Q : I am a 42 year old individual. I own a small cycle shop. Since last 3-4 years my wife has been noted to have lot of oddities in her behavior. She is keen about cleanliness which is more than an average individual. All the time she is preoccupied about cleanliness, and is noted to be cleaning the house, utensils, cloths etc continuously. Whenever she goes out, she washes all her cloths, take an overhead bath & is keen that we all i.e. myself and our two children also do the same. She washes all utensils in the house 3-4 times in a day. If anybody visits our house, after he leaves, the cleaning procedure starts again. She has to clean the chairs, bed sheets etc. She spends lot of time in the bathroom, cleaning the bathroom. She needs about one cake of soap every 2-3 days. As she spends lot of time in water, she has developed small injuries over her palms and feet. She finishes approximately one and half thousand liters of water everyday, and if there is no water, because of water scarcity, she asks for a water tanker and continues with her cleanliness program. Myself & our children are all fed up of her activities. We are unable to convince her & we have to follow the rituals even if we don’t agree to them. What do we do?

Ans : What you are describing above is a classical example of OCD i.e. Obsessive Compulsive Disorder. In marathi it is also called as ‘Mantrachal’. In this illness, the patient himself is distressed to a large extent. The relatives too are distressed watching the patient doing the rituals again and again and again overtime. In this illness the patient repeatedly gets the same thought about something and starts doing an act which he continues to do repeatedly. The classical definition of obsession is repeated intrusive thought, which the patient identifies as his own thought and acts upon this thought in the form of repetitive behavior, are called as compulsions. The patient identifies these thoughts as useless, but is unable to ignore them. This illness occurs because of patient’s inability to shift his focus from one thought process to another. Due to his preoccupation he is unable to switch to any other task from the present task. With proper treatment usually patients improve significantly in this illness. There are lot of new
medicines which are available for this type of illness. But medicines alone may not be helpful, and patient may need to undertake what is called as behavioral treatment for this illness. I think your wife needs immediate intervention by a psychiatrist, and I am sure she will improve with the proper treatment.