Qué es y qué no es un Trastorno Obsesivo Compulsivo (TOC)

El Trastorno Obsesivo Compulsivo

Seguramente, mas de una vez hemos escuchado la frase “tengo un Toc”, haciendo referencia, de forma coloquial, a tener algún tipo de “maña” o ritual especifico a la hora de hacer algo de una manera determinada.

Por ejemplo, alguien que en general y porque sí, le gusta que sus cosas estén sumamente ordenas, podría decir eso. O alguien que siempre escucha sus audios de whatsapp antes de mandarlos. Alguien que le gusta limpiar el piso con lavandina “sí o sí”. Y así miles de ejemplos. Algo que esas personas sienten como personal y fuera de lo común o algo exagerado en cuanto a conductas.

Las siglas de la palabra TOC se popularizan, quizás, por uno de los temas bastantes frecuentes para algunas personas con este padecimiento que son las obsesiones y compulsiones por la contaminación, y por ende la limpieza extrema y exagerada. También quizás porque se mal entiende como algo que todos conductualmente podríamos tener. O también quizás porque se popularizo como tema para llevarlo a obras de teatro o cine.

Tener una maña, ser un poco “mañonso”, no hace al diagnostico de TOC. De hecho cualquier persona puede tener una forma específica o reiterativa de hacer ciertas cosas sin la necesidad de tener un diagnostico de trastorno Obsesivo compulsivo.

Como sus siglas hacen referencia, es un trastorno, es un padecimiento, que quien lo vive, lo sufre. Voy a pasar a explicar mas este diagnostico y posible tratamiento.

Hablamos de TOC, Trastorno Obsesivo Compulsivo, cuando un profesional de la Salud mental (ya sea Licenciado en psicología, o psiquiatra) arriba a ese diagnostico. El mismo se hace desde el conocimiento de las características del trastorno y basándonos en el Manual diagnostico para desordenes mentales, versión 5, el DSM V.

El trastorno obsesivo-compulsivo (TOC) es un trastorno mental crónico que a grandes rasgos se caracteriza por:

  • Pensamientos obsesivos, que son incontrolables, intrusivos y recurrentes, y que generan mucho malestar y ansiedad
  • Compulsiones, que son conductas y comportamientos, “visibles o mentales” repetitivos que surgen como una respuesta que se siente como inevitable de hacer algo una y otra vez, aunque la persona no quiera o piense que no debería hacerlo.
  • Y que, como consecuencia, todo esto genere deterioro significativo en al menos un área de la vida

Del pensamiento Obsesivo se genera la compulsión, con la falsa creencia de que llevando a cabo dicha acción la ansiedad y malestar que genera el pensamiento se desvanece. Si bien en el momento muchas veces la ansiedad baja, lo que se corroboro es que luego aparece con mas fuerza y de manera repetitiva

Hay distintos tipos de TOC estudiados, distintas temáticas, según el contenido de los pensamientos obsesivos y las compulsiones. Por ejemplo pensamientos obsesivos de contaminación traen en general aparejada una compulsión extrema por la limpieza. Hay también otro tipo de Toc con contenido de pensamientos violentos, por ejemplo, que traen aparejadas conductas de evitación en general.

Los síntomas suelen comenzar de forma progresiva y pueden variar su gravedad a lo largo de la vida; tendiendo a empeorar cuando la persona está viviendo un mayor estrés. También los tipos de obsesiones y compulsiones experimentadas suelen cambiar con el tiempo. Y, en los casos más severos, estos pueden llegar a ser incapacitantes.

El tratamiento de primera línea, con eficacia empírica es la combinación de psicofarmacología y Terapia cognitivo conductual, específicamente la EPR, que es la exposición con prevención de respuesta. De manera muy resumida y a grandes rasgos, es un tratamiento donde el paciente es expuesto a una situación que le desencadena su pensamiento y por ende su compulsión (como tocar superficies sucias, por ejemplo, que desencadenaría el pensamiento de estas “sucio o contaminado) y se les impide llevar adelante su ritual habitual (como lavarse las manos, que es la compulsión).

Existe una variedad de tipos de trastornos obsesivo-compulsivos y todos ellos requieren ser atendidos por un especialista en salud mental, para aliviar el malestar y evitar problemas serios en el futuro. Es un trastorno, que con el tratamiento adecuado, se puede sobrellevar, salir adelante y poder tener una vida plena, orientada a lo que es importante para la persona que lo atraviesa.

Siempre es necesario tener en cuenta que solo un especialista matriculado es quien debe hacer el diagnostico y llevar a cabo el tratamiento, que tiene, según la severidad, grandes posibilidades de éxito.

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