“Aaaeeeee…..” , the child screamed and then there was a loud bang followed by sobs then “please…please….do it na- only once….makes me feel better. Don’t you love me to even do this much”……more sobs. This child sounded very very disturbed. And as this recorded voice clip played on the mother’s phone, she was crying while the father stared stoically out of the window. This voice clip was recorded at home when Milesh (not his real name) 10 years old had spent about 2 hours scrubbing his feet, followed by both parents having scrubbed his feet a few times. But Milesh was not sure the ‘germy germs’ had gone and wanted Mother to scrub a bit more, just to be sure. Milesh had obsessive compulsive disorder.
How does OBSESSIVE COMPULSIVE DISORDER (OCD) start ?
Obsessive Compulsive disorder typically begins in childhood or late adolescence. The sufferer begins to experience repeated unwanted thoughts, images, impulses or doubts. The themes evoke shame and secrecy- sex, blasphemy (religious), harm to loved people, dirt and contamination. The person very well knows that the thoughts are irrational but can’t understand what is causing them- and feels guilty or abnormal. The person tries to reduce the discomfort by doing some rituals- but their intensity progressively increases causing more trouble. At such time the quality of the thoughts or intensity of distress causes the person to become extremely unhappy, to the extent of provoking suicide.
How o family members get caught in the symptoms
Family members are the first to know the problem. It seems to them that just reassuring the person or doing some rituals takes a few minutes of their time, but makes their loved one feel better. So out of love they do it. Soon enough they are spending more and more time just doing things or saying things (that are basically unnecessary) just to keep the peace and harmony at home. They have become involved in Obsessive Compulsive Disorder. At this stage, family members realize something is wrong and is not going away- they need help.
What can family members do to help?
As a family member living with a person with OCD (Caregiver), it is important to first dis-entangle oneself from the symptoms first. Gently but firmly one refuses to engage in the rituals (compulsions) demanded by the sufferer. So if a patient is seeking reassurance for a doubt….do not answer it; because that makes the symptoms worse. Show your love by being gentle, being there, using comforting words and being patient while the sufferer deals with their emotions in the form of an outburst or a heartrending wail or even suicidal or violent threats. Sometimes one may have to function as a co-therapist and supervise OCD therapy at home. OCD therapy provokes much distress and patient tends to avoid it. So as a caregiver, again one has to learn to be gently assertive and motivate the patient on a daily basis with your words and actions- that ‘this is required for you to heal’.
Keeping a record of a patient’s behaviors and reporting them to the treating team is important. Among all mental health issues, OCD is one disorder that takes a lot of time and effort for recovery. It also requires higher doses of medications; almost to the edge of tolerance. Hence the caregiver of a person with OCD has to have extra hope and fortitude- sometimes for several weeks there is no change; plus the patient has to be constantly kept engaged in therapy by keeping the spirits up (whew!).
Your take home message
OCD is treatable and the period after recovery is surely worth the trouble. Make sure you remain fit to enjoy the lovely days that await you after the patient improves- don’t let the stress of the disease and caregiving wear you down. It is useful to maintain a calm and watchful countenance. Coordinate closely with the treatment team and follow their advice. Give them feedback if something is not working. Seek help for your own emotional turmoil as it is very difficult to witness the suffering of a loved one. Treatment of OCD is difficult, not impossible.