116

=Case #116- Margaret = = =

Margaret is an 18 year old girl who lives what some may call a "typical, habitual" life. Although Margaret feels that she's living by her usual routine, people around her feel that she has changed somewhat. Margaret used to have some friends, but recently she lost all of them. It seems that her peers don't understand some of her behaviors.

Margaret's day starts at the same hour everyday: 6 o'clock. Everything must follow the schedule and be at its proper place. Then she takes a shower for an hour; she can't stop thinking that she'll be contaminated by the germs that seem to be all around her. After the long shower, she goes to her closet. Margaret's closet is perfectly organized. She has a drawer for socks and underwear, separate closet for coats, jackets, sweaters, T-shirts, blouses...and so on. All her clothes are organized by the color of rainbow. Even the idea of them being out of place drives her crazy. After deciding what to wear, she wears her clothes in this order: underwear first, pants next, socks, shirts, then outerwear. She then must put on lotion, sunscreen, make-up, and brush her hair. If she does this in any other order, Margaret dreads all day in fear that something bad might happen.

Occasionally, Margaret's sister Lil comes by Margaret's house. Though Margaret loves Lil, she hates it when Lil comes over, because Lil "ruins" things. Lil sits on the couch and puts the cushion on the wrong section of the sofa. She even changes the order of the drinks in the refrigerator and throws away things without Margaret's permission. Last time Lil came over, Lil lost a yellow pencil that was sitting on the top left corner of Margaret's desk. After Lil lost the pencil, Margaret was so preoccupied with the pencil's whereabouts that she couldn't sleep for three days. To Margaret, people coming over to her house is a nightmare.

When Margaret goes outside, she always checks everything before she leaves. She has to make sure that the stove is turned off, the curling iron unplugged, the doors and windows closed or locked. She also has to take her hand sanitizer and must wash her hand every hour when she's outside, because she's horrified by the idea of getting germs on her hands. When she comes back home, she checks the house again. Once again she checks to make sure that the stove is turned off, the curling iron unplugged, the doors and windows closed. If she goes out and comes back in several times a day, she must do this every time she goes outside and comes back in. Before she goes back to her bed, she takes an hour long shower again. She puts her coat back to where it belongs and lays down on her smooth bed. If the bed sheet is wrinkled in any way, she doesn't feel like lying down.

After making sure that everything is in its place, Margaret closes her eyes to go to sleep.

Diagnosis: Margaret has a disorder what is referred to as obsessive-compulsive disorder, otherwise known as OCD. A person with an OCD will have anxiety attacks, and in order to reduce the anxiety one will be repeating such actions that would seem peculiar to the others in society. Margaret, in this case, is showing an obsession with neatness and perfection. This can be also seen as being a perfectionist in the society, yet her symptoms of being irritated whenever her neatness is destroyed lead to the fact that she has a disorder that needs treatment. The danger of this disorder become an issue because the patient sometimes recognizes oneself that one has such disorder, and would actually be more stressed. This is a common mental disorder in U.S, and it can be treated through counseling and medications.

There are few therapies that can be used to treat this disorder and one of them is exposure and ritual prevention. This therapy is trying to control the anxiety that one is feeling in order to reduce the obsession over neatness, in this case. By getting this treatment, Margaret can learn that she has issues and it is mild enough for her to recover from. Another treatment for her would be medication. The medications usually used for this disorder is serotonin and re uptake inhibitor which relives the symptoms.

resource:

http://emedicine.medscape.com/article/287681-overview accessed on January 8th, 2010. http://www.psych.org/public_info/ocd.cfm January 9th, 2010. http://kidshealth.org/teen/your_mind/mental_health/ocd.html January 9th, 2010.

In-Class Case Observations 

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