Brief Answer:
She is suffering from OCD, treatment is there

Detailed Answer:
Hi XXXXXX,

Thanks for writing to us.

I can understand your concern for your sister.

Her history clearly suggests that she is suffering from Obsessive Compulsive Disorder(OCD) without insight.It means she is not aware that there is something wrong.

In OCD two components are there:
Obsessions: Intrusive, repetitive thoughts come in person's mind like something is not clean or it is dirty that it can be unhealthy and cause some health hazards. These frequent thoughts lead to...Compulsions.
Compulsions: These are repetitive acts or behavior person has to do in response to their obsessive thoughts to relive anxiety like cleaning again and again.

These obsession and compulsions take lot of time of the person than required at cost of daily routine and family activities.

It is very common problem.

Treatment is there.

One is pharmacotherapy: it is main approach. High dose SSRI like fluoxetine or fluvoxamine like drugs are mainstay of the treatment. If no improvement other drugs like clomirpamine can be added. Short term anti anxiety medicines from benzo group also have role in initial control of symptoms.

Second is psychotherapy: Multiple approaches are there. But CBT- Cognitive Behavior Therapy is well evident and successful.

Both approaches generally applied simultaneously in moderate to severe cases.

In her case main problem is she is not ready to accept that she has problem.

You can do following things:

If she is well educated, ask her to read about OCD from internet and allow he r to think over the same. She may convince for treatment.

If that not work, try to convince her with help of someone close to him who can make her ready to go to psychiatrist once.take prior appointment of psychiatrist and doctor should be aware about his history before she meets doctor so doctor can think how to convince her for treatment.

If that does not work, ask some psychiatrist for home visit to convince her for treatment.

If she is ready to consult your family doctor, one family member should consult doctor initially and tell her history. Your family doctor can consult a psychiatrist friend and decide the medicines and write the same by telling that these are the medicines for some other problem.(however if she is well educated and using internet or can ask chemist about the drug, this will not work)

In last resort if she even does not be ready, she can be forcefully treated when her problem is harmful to her,family or society in any manner according to laws. Psychiatrist can personally guide you more about the same.


As early start the treatment as good the results.


Hope I have answered your query, I will be happy to help further.

Regards,
Dr.Chintan Solanki.

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