DANIEL Kumar has really clean hands. That is probably because he loves to wash them (sometimes up to 10 times a day) and when no one is looking, he uses a toothbrush while he’s at it.

“I’d feel a little uncomfortable if I don’t brush my hands, especially after doing something that gets them dirty, like washing the car or eating,” says the 23-year-old management trainee.

He carries a toothbrush with him all the time and no, it’s not the same pair he uses to brush his teeth.

“I like washing my hands and scrubbing my fingernails with the brush because it’s much cleaner afterwards. You don’t know what kind of germs your hands come in contact with throughout the day,” says Daniel.

Lee Pei Wen has to arrange her stationery on the table according to their shapes and sizes before she could start using them

What’s stranger than the sight of a grown man religiously brushing his fingernails with a toothbrush is the fact that Daniel doesn’t care how dirty or clean the rest of his body is.

“I don’t know why but I have this fixation with only my hands. I can go without a shower for a few days, but won’t last an hour without washing my hands after they get dirty. I’d go a little antsy and crazy,” he explains.

Such behaviours like Daniel’s is not uncommon, although they are often mistaken for being traits of Obsessive Compulsive Disorder (OCD).

“Many people have their own idiosyncrasies, for example, preoccupation with orderliness, cleanliness, eating right, choice of clothing and more. It’s the degree of odd behaviours and the effects they may have on one’s life that determines whether or not one has OCD,” says Cyberjaya University College of Medical Sciences associate professor in Psychiatry and consultant psychiatrist Dr Muhammad Najib Mohamad Alwi.

OCD is characterised by persistent and recurrent obsessions and compulsions. An obsession is defined as odd thoughts, ideas, impulses and images that are considered intrusive and cause a lot of distress to an individual. These thoughts and ideas are not excessive worries about real-life problems but rather oddities that came to the person’s mind and serve no sensible purpose. Compulsion, on the other hand, is repetitive behaviours or mental acts (such as counting or repeating words silently) with the goal of preventing or reducing anxiety or distress but definitely not for pleasure or gratification.

“Normal obsessions and compulsions end and OCD starts when the odd behaviours become ‘ridiculous’ even to the affected person, and serve only to unnecessarily delaying his or her daily activities, and to cause suffering to him or herself – and sometimes others too!” says Dr Najib.

Another individual on her way to the OCD “hall-of-fame” is Sheryll Siew, who could potentially be the Health Ministry’s poster child. She’s been doing everything the ministry promotes to curb the spread of Influenza A (H1N1) way before the virus found its way to Malaysia.

Sheryll has to have a 30-minute (or longer) shower at least twice a day; washes her hands repetitively; and wipes everything before and after she touches them.

One of her favourite after-school rituals is to take all the books out of her schoolbag, wipe them clean from one corner to another, and arrange them back in their original positions. God forbid if the ritual is disrupted.

Sheryll Siew spends a lot of time washing her hands and doesn't miss the opportunity to do so when there's a washing basin nearby.

“If anything goes wrong when I’m doing this task, I’ll start the whole routine again till I’m satisfied,” says 16-year-old Sheryll.

Her friends Vinoda Ganase and Lee Pei Wen are equally eccentric in their own ways. Vinoda can only increase the television volume level by fives and has to even out the toothpaste on her toothbrush before she can commence brushing.

“The volume thing never works anyway, but I cannot do it otherwise. It’s always either too loud or too soft but I cannot know that the volume number is anything besides the multiplication of five,” says Vinoda.

On her habit of levelling the toothpaste on her toothbrush, Vinoda says, “I cannot have too much toothpaste or too little. I’ll take some off, and put some on until I know there’s even amount of toothpaste on every bristle. I also cover the edges,” she says.

Vinoda finds her own habit annoying sometimes, especially in the mornings when she’s rushing off to school, but nevertheless, it’s a task she has to complete or else it’ll nag her for the rest of the day. The same goes for Sheryll, who must keep things clean and tidy or else “I’ll feel very uncomfortable”.

Dr Najib says that behaviours like above can be described as having “OCD traits”. This is when the person has frequent obsessions and compulsions like concerns about cleanliness, orderliness, symmetry, perfectionism and so on but they are not severe enough to seriously affect his or her daily functioning.

“When these behaviours become more persistent and gradually became a permanent part of the person’s behaviour and start to cause distress to the person, then they would be described as having ‘Obsessive Compulsive Personality Disorder’ or otherwise known as ‘Anankastic Personality Disorder’. This condition has been shown to predispose someone to get OCD,” he says.

Another OCD-nominee, Pei Wen loves her quirkiness and can’t have enough of them. She loves arranging things, and does that with everything that can be arranged.

“Everything in my pencil case has to face one side, and when I arrange the stationery on my desk, they have to be aligned according to shape and sizes,” says Pei Wen, 16.

The clothes in her closet are either colour or material-coordinated; the pictures in her folder are arranged according to topics, subtopics, date and person (and yes, in that exact order); and God help us all if the food on her plate actually touch each other.

“I have to make sure that each food item is separated and I won’t eat until I’ve arranged them nicely and the plate of food looks pretty,” she says happily.

Well, the behaviours portrayed by the individuals above are still in the idiosyncrasy stage, a cute oddity that draws laughter and amusement from others, but Dr Najib stresses that OCD starts when the odd behaviour becomes “ego-dystonic” (not a preferred behaviour) to the person and they cause major difficulties in the person’s life.

“This is in the context where, the behaviours are recognised by the person to be unreasonable and excessive. It is hoped that at this point, the person would realise that they also need to seek treatment, although unfortunately, this often not the case.

Vinoda Ganase, 16, has to even out the amount of toothpaste on her toothbrush before she could start brushing her teeth every morning.

“Apart from the discomfort, OCD can also cause other psychiatric symptoms like depressive mood, and on occasion may even lead to suicide,” he adds.