Unusual Behaviors: Is It OCD or Something Else?

What exactly is this disease?

My boyfriend's family has a mother who talks to herself.
I've observed her in the kitchen, where she mutters and curses at the walls and laughs at the air, which I find quite frightening.
Today, I heard her cursing, and she said, "You can help too, Mr.
Zhang," followed by a string of insults.
I have no idea who this Mr.
Zhang is.
When there are people around, she doesn't exhibit this behavior.
She hasn't worked for a long time, and all financial support comes from her husband.
However, she insists on doing everything according to her husband's standards, such as the amount of rice to cook or the method of cooking.
She spends a long time doing housework at home, waking up at four or five in the morning to clean the bathroom.
When the garbage truck comes, she repeatedly asks for the room's trash can throughout the afternoon, even if I'm about to go to my night shift.
In winter, she asks for blankets to dry outside, even if I've just finished a night shift.
Is this a sign of obsessive-compulsive disorder? Her husband has been retired for several years and spends all day watching stocks.
The only household chore he helps with is sorting vegetables, which I see him do only once every few months.
Their clothes are often left on the floor, and she washes, dries, and folds them every day, doing multiple loads of laundry.
She washes each piece of clothing separately, even in winter when clothes take longer to dry, and she insists on using the dryer, regardless of whether the clothes can be dried or not.
Could this be due to her high levels of stress? Additionally, there is an autistic brother in the family.

Chen Manyou, 20~29 year old female. Ask Date: 2015/09/06

Dr. Xiao Minghong reply Psychiatry

Hello Ms.
Chen,
Based on the behaviors exhibited by your boyfriend's mother, she seems to display signs of soliloquy, rigidity, and inflexibility, as well as an early retirement and possibly inadequate ability to perform household tasks.
These behaviors differ from typical obsessive-compulsive disorder; however, a definitive diagnosis would require further discussion and evaluation.
If her behaviors have caused distress for her personally or for you, it is advisable to seek an assessment at a psychiatric outpatient clinic.
If you have known her for many years, you may want to observe whether her soliloquy has increased in frequency, whether her abilities have continued to decline, whether she engages in social activities, or if there are any other unusual behaviors.
You can discuss your observations with the physician during the consultation, which should lead to the most appropriate diagnosis and treatment.
Wishing you all the best.
Sincerely,
Dr.
Hsiao Ming-Hung, Psychiatry

Reply Date: 2015/09/06

More Info

Understanding unusual behaviors in individuals can be complex, especially when considering the potential underlying psychological conditions. In the case you presented, the behaviors exhibited by your boyfriend's mother raise several questions about her mental health and daily functioning.
Firstly, the act of talking to oneself, especially in a seemingly confrontational manner, can be indicative of various psychological states. While it might be easy to jump to conclusions about conditions like Obsessive-Compulsive Disorder (OCD), it is essential to consider a broader range of possibilities. OCD is characterized by intrusive thoughts (obsessions) that lead to repetitive behaviors (compulsions) aimed at reducing anxiety. However, the behaviors you described, such as talking to the walls and expressing frustration towards an unseen "Mr. Zhang," may not fit neatly into the OCD framework.

Instead, these behaviors could suggest a few different scenarios:
1. Psychotic Disorders: The self-talk and apparent delusions (believing someone named "Mr. Zhang" is present) could indicate a psychotic disorder, such as schizophrenia. Individuals with such disorders may experience hallucinations or delusions that can manifest as talking to themselves or reacting to stimuli that are not present.

2. Stress and Anxiety: Given that she is managing a household with a husband who is retired and a son with autism, it is possible that she is experiencing significant stress. Chronic stress can lead to anxiety and unusual coping mechanisms, such as talking to oneself as a way to process thoughts or emotions.

3. Obsessive-Compulsive Traits: While not necessarily OCD, her behaviors around cleanliness and orderliness (washing clothes multiple times a day, needing to follow her husband's standards) may suggest obsessive-compulsive traits. This could be a way of exerting control in her environment, especially if she feels overwhelmed by her responsibilities.

4. Coping Mechanisms: The behaviors could also be a form of coping with her circumstances. If she feels isolated or overwhelmed, talking to herself might provide a sense of companionship or a way to express her frustrations without externalizing them towards her family.

5. Cognitive Decline: Depending on her age, there could also be factors related to cognitive decline or dementia. Individuals with dementia may exhibit unusual behaviors, including confusion about their surroundings and difficulty in recognizing familiar people or objects.

Given the complexity of her situation, it would be beneficial for her to receive a comprehensive evaluation from a mental health professional. This evaluation could help determine if there are underlying psychological conditions that need to be addressed, and it could provide her with the support she may need to cope with her stressors effectively.

In the meantime, it is essential to approach the situation with empathy and understanding. If her behaviors are causing distress to those around her, it may be helpful to gently encourage her to seek professional help. Family support can also play a crucial role in her well-being, especially in managing the dynamics of caring for a child with autism and navigating her husband's retirement.

In conclusion, while the behaviors you described may raise concerns about OCD or other mental health issues, they could stem from a variety of factors, including stress, anxiety, or even cognitive decline. A professional assessment would provide clarity and direction for appropriate interventions and support.

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