Pathological Cleanliness and Memory Issues: A Psychiatric Perspective

Q: Pathological Cleanliness and Memory Issues: A Psychiatric Perspective

Hello W： Since your issues have affected your daily functioning and social adaptability, it is recommended that you visit the outpatient clinic for further evaluation, management, and treatment. <br>(Dr. <br>Chen is currently on leave without pay at our hospital, and this respons

Obsessive-Compulsive Disorder (OCD)? Poor memory!

Hello, Doctor: I would like to ask you about my symptoms, which seem quite strange.
I might have a natural tendency towards cleanliness, but I feel like it has become pathological.
For example, whenever I see something dirty on the street or anywhere, I feel as if I have touched it, even though my friends tell me that I haven't.
However, I still obsess over the idea that I did! When I get home, I immediately wash all the clothes and my backpack that I wore outside, and after that, I rush to take a shower.
I also wash my hands for a long time and very vigorously.
Is this already pathological cleanliness? Additionally, when I walk in crowded places, I feel scared and want to leave as quickly as possible.
Do I have a problem? Furthermore, my memory is very poor; someone might tell me what to do, but I might forget it within a minute.
Sometimes, I even throw money into the trash can.
When I was studying, my memory was also very poor; I had to write a sentence more than 30 times just to remember it, and I can't guarantee that I can memorize it.
What should I do?

W, 10~19 year old female. Ask Date: 2007/06/14

Dr. Chen Meizhu reply Psychiatry

Hello W: Since your issues have affected your daily functioning and social adaptability, it is recommended that you visit the outpatient clinic for further evaluation, management, and treatment.
(Dr.
Chen is currently on leave without pay at our hospital, and this response is provided on behalf of Dr.
Chen Chih-Tsai, the head of the Child Psychiatry Department.)

Reply Date: 2007/06/14

More Info

Your concerns about your symptoms suggest that you may be experiencing a combination of obsessive-compulsive tendencies and memory issues, which can significantly impact your daily life. Let's break down your symptoms and explore them from a psychiatric perspective.

Firstly, your description of "pathological cleanliness" aligns with symptoms often seen in Obsessive-Compulsive Disorder (OCD). Individuals with OCD may have intrusive thoughts (obsessions) that lead to compulsive behaviors aimed at reducing anxiety. In your case, the fear of contamination or dirt seems to trigger a compulsive need to wash your clothes, bathe, and wash your hands excessively. This behavior is not just a preference for cleanliness; it appears to be driven by anxiety and fear of contamination, which is characteristic of OCD.

The fact that your friends reassure you that you haven't touched anything dirty, yet you remain fixated on the idea that you have, indicates that your thoughts are not aligned with reality. This cognitive distortion is common in OCD, where the individual feels compelled to act on irrational fears despite evidence to the contrary. It's essential to understand that these compulsions are not merely habits but are often a way to cope with underlying anxiety.

Additionally, your feelings of discomfort in crowded places suggest a possible social anxiety component. Many individuals with OCD also experience anxiety in social situations, fearing judgment or embarrassment. This can lead to avoidance behaviors, where you may feel compelled to leave crowded areas to alleviate your anxiety.

Regarding your memory issues, it is not uncommon for individuals with anxiety disorders, including OCD, to experience difficulties with concentration and memory. Anxiety can consume cognitive resources, making it challenging to focus and retain information. The fact that you forget tasks shortly after being told about them, or misplace items like money, can be frustrating and may contribute to your overall anxiety.

To address these issues, it is crucial to seek professional help. A mental health professional, such as a psychiatrist or psychologist, can provide a comprehensive evaluation and develop a tailored treatment plan. Cognitive Behavioral Therapy (CBT) is particularly effective for OCD and anxiety disorders. CBT helps individuals identify and challenge irrational thoughts and develop healthier coping strategies. Exposure and Response Prevention (ERP), a specific type of CBT, is often used to help individuals confront their fears gradually and reduce compulsive behaviors.

In some cases, medication may also be beneficial. Selective serotonin reuptake inhibitors (SSRIs) are commonly prescribed for OCD and can help alleviate symptoms by balancing neurotransmitters in the brain.

In summary, your symptoms of pathological cleanliness, anxiety in crowded places, and memory difficulties suggest a complex interplay of OCD and anxiety. It is essential to seek professional help to receive an accurate diagnosis and appropriate treatment. Remember, you are not alone in this, and with the right support, you can work towards managing your symptoms and improving your quality of life.

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