CO-EXISTENT PSYCHOSIS WITH OBSESSIVE COMPULSIVE DISORDER

This is  story of Mr. A, he was brought to Tulasi, with the chief complaints of aggressive, violent behavior, suicidal and homicidal ideas, sleep disturbance, suspiciousness and spending many hours a day counting and  taking tablets, doubting and checking doors , windows if they were closed, gas cylinders and lights were off.

When he came to Tulasi, he was looking very calm, but it was the lull before the storm. As soon as he entered the premises, he attacked the doctor and injured him badly. It was a herculean task to control him. He was given sedation then only he came under control.

After a day Mr. A apologized to the whole staff for almost 20 times. Now you must be thinking, what was the mystery behind sudden change in his behavior?

To unfold the mystery, we have to go through the history, which is as below-

Eleven years ago, a young boy brought up by his father and grandmother( as his mother left him when he was an infant) was leading a normal teenager’s life. One fine day during his 11th std  exams , it was his 2nd exam, he went to school but came back and told his father that he could not take  the exam as he was afraid that he would fail.

His father told him he should not worry soon everything would be alright. The boy locked himself in his room, his father thought that he needed some space, so he did not bother him.

He was taking his meals in his room and that continued for two days, on the third day when father went to talk to him, he heard that his son was talking to self.

He saw a horrible scene, his father was shocked. He saw that his son was wearing a suit talking to self and a tub was lying in which he had been doing stool and piss. He (Mr. A) told him that he was asking for help from God and he had answered him that he would save him, he could hear God talking to him.

His father understood that something was wrong with him but he did not know what to do. Then one of his relatives suggested to take him to Dr. Gorav (psychiatrist). He immediately took him to the doctor, there he was diagnosed with schizophrenia, he was admitted  for 15 days and as soon the symptoms were under control, he got discharged.

He was manageable at home as he was taking medicines. His father changed the residence, shifted to another place. Mr. A  again started showing irrational behavior such as counting  medicines for at least hundred times, checking the doors and windows, if they were locked, checking the lights were off and washing hands till they bleed. He did not like to go out, he would go only for buying household things but gradually that stopped too. When his father forced him he said that if  he would go out, he would meet with an accident. He further believed that people wanted to kill him, he heard some noises from ceiling, he told that a girl made these noises to kill him, he felt hopeless and worthless and wanted to die.

He told his father that he wanted to jump from terrace. When he became unmanageable his father again admitted him in Tulasi Rehabilitation, this time, the diagnosis was Schizoaffective disorder comorbid OCD. He underwent psycho-social rehabilitation for a few months and got discharged. He  came in day care for a few months.

Then he stayed at home, he tried to complete his studies but could not do so. He told his father that he wouldn’t take the medicines as there was no relief in repetitive thoughts and behavior, and he wanted to see another psychiatrist, they changed several psychiatrists every year but there was no relief and the situation got worst.

Twenty days back, Mr. A totally stopped taking medicines, he got suspicious about his father and doctors, he said that they were trying to ruin his brain and they had done something wrong to him by giving medicines, he got aggressive and violent day by day. He asked his father to get his visa for USA, he did not want to live in India because people are very corrupt. A day before he threatened his father, sitting in front of him, holding a big knife in his hand, he told that he would kill him and self.

At that time his father was very hopeless, he was confused and horrified, then only he realized that only treatment and rehabilitation could save him and his son. He decided to re-admit him.

Things To Know-

Psychosis is a serious mental disorder characterized by thinking and emotions that are so impaired, that they indicate that the person experiencing them has lost contact with reality. These experiences can be frightening and may cause people who are suffering from psychosis to hurt themselves or others.

It is normal occasionally to go back and double check that the lights are off or door is locked. But if you suffer from OCD, obsessive thoughts and compulsive behaviours become so excessive they interfere with your daily life. No matter what to you do, you can’t seem to shake them.

It is crucial to differentiate between a Psychotic disorder and OCD, because drugs that are prescribed for psychosis (antipsychotics) have been known to induce or exacerbate symptoms of OCD. Psychotic disorder comorbid OCD patients and their care-givers need to be aware that the things are not always what they seem. A misdiagnosis of psychosis in those with OCD is just one example. But help is available, psycho-social rehabilitation and medicines are the essentials.

contributed by MS JYOTI BERNARD PSYCHOLOGIST

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CO-EXISTENT PSYCHOSIS WITH OBSESSIVE COMPULSIVE DISORDER was last modified: November 2nd, 2014 by Tulasi Rehab