Suffering from OCD. Not taking medicines consciously. How to cure?
Patient: My unmarried daughter aged 24 yrs has been suffering from OCD such as playing brainvita game, surfing facebook repeatedly, listening to ipod frequently/listening to songs on player aloud, when in the bedroom, she sits with her arms resting on hip, gets up and then stands and then with a jerk sits on the bed. she also has been browsing through one particular photo album relating to us including herself, refuses to part with the album. she does not venture outside our balcony leave alone outside. she has been abusing us (parents) whenever v ask a general query getting aggressive. She used to blame her state of affairs such as short hair/ skin infection , menstrual problem and other aliments on some of our close relatives. she does not do daily tasks such as cooking, cleaning the house, washing clothes, leaves all of them too her mummy (aged 59 yrs). She started getting depressed somewhere in 2004 when she failed to perform to her expectations on XII Std scoring only 52% thereby denied getting admitted to some college. BCom Correspondence Course of Delhi University she took up; result was the same, got compartments in the I and III Yr course. She did complete the course after much pursuasion with a gap of one year. Simultaneously, she tried to pursue Company Secretary Course, completed only Foundation Course and in the first yr after that, the assignments which sent was returned to her advising her to focus on the questions in it and reply accordingly. From then on, she felt quite dejected. She did apply for NIIT Computer Course without our concurrence, forced mummy to shell out cheque for tuition fee, but after delivering it to the institution, stopped attending classes. v told her there was no need to apply because vr already having computer; she did not listen to us. She has been applying for job at times but without confiding with us. She used to venture out voluntarily for interview but failed to get anything. Thereafter, she did join a 2 yr course in South Delhi Women Polytechnic but after completing a successful one year, she remitted tuition fee for Rs 8,000/- by forcing us to part with for the 2nd yr but after a day she decided to stop attending once for all. Ultimately, v did take her to a psychiatrist in Safdarjung Hospital and after counselling, began to take risperidone and pari tablet for a month but failed to turn up to see the concerned doctor. v had to indirectly administer the tablets by mixing with dough. v have settled down here after retirement in Oct 2011 and as of now giving her sezodon liquid 2 ml with Pacitane on advise by a private psychiatrist here. No visible impovement has been noticed. In this scenario, is it advisable to search for matrimonial alliance? Please advise as to how to make her take tablets/liquid consciously because even now, v had to mix the liquid with lime water/salad/buttermilk without her knowledge. she rarely talks to us on any subject, excepting that she makes tea for self, eats whatever was served to her, but not a trace of sympathy, affection towards us. Awaiting ur advice. Doctor: Hello, Sir..from the detailed history you have provided it is clear that she had been diagnosed correctly and she has been given right medication. But as you have mentioned she is not showing much improvement , it is clear that she need trial of other drugs as well. There are many options available and you can give those medication. But for that you need to visits a near by psychiatrist and get the required prescription. As far as your desire to give her medication with her knowledge , than you need to admit her in a institutional setup as in her illness patient consider them self absolutely fine and think that there is no need of treatment. Another question you asked is about her marriage. Mostly people advice that get such people married and change in place will make a difference. But I would suggest you to think many times before taking such step, as marriage does not cure such illness and it may even act as a stressor and aggravate it. Also you should let the other party aware of her condition pre marriage because after marriage they will eventually get to know her condition and you may have to go through a lot of legal hassle . So overall consult a good psychiatrist, do regular follow up and she can be better with that.