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Having phobia for dust and toilet. Does not use wash room frequently. Any medications? How to deal with this?

Jun 2013
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Practicing since : 2005
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My wife is having Phobia of Dust, toilet etc. She tends to avoid going washroom. During the whole day she hardly go bathroom for urine after taking bath. In case of loose motions she takes bath after every visit to toilet. She don't even go near to door of bathroom. During initial two years of my daughter birth she used Diapers for round the clock. Then we noticed her problem. Now I am helping my daughter (aged 4 years) in all her basic need of washroom and alike for last two years.

My wife use kitchen for washing her hands n times whenever she touch something dirty (ofcourse by telling lie and all that) . I have also seen her bathing with bottle in kitchen after finishing her bath in bathroom. She is so sick of bathroom/toilet that she even dont take her cloths in bathroom . She is used to of telling lie in every small things in which we notice her doing such things. I hope you understood the basic problem.

Now my question is that whether she is curable? And if so what kind of the treatment is? In case treatment involves medicines; whether taking medicines will disturb hormones. Actually we are planning for second child and she told me that some Doctor told her that not to take medicines as it will effect pregnancy and all that. Thus you are requested to advise. Is consulting through you is sufficient (including medicines, if any) or we should consult some local doctor also. Please specify the specialization.
Posted Thu, 13 Jun 2013 in Mental Health
Answered by Dr. Sushil Kumar Sompur 17 minutes later
Hi there ~

I understand your concerns for your wife. Anxiety disorders are common and having a specific phobia and obsessive compulsive disorders (OCD) is part of the anxiety disorders. Visiting with a psychiatrist and giving them an entire history will make things better for you and your wife, get therapeutic intervention as well as very effective medication for the same although it may take a while for the medications to act and you might have to be patient and persistent. Although, I do not want to discourage you, the issue is manageable though not entirely curable, since it is more like diabetes than an infection. Hence your persistence and patience is appreciated. SSRIs (selective serotonin reuptake inhibitors) are known to help in these conditions. She may also have sleep issues which should be delved into deeper and your psychiatrist may be able to help with this as well. SSRIs also do not have any evidenced effect on pregnancy and there are no evidences for any congenital abnormalities from using SSRIs. Although I am a qualified psychiatrist, I can only advise here on this forum and you need to consult a psychiatrist to get the medications prescribed. I hope this helps.

Take care and have a lovely day!
Above answer was peer-reviewed by
Follow-up: Having phobia for dust and toilet. Does not use wash room frequently. Any medications? How to deal with this? 1 hour later
SSRIs (selective serotonin reuptake inhibitors) ? These are medicines? Is there any other side effect of treatment of such disorders either through medicines or medication. My wife told that obesity is the side effect of medicines in such cases. (Though her this statement may be to avoid going to Doctor/s).
Answered by Dr. Sushil Kumar Sompur 24 hours later
Hi there ~

Sorry for the slight delay in reply. As the name implies, OCD is characterized by two hallmark symptoms. Obsessions are recurring and disturbing thoughts, impulses, or images that cause significant anxiety or distress. Compulsions are feelings of being driven to repeat behaviors, usually following rigid rules (such as washing hands multiple times after each meal). When these symptoms interfere with work, social activities, and personal relationships, it is time to consider treatment.

For initial treatment of OCD, the APA (American Psychiatric Association) recommends cognitive behavioral therapy, drug therapy with selective serotonin reuptake inhibitors (SSRIs), or a combination of the two.

Behavioral treatment. The most effective behavioral treatment for OCD is exposure and response prevention. In this therapy, patients encounter the source of their obsession repeatedly and learn ways to stop performing associated rituals until they are able to resist these compulsions.

Behavioral treatment alone may be an option for patients with mild symptoms of OCD or for those who don’t want to take medications. It may take three to five months of weekly sessions to achieve results. The goal is to gradually extinguish a conditioned behavior pattern.

SSRIs. Drug treatment may be tried first if behavioral therapy isn’t available or convenient, or if the patient’s symptoms are severe.

All of the SSRIs are equally effective, although individual patients may respond better to one than another, and it may take some trial and error to determine which one is best. Generally 40% to 60% of patients with OCD will experience at least a partial reduction in symptoms after treatment with an SSRI. However, many continue to have residual symptoms.

To treat OCD, SSRI doses are usually higher than those used for depression. It also takes longer for these medications to alleviate symptoms of OCD. While patients with major depression might take two to six weeks to respond to an SSRI, patients with OCD typically take 10 to 12 weeks to respond.

The most common side effects of SSRIs are gastrointestinal distress, restlessness, insomnia, and sexual dysfunction (such as reduced libido, erectile dysfunction, and inability to reach orgasm). All SSRIs work in a similar way and generally cause similar side effects. However, each SSRI has a different chemical makeup, so one may affect you a little differently from another.

Side effects of SSRIs can include:

Dry mouth
Nervousness, agitation or restlessness
Reduced sexual desire or difficulty reaching orgasm
Inability to maintain an erection (erectile dysfunction)
Increased sweating
Weight gain
You may experience less nausea with extended- and controlled-release forms of SSRIs. As with most antidepressants, sexual side effects are common with SSRIs. They occur in over half the people who take them.

Maintenance therapy. Many patients successfully treated for OCD will benefit from continuing medication indefinitely. A few medication discontinuation trials have been conducted in OCD patients, and most have found high relapse rates after SSRI withdrawal. It’s possible that lower doses can be used during maintenance treatment, but this is not clear.

I hope this helps. Take care and have a lovely day!
Above answer was peer-reviewed by
Follow-up: Having phobia for dust and toilet. Does not use wash room frequently. Any medications? How to deal with this? 17 minutes later
Thanks Doctor for explaining so much. So what is your advise, Should we go for treatment considering so much risk of side effects.? My wife also has very unstable mind and nature. She get furious very soon and also relax too.. In case of treatment if anything goes wrong, it may effect our relation as blame game and alike is more likely in such case.

I hope you understand. Please give suggestion.
Answered by Dr. Sushil Kumar Sompur 20 minutes later
Hi there ~

I believe you should go for treatment, primarily for her and also express to the psychiatrist that you all have problem of anxiety, since you have been worried about the whole situation. I would like for the advise you both to take medications. That way hopefully your relationship with each other is also not affected.

I hope this helps.

Take care and have a lovely day!
Above answer was peer-reviewed by
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