense and disruptive, driven by persistent unwanted thoughts. OCD is a genuine mental health condition that can lead to substantial challenges in a person's life.

What is OCD?

Obsessive-compulsive disorder consists of two main components: obsessions and compulsions. Individuals may experience one or both, leading to considerable distress.

Obsessions are intrusive and repetitive thoughts, urges, or images that persist and generate anxiety. For example, someone might excessively worry about spreading germs to loved ones. These obsessive thoughts can vary widely and are not reflective of a person's character; rather, they are symptoms of an illness.

Compulsions are behaviors aimed at alleviating the anxiety caused by obsessions. These may include washing, organizing, or following specific rituals. Some compulsions are subtle, such as silently counting or repeating phrases. Many individuals feel compelled to perform these actions until they achieve a sense of 'rightness.' It's crucial to recognize that compulsions serve as a coping mechanism for obsessions, and individuals with OCD may feel significant distress if unable to fulfill these actions.

Those with OCD often realize that their obsessions and compulsions are irrational, yet they struggle to gain control over them. Additionally, obsessions and compulsions can evolve over time.

Signs and Symptoms

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A phobia is an overwhelming and debilitating fear of an object, place, situation, feeling or animal.

Phobias are more pronounced than fears. They develop when a person has an exaggerated or unrealistic sense of danger about a situation or object.

If a phobia becomes very severe, a person may organize their life around avoiding the thing that's causing them anxiety. As well as restricting their day-to-day life, it can also cause a lot of distress.

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Symptoms

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A phobia is a type of anxiety disorder. You may not experience any symptoms until you come into contact with the source of your phobia.

But in some cases, even thinking about the source of a phobia can make a person feel anxious or panicky. This is known as anticipatory anxiety.

Symptoms may include:

• unsteadiness, dizziness, and lightheadedness

• nausea

• sweating

• increased heart rate or palpitations

• shortness of breath

• trembling or shaking

• an upset stomach

If you do not come into contact with the source of your phobia very often, it may not affect your everyday life.

But if you have a complex phobia, such as agoraphobia, leading a normal life may be very difficult.

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Types of phobia

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There are a wide variety of objects or situations that someone could develop a phobia about.

But phobias can be divided into 2 main categories:

• specific or simple phobias

• complex phobias

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Specific or simple phobias center around a particular object, animal, situation or activity.

They often develop during childhood or adolescence and may become less severe as you get older.

Common examples of simple phobias include:

• animal phobias – such as dogs, spiders, snakes or rodents

• environmental phobias – such as heights, deep water and germs

• situational phobias – such as visiting the dentist or flying

• bodily phobias – such as blood, vomit or having injections

• sexual phobias – such as performance anxiety or the fear of getting a sexually transmitted infection (STI) 

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Complex phobias tend to be more disabling than simple phobias. They usually develop during adulthood and are often associated with a deep-rooted fear or anxiety about a particular situation or circumstance.

The 2 most common complex phobias are:

• agoraphobia

• social phobia 

Agoraphobia is often thought of as a fear of open spaces, but it's much more complex than this.

Someone with agoraphobia will feel anxious about being in a place or situation where escaping may be difficult if they have a panic attack.

The anxiety usually results in the person avoiding situations such as:

• being alone

• being in crowded places, such as busy restaurants or supermarkets 

• travelling on public transport

Social phobia, also known as social anxiety disorder, centers around feeling anxious in social situations.

If you have a social phobia, you might be afraid of speaking in front of people for fear of embarrassing yourself and being humiliated in public.

In severe cases, this can become debilitating and may prevent you carrying out everyday activities, such as eating out or meeting friends.

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What causes phobias?

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Phobias do not have a single cause, but there are a number of associated factors.

For example:

• a phobia may be associated with a particular incident or trauma

• a phobia may be a learned response that a person develops early in life from a parent or sibling (brother or sister)

• genetics may play a role – there's evidence to suggest that some people are born with a tendency to be more anxious than others

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Signs and Symptoms

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Insomnia symptoms may include:

• Difficulty falling asleep at night

• Waking up during the night

• Waking up too early

• Not feeling well-rested after a night's sleep

• Daytime tiredness or sleepiness

• Irritability, depression, or anxiety

• Difficulty paying attention, focusing on tasks, or remembering

• Increased errors or accidents

• Ongoing worries about sleep

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When to see a doctor

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If insomnia makes it hard for you to function during the day, see your doctor to identify the cause of your sleep problem and how it can be treated. If your doctor thinks you could have a sleep disorder, you might be referred to a sleep center for special testing.

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Causes

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Insomnia may be the primary problem, or it may be associated with other conditions.

Chronic insomnia is usually a result of stress, life events, or habits that disrupt sleep. Treating the underlying cause can resolve the insomnia, but sometimes it can last for years.

