Supporting a Family Member with OCD: Strategies for Caregivers

If a family member has obsessive-compulsive disorder (OCD), how can the family assist her?

Hello Dr.
Ding,
1.
My sister is a patient with obsessive-compulsive disorder (OCD) and has been seeing a doctor for quite a long time.
Although she is still undergoing treatment, she has started to resist taking the medications prescribed by her doctor because she feels that they have no effect.
Additionally, my sister has a history of dizziness, and she believes that taking psychiatric medications makes her head feel very dizzy, which reminds her of previous episodes of dizziness.
We have consulted with the doctor, who stated that this particular psychiatric medication does not have such side effects, but my sister is now completely resistant to taking the medication, and our family is unsure of what to do.
2.
When my sister engages in repetitive behaviors, she sometimes injures herself.
Even when she becomes frustrated but cannot stop, she will hit herself or the wall, or even bang her head against the wall.
This is very painful for us as her family to witness.
We know we need to soothe her emotions, give her love, strength, and companionship, but when she injures herself, it is impossible not to intervene.
However, stopping her may trigger a breakdown, crying, hysteria, or even exacerbate her dizziness symptoms.
In this situation, we as her family truly do not know what to do.
We have been continuously communicating this issue with the doctor, but the responses we receive feel vague and powerless.
Is there a more concrete method we can follow to know how to help her?
3.
According to the doctor, after taking medication for a period of time, there should be some improvement.
My sister has indeed been taking her medication, but her symptoms have not improved significantly, which has led her to resist taking the medication and distrust the doctor.
In such a situation, should we consider switching to another attending physician or another hospital?
Thank you very much for taking the time to read my concerns, and I hope you can provide me with more specific advice.
Thank you!

Xinli Jiaozui de Jiaren, 20~29 year old female. Ask Date: 2016/01/04

Dr. Ding Shuyan reply Psychiatry

Hello, the treatment for obsessive-compulsive disorder (OCD) indeed requires time and patience.
Not only may the medication need to be taken at higher doses, but it is also quite common for a patient to switch to a different medication if the first one is ineffective.
The medications used to treat OCD are well-known, so this aspect is less dependent on the physician, and there is no particular need to seek a renowned specialist.
However, the psychological factors involved in seeing a doctor can be quite significant; patients often feel better psychologically when taking the same medication prescribed by a trusted physician.
If the patient truly does not trust their original doctor, it would be reasonable to consider changing physicians.
As for which doctor to switch to, it is best to involve her in the discussion to make a decision, as this can help foster a sense of trust.
Wishing you all the best.
Sincerely, Dr.
Ding Shuo-Yan.

Reply Date: 2016/01/04

More Info

Supporting a family member with Obsessive-Compulsive Disorder (OCD) can be a challenging journey, especially when the individual is resistant to treatment or medication. Here are some strategies that caregivers can employ to provide effective support while also taking care of their own well-being.

Understanding OCD and Its Treatment
OCD is a mental health condition characterized by persistent, unwanted thoughts (obsessions) and repetitive behaviors (compulsions) that the individual feels driven to perform. Treatment typically involves a combination of cognitive-behavioral therapy (CBT), particularly exposure and response prevention (ERP), and medication, such as selective serotonin reuptake inhibitors (SSRIs).
It's important to recognize that while medications can be effective, they may take time to show results, and side effects can vary. If your sister is experiencing dizziness and believes it is linked to her medication, it is crucial to communicate this with her healthcare provider. Sometimes, a medication adjustment or a different medication may be necessary to alleviate side effects while still managing her OCD symptoms.

Strategies for Caregivers
1. Open Communication: Encourage open dialogue about her feelings regarding the medication and treatment. Validate her concerns about dizziness and discuss them with her doctor. This can help her feel heard and may reduce her resistance to treatment.

2. Education: Educate yourself and your family about OCD. Understanding the disorder can help you empathize with her struggles and provide informed support. Resources from reputable organizations like the International OCD Foundation can be beneficial.

3. Encourage Professional Help: If your sister is resistant to her current treatment plan, it may be worth discussing the possibility of seeking a second opinion or changing healthcare providers. A fresh perspective might offer new treatment options or approaches that resonate better with her.

4. Supportive Environment: Create a supportive and understanding home environment. Encourage her to express her feelings and fears without judgment. Let her know that it’s okay to have bad days and that you are there for her.

5. Coping Strategies: Help her develop coping strategies for when she feels overwhelmed. This could include mindfulness techniques, grounding exercises, or distraction methods that can help her manage her compulsions without resorting to self-harm.

6. Set Boundaries: While it’s important to be supportive, it’s equally crucial to set boundaries. If her compulsive behaviors are harmful, gently intervene without escalating the situation. You might say something like, “I understand that you feel the need to do this, but I’m worried about your safety.”
7. Self-Care for Caregivers: Caring for someone with OCD can be emotionally taxing. Make sure to take time for yourself, engage in activities you enjoy, and seek support from friends, family, or support groups. This will help you maintain your mental health and be a better support for your sister.

8. Encourage Gradual Exposure: If she is open to it, encourage her to gradually face her fears through exposure therapy techniques. This should be done under the guidance of a trained therapist, as it can be challenging to navigate on your own.

9. Celebrate Small Wins: Acknowledge and celebrate any progress, no matter how small. This can help boost her confidence and motivation to continue with her treatment.

Conclusion
Supporting a family member with OCD requires patience, understanding, and a willingness to adapt strategies as needed. It’s essential to maintain open lines of communication with her healthcare providers and to advocate for her needs. If her current treatment isn’t working, exploring new options with her can lead to better outcomes. Remember, you are not alone in this journey, and seeking support for yourself is equally important.

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