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Suggest treatment for obsseive compulsive disorder

Answered by
Dr. Seikhoo Bishnoi


Practicing since :2007

Answered : 5006 Questions

Posted on Thu, 14 Aug 2014 in Mental Health
Question: Hello Doctor,
My wife has OCD, and i joined this site so as to help her.
My wife is a Taurus (EARTH) while i am a Verseau (AIR), and we dont match at all.
Sometimes i cannot understand her at all with this OCD problems.
How can i cope and understand her and get her out of this?
My wife does not cook anymore and i had to hire someone to cook;
For food at home i will do all things by my own and sometimes will wash cloth and put to dry as my wife will do nothing..
please help me on this issues.
Answered by Dr. Seikhoo Bishnoi 17 minutes later
Brief Answer:
Hello Welcome to HCM

Detailed Answer:
Thanks for asking

I have read the problem described and I can understand your problem. OCD is one type of anxiety disorder and it follows relapsing and remitting course which cause huge burden to caregiver in serious cases. Two modalities of treatment are available for OCD, Pharmacotherapy and Psychotherapeutic methods. A combination of both usually cause early and good response.

I would request you to kindly elaborate her chief complaints in details along with onset and duration of complaints so that I can help you.

Above answer was peer-reviewed by : Dr. Ashwin Bhandari
Follow up: Dr. Seikhoo Bishnoi 19 minutes later
Her chief compaints:
- If she does anything at home, she will feel like dirty and would wash her hands and would take out dirt off her clothes; Last time i move an objet on the table and she feel like a panic. Her mind controls her and she would fight but sometimes she will obey everything her mind will sugest here; I am not allowed to do anything at time, i cannot enter the kitchen, or use the washing machine etc.
I had to make a small kichen outsite my house and where some will come to cook everyday; i have to eat there in a limited space, even if you have a large dinning room i cannot profit that; I am tired with all this, and something i feel like leaving here for someone else; But i know she has a disease and this is affecting us; How can we get out of this situation?
Answered by Dr. Seikhoo Bishnoi 28 hours later
Brief Answer:
Hello again

Detailed Answer:
I can understand your concern. She is having obsessions of contamination and then compulsive hand washing. Apart from that the symptoms has progressed to obsession of dirt and excessive hygiene. These are causing significant problems in your personal life and she is also getting severe stress. She is also having obsession of orderliness which is the reason of panic like situation she faced on moving the objects.

Now the treatment part of OCD. As from symptoms it appears that she is having severe OCD and medicinal treatment is must for her. Medicines like SSRIs as Fluoxetine, Paroxetine, Escitalopram are commonly used to treat OCD. The treatment is really difficult and it takes time so you have to be very patient and you should keep faith in pharmacological treatment. The medicines are usually used in high doses and usually start showing response in about 6-12 weeks.

In a number of patients poor compliance is main reason of treatment failure, so to keep proper compliance you have to motivate her regularly.

Other than SSRI if patient don't respond then Clomipramine is used for treatment. A number of doctor prefer to use combination therapy of one SSRI and Clomipramine for OCD. You should visit a Psychiatrist for detailed prescription.

Other than Medicines non medicinal treatment like Behavior Therapy is also very effective in OCD. Combination of Medicines and Behavior Therapy is best. Behavior therapy includes various modalities like Exposure and Response Prevention (ERP), Progressive Muscle Relaxation (PMR), Desensitization etc. In her case Exposure and Response prevention will suit best.

I would request you to please motivate her and consult a Psychiatrist.

Secondly I can understand the problems you are facing. Care givers of OCD also face severe distress. Keep yourself busy in good things and try to help her. Don't feel bad, think about her, she is ill and she need treatment.

Thanks, if you have more doubts you can ask again.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
Follow up: Dr. Seikhoo Bishnoi 13 hours later
thank you doctor for the answers.

We consulted a psychiatrist first, and the doctor gave my wife some medicines.
My wife took one or two and feel like getting mad, and would want to suicide, so she stop all medicines right after the 2nd or 3rd day.
She will never take any medicines again.

We went then to consult a psychologist who would only give advice; we spend 7 to 9 month with her and her fees was $35 per session, and we did around 25 sessions; then i stopped because i could no longer afford and my wife situation was not getting better;

What is ur advice to me, what should i do?
Should i again consult the same psychologist again and start the treatment again?

psychologist or

I have a one to one meeting with psychologist today:
- to sum up on her previous service to us
- the good thing that happened
- the bad thing that happened

- About my wife symptoms
- About how she will tackle and handle the situation now

What advice can you give me doctor, abt that i shoe uld tell my doctor, in the past she refuses to give mediciines, only talk and talk, her treatment is very time consuming and her fees is very high, abt how she can heelp us to get out of this situation rapidly and so that my wife become normale again?
Answered by Dr. Seikhoo Bishnoi 2 days later
Brief Answer:
Hello again

Detailed Answer:
As I have mentioned earlier also that she is having severe OCD and only psychotherapy will not work. Although behaviour therapy is one of best treatment for OCD but to make her compliant to Behavior therapy or other psychological interventions we have to give her medicines.

From her symptoms you have described I would like to tell you that she need doses in higher ranges and for prolonged period of time. As you have mentioned that psychological treatment is costly and also result is not satisfactory so in such situation best is to consult a Psychiatrist. The psychiatrist will not only give you advice for drugs but will also help in behavioural interventions like ERP. For muscle relaxation (Progressive Muscle Relaxation) you can search youtube. You can learn there and then you can teach her. But before that she should come in such situation that she become compliant to therapy and for that medicines are must.

Hope this helps you, you can ask again if you have more doubts.
Above answer was peer-reviewed by : Dr. Ashwin Bhandari

The User accepted the expert's answer

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