Wife OCD Advice Needed

[Barnes]

I’m trying my best to manage a toddler and a wife with OCD. I’ve known my wife for around 3 years and initially noticed something was not quite right, however only recently had a psychiatrist confirm OCD. Naturally i’m concerned it may be OCD and another undiagnosed disorder. Currently she’s taking Sertraline, she was prescribed medication I believe for explosive anger but stopped taking that due to side effects. Furthermore in the past 18 months she had some therapy (currently stopped.)  

It seems that for most of her life she has lived with this condition. The key stresses are:

1. Anger. If you question behaviour she can quickly get very angry…and take a day to calm down. With a child I feel it’s not acceptable but she is totally oblivious to anyone when angry. 

2. I’ve noted shes takes around 2-  6 hours to get ready, make up and clothes. Her hair is a major pre occupation. As you can imagine taking a child out of a walk during the day is almost impossible for her. 

3. Packing a bag, is unbearable for her. I’ve watched her take hours to pack and re-pack. It’s heart breaking to watch. Even organising objects in a cupboard are avoided….and suitcases are left unopened for months. She reluctant to throw away some packing, and keeps empty boxes. (She’s not a crazy hoarder but to me so many empty boxes seem irrational) 

4. She has a breakfast routine which takes around 1.5 Hours. The tea/ cups/ etc seem like a ritual. She very rarely will clean up after, so often I’m tidying up after her. Having said that she will follow some irrational cleaning activities.  

With the time taken for the above she is unable to work.  

She’s of Italian origin and as a result we spend a few months out there, so I paid for private Italian psychiatric support and this initially made a difference, as the previous talking therapy was doing little to help particularly with the anger. The issue I have is getting feedback from the medical professionals in italy, and the fact when in the UK we are not able to visit the psychiatrist (no option of video call unfortunately.) 

We live in South West London, and I wonder if there is any advice you might have as going via the NHS/ Private Self Pay.

Thanks!

[Hal]

Hi Barnes,

I'm so sorry as a family you're going through such a difficult time, I can only imagine how hard it must be for you all, especially with the demands a young child can bring. 

Your wife's clearly coping with OCD and more than likely may also be struggling with Body Dysmorphic Disorder (BDD). Her worries and preoccupation around her appearance suggests that that is also increasing her isolation and will need more support.

It's positive you've been able to get a diagnosis, but do you know if the help from the psychiatrist in Italy was in the form of Cognitive Behavioural Therapy (CBT)? This link goes into more detail about what it is and how vital it is when it comes to treating the disorder and BDD.

https://www.ocduk.org/overcoming-ocd/cognitive-behavioural-therapy/

It must be very difficult seeing your wife go through this...and the impact her anger is having on you, but those outbursts are more than likely being driven by the high anxiety and fear she's feeling. All being well once she receives more help and guidance towards tackling those fears, that anger will ease away.

I would urge your wife to have a chat with her GP about accessing the CBT through the NHS or you can also self -refer now using the Improving Access to Psychological Treatments (IAPT) option and bypass your doctor.

This link covers all the bases:

https://www.ocduk.org/overcoming-ocd/accessing-ocd-treatment/accessing-ocd-treatment-through-the-nhs/

Private treatment is also available by finding a CBT therapist through the British Association of Cognitive Behavioural Psychotherapies (BABCP) It is expensive though, but please be wary going to someone not accredited with them. Going through the BABCP guarantees a good standard of care and treatment, whereas a counsellor with the bacp doesn't.

https://babcp.com/

It goes without saying the charity and forum is always here to help you both too, so please don't hesitate asking us anything. Do you think your wife might be prepared to take a look at the forum?

[Barnes]

Dear Hal

Thank you for the prompt advice. 

I will investigate the BDD, and initially I think you’re right.

With respect to treatments she’s had:

1. CBT two years ago, an online course in the UK. From memory the problem surrounding this was the fact she was late for almost every zoom call….so was very difficult to gauge it’s efficacy. It’s never easy discussing treatment, and outcomes with my wife. Furthermore I/ we had no idea about her OCD. 

2. Thereafter she had around 15 visits to an Italian Psychologist, in person, and again the outcome from my side was difficult to gauge. He advised her to medicate and she avoided this advice for almost 6 months. The Psychologist has not advised OCD, but suggested at one meeting :Borderline. 

3. Finally we (together) visited an Italian psychiatrist, and with the proscribed medication the difference with her anger was immediate. Anger as you mention is a coping instinct to help her mask the underlying issues. Thank god he spotted OCD! 

I will certainly follow your advice and talk to the Her/ and GP about CBT, maybe now with medication it will prove much more useful. In addition, I’ll help with timing keeping to ensure she make’s the sessions. 

Once again thank you for the advice! 

Harry