Linda is a 56-year-old woman who presents for outpatient assessment. Her symptoms started slowly; she tells you that she was always described as an anxious person and remembers being worried about a lot of things throughout her life. For instance, she reported she was very afraid she’d contract HIV by touching doorknobs, even though she tells you she knew this was “irrational.” She tells you that about 10 years ago, following a few life stressors, her anxiety and intrusive thoughts worsened significantly. She tells you she began washing her hands excessively. She reports she developed an intense fear that someone would break into the house and it would be her fault because she left something unlocked. She states that this fear led her to repeatedly check doors and windows before sleep in a specific order, which was a source of contention with her husband. She says that her fear of making a mistake also leads her to be slow to turn in work for her job, checking many times to make sure there are no mistakes, for which she gets reprimanded on occasion.
Linda reports that her symptoms are getting worse, which is why she has sought treatment. For example, currently she washes her hands until she finishes the whole soap bar, and her hands are cracked because they are so dry. She says she continues to check the doors and windows of her house numerous times throughout the day, not just at night, and has on occasion driven home from work to be sure everything truly was locked. If she notices even a speck of dust on the floor, she states she has the urge to clean the whole house and she often complies with that urge.
Linda expresses significant distress over these symptoms, as they are taking up more of her time and robbing her of her confidence, as she is increasingly distracted at work and in her family life.
Diagnosis: Obsessive Compulsive Disorder
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