Common causes of chronic insomnia include:

• Stress. Concerns about work, school, health, finances or family can keep your mind active at night, making it difficult to sleep. Stressful life events or trauma — such as the death or illness of a loved one, divorce, or a job loss — also may lead to insomnia.

• Travel or work schedule. Your circadian rhythms act as an internal clock, guiding such things as your sleep-wake cycle, metabolism and body temperature. Disrupting your body's circadian rhythms can lead to insomnia. Causes include jet lag from traveling across multiple time zones, working a late or early shift, or frequently changing shifts.

• Poor sleep habits. Poor sleep habits include an irregular bedtime schedule, naps, stimulating activities before bed, an uncomfortable sleep environment, and using your bed for work, eating or watching TV. Computers, TVs, video games, smartphones or other screens just before bed can interfere with your sleep cycle.

• Eating too much late in the evening. Having a light snack before bedtime is OK, but eating too much may cause you to feel physically uncomfortable while lying down. Many people also experience heartburn, a backflow of acid and food from the stomach into the esophagus after eating, which may keep you awake.

Chronic insomnia may also be associated with medical conditions or the use of certain drugs. Treating the medical condition may help improve sleep, but the insomnia may persist after the medical condition improves.

Additional common causes of insomnia include:

• Mental health disorders. Anxiety disorders, such as post-traumatic stress disorder, may disrupt your sleep. Awakening too early can be a sign of depression. Insomnia often occurs with other mental health disorders as well.

• Medications. Many prescription drugs can interfere with sleep, such as certain antidepressants and medications for asthma or blood pressure. Many over-the-counter medications — such as some pain medications, allergy and cold medications, and weight-loss products — contain caffeine and other stimulants that can disrupt sleep.

• Medical conditions. Examples of conditions linked with insomnia include chronic pain, cancer, diabetes, heart disease, asthma, gastroesophageal re-flux disease (GERD), overactive thyroid, Parkinson's disease and Alzheimer's disease.

• Sleep-related disorders. Sleep apnea causes you to stop breathing periodically throughout the night, interrupting your sleep. Restless legs syndrome causes unpleasant sensations in your legs and an almost irresistible desire to move them, which may prevent you from falling asleep.

• Caffeine, nicotine and alcohol. Coffee, tea, cola and other caffeinated drinks are stimulants. Drinking them in the late afternoon or evening can keep you from falling asleep at night. Nicotine in tobacco products is another stimulant that can interfere with sleep. Alcohol may help you fall asleep, but it prevents deeper stages of sleep and often causes awakening in the middle of the night.

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Insomnia and aging

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Insomnia becomes more common with age. As you get older, you may experience:

• Changes in sleep patterns. Sleep often becomes less restful as you age, so noise or other changes in your environment are more likely to wake you. With age, your internal clock often advances, so you get tired earlier in the evening and wake up earlier in the morning. But older people generally still need the same amount of sleep as younger people do.

• Changes in activity. You may be less physically or socially active. A lack of activity can interfere with a good night's sleep. Also, the less active you are, the more likely you may be to take a daily nap, which can interfere with sleep at night.

• Changes in health. Chronic pain from conditions such as arthritis or back problems as well as depression or anxiety can interfere with sleep. Issues that increase the need to urinate during the night ―such as prostate or bladder problems ― can disrupt sleep. Sleep apnea and restless legs syndrome become more common with age.

• More medications. Older people typically use more prescription drugs than younger people do, which increases the chance of insomnia associated with medications.

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Insomnia in children and teens

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Sleep problems may be a concern for children and teenagers as well. However, some children and teens simply have trouble getting to sleep or resist a regular bedtime because their internal clocks are more delayed. They want to go to bed later and sleep later in the morning.

Signs & Symptoms

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The signs and symptoms of stress may be cognitive (thinking-related), emotional, physical or behavioral. Their severity can range from mild to severe.

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Cognitive symptoms include:

• difficulty concentrating or thinking

• memory problems

• negativity or lack of self-confidence

• constant worrying

• difficulty making decisions.

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Emotional symptoms include:

• moodiness

• low morale

• irritability

• feeling hopeless or helpless

• feeling apprehensive, anxious, or nervous

• feeling depressed

• feeling unhappy or guilty

• feeling agitated or unable to relax.

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Physical symptoms include:

• headaches

• muscle tension or other physical pain or discomfort

• stomach problems

• nausea, diarrhea or vomiting

• loss of sex drive

• rapid heart rate

• high blood pressure

• fatigue.

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Behavioral symptoms include:

• changes in eating or sleeping patterns

• social withdrawal

• nervous habits such as nail biting, teeth grinding or foot tapping

• increased use of caffeine, cigarettes, alcohol or other drugs

• neglect of family or work responsibilities

• decline in performance or productivity.