Q: My sister appears to be suffering from obsessive compulsive behaviour. She repeatedly washes her hands. Further, she has the habit of cleaning vessels, which have already been cleaned and also keeps washing the bathroom. I would like to give a little background that we lost our father when we were teenagers, and the family responsibility fell on my sister, being the elder daughter. She also has a congenital kidney problem i.e. she has adult polycystic kidney disease, though at present it is asymptomatic. She is a known hypertensive on Tab lustily 2.5 mg. Her behaviour creates tension in the family because all the cleaning has to be done by her or under her supervision, else she is not satisfied. If things are not done as she requires, she keeps grumbling non-stop and the atmosphere at home becomes unbearable. I am aware she has a problem but if I suggest that she should see a psychiatrist or undergo cognitive therapy she will hit the roof. Kindly help.

A:Your sister's habits do not necessarily qualify as Obsessive Compulsive Disorder, unless she is compelled to act in that way. In most cases of obsessive compulsive disorder, the individual is aware of the compulsive nature of their behaviour along with the difficulty it is causing. Her present behaviour may be indicative of the possibility of developing Obsessive Compulsive Disorder in the future when the stresses may increase. At that point the compulsive aspect may also set in. But, specially since you have mentioned that family tension seems to be an aggravating condition, it may be possible that she finds washing of utensils a task that helps take her mind off her other problems. However, this possibility is based on the assumption that her behaviour is infrequent. Besides the association of washing utensils with reduction in stress and tension is maladaptive. Its important that you assist your sister in learning techniques such as progressive relaxation and meditation that may help her in a more positive manner.