“Murmuring Voices”

She was covered from head to toe when she visited my clinic. The only thing that was visible to me was her eyes. She came along with her brother and mother. “She remains in house a whole day long and takes bath 5 times in a row. She believes as if she is not going to do that she will not become clean” her brother said. Her mother continued “Whatever the small amount of tasks she does at home she repeats it 5 times and if she is being stopped from doing that she acts as if something very bad is going to happen. She really gets very distressed on that”. I looked at her she continued her back and forth movement and a little murmuring sound coming from her mouth as if she was reading something. I tried to talk to her while calling her name “Amna, Amna can you tell me how are you”. “I am not clean, I need to take bath, and I won’t be forgiven”. Keeping her eyes stuck on floor she continued her murmuring a little bit louder. Her mother placed her hand on her shoulder in an effort to calm her daughter down she continued speaking with tears in her eyes “She just says these sentences and feels that she is not clean. She washes her clothes, her belongings, and her washroom again and again. She does not let anyone use her washroom or go to her room. Her such kind of behaviors sometimes irritate other siblings and they become aggressive. Sometimes they call her mad or insane. Please doctor help us. Initially, we did not take it serious but it is getting worst day by day.” She looked at me with helplessness and continued crying.

“Obsessive Compulsive Disorder (OCD)” is commonly known as a chronic, long-lasting condition that involves uncontrollable, reoccurring thoughts and/or behaviors that a person feels the urge to repeat over and over. It is a type of anxiety disorder that has some common signs and symptoms that are being noticed are Obsessions, Compulsions, or both. Obsessions are defined as repeated thoughts, urges, or mental images that cause anxiety. The urges may include fear of germs, unwanted forbidden or taboo thoughts involving sex, religion or harm, aggressive thoughts towards others or self, having things symmetrical or in perfect order. Whereas Compulsion is defined as repetitive behaviors that may include excessive cleaning and/or handwashing, ordering and arranging things in a particular, precise way, repeatedly checking on things, such as repeatedly checking to see if the door is locked or that the oven is off or compulsive counting. Above mentioned symptoms interfere with all aspects of life of an individual hence making it difficult for them to fully function in daily life activities.

Most people get diagnosed with OCD by about 19 years of age. It is also noted that boys get earlier age of onset than girls. According to National Comorbidity Survey Replication among year 2001 to 2003 (NCS-R), the prevalence of OCD is estimated to be 1.2% in U.S. adults with OCD was higher in females as compared to males. Among adult, suffering from OCD one half (50.6%) had serious impairment. Another 34.8% of adults with OCD had moderate impairment and 14.6% had mild impairment. It is the disorder that gets neglected by the family or social group at beginning to the point that it becomes difficult for the person to function normally in their surroundings. There is a pressing need for awareness regarding OCD to the general population. Initial symptoms may get reduced by the use of therapy but as the disorder gets prolong there may be the need for medicines as well. Any kind of help related to Mental Health can be catered through contacting the Pakistan Institute of Living and Learning that is working for the Mental Health of society in general.