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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 11 of 11. This is the beginning of the thread.
Posted by g_g_g_unit on May 18, 2011, at 8:43:31
Hey .. so I've been having some OCD-like concerns about my condition and its management, which have been interfering with my ability to pursue employment, and I was just wondering if anyone could offer some advice.
I've mentioned on here before that my family immigrated just over a year ago, and I've been unable to find a job during that period. I don't qualify for disability either until I've lived here at least another year. In our prior country-of-residence, I was working 9 hours a week - even while severely depressed - but found that since I had formed most of my relationships with my coworkers while relatively 'well', they were less attuned to the sudden decline in my sociability. It was a customer service role, and I found that I could perform the basics of my job without difficulty - i.e. affect a polite manner, etc. - but spontaneous interaction became extremely difficult.
Prior to that job, I had always worked part-time, ever since being struck down by OCD at the age of 18. There was a period where I was freelance writing from home as well, but I eventually had to give that up.
Unfortunately, my condition has deteriorated even further since immigrating, and I've found that symptoms like psychomotor retardation have become much more prominent. In fact, I spent a considerable portion of last year lazing around in bed. My social skills were even worse as a result of the decline in mental/physical energy, i.e. I sometimes struggled to project my voice, would go 'blank' even during routine phone conversations, etc.
On top of that, I was/am still battling OCD and severe anxiety.
Up until this point, my parents have only had a very superficial understanding of my condition, and have been pressuring me to find work, claiming that I'm just tired because "I'm out of shape" (despite the fact that I would routinely swim 1km most days before major depression). I received poor treatment during that first year - I was misdiagnosed as schizophrenic, etc. which further jeopardized things. I'm seeing a much better psychiatrist now, and am also in therapy for OCD, but even then, things are still difficult. I tried having a meeting with my psychiatrist and parents, but he never really went into the OCD, and I've found myself now having to write a letter which I plan to give to them explaining exactly how it manifests.
Anyway, I've found that I have these (potential) misconceptions about medication, which are preventing me from applying for a suitable job. For example, I'll think (in an OCD sense) that I could end up on an anti-psychotic for anxiety (which I suppose isn't completely unrealistic at this point) and will be so emotionally and mentally numb/sedated that people will think I'm a freak - and therefore will refrain from applying from any customer service positions out of fear.
Because I'm not capable of labor etc., ruling out any job where I interact with people doesn't leave very much. I've been looking at disabled-employment agencies, but they seem to primarily cater to intellectual disabilities. I went to one group meeting and - without wanting to offend anyone - found it really depressing, simply because most of the people there were afflicted with things like mental retardation, etc., and I feel like I'm more high-functioning than that.
So I would appreciate hearing:
a) whether I am indeed catastrophising, as I suspect, my appraisal of treatment with anti-psychotics, and whether it would still be possible to work in mainstream society while taking one (sorry if that sounds ridiculous, but that's the nature of OCD, I suppose)?
and b) whether it wouldn't be such a bad idea to push myself into some kind of part-time work at the moment? I am taking just 25mg of Zoloft, which has eliminated the worst of my fatigue, though I'm having some mixed-type symptoms and don't suspect I'll be kept on it. But my point is that my depression does seem to respond to treatment, and I am seeing a psychiatrist, so it's not like I'd be left hanging.. but then again, I do have this unfortunate habit of never knowing when to back off and stop stressing myself, so I donno.
option c) would be to pursue work at some kind of disability center until I'm more stabilized, though (again, please don't take offense to this) I wonder how it might affect my self-confidence.
Thanks, and sorry this was so long!
Posted by Solstice on May 18, 2011, at 10:16:21
In reply to meds + employment, posted by g_g_g_unit on May 18, 2011, at 8:43:31
> a) whether I am indeed catastrophising, as I suspect, my appraisal of treatment with anti-psychotics, and whether it would still be possible to work in mainstream society while taking one (sorry if that sounds ridiculous, but that's the nature of OCD, I suppose)?
I think you can work in mainstream society while taking an anti-psychotic. If an anti-psychotic relieves your symptoms sufficiently, then you'll likely be able to work in mainstream society Because you are taking an anti-psychotic.
> and b) whether it wouldn't be such a bad idea to push myself into some kind of part-time work at the moment? I am taking just 25mg of Zoloft, which has eliminated the worst of my fatigue, though I'm having some mixed-type symptoms and don't suspect I'll be kept on it. But my point is that my depression does seem to respond to treatment, and I am seeing a psychiatrist, so it's not like I'd be left hanging.. but then again, I do have this unfortunate habit of never knowing when to back off and stop stressing myself, so I donno.I like this option. I'd go for the part-time job because:
1. It can serve as a transition-type thing. Like learning to ride a bicycle before taking on a motorcycle.
2. A part-time job would be an experiment of sorts. You would be experiementing with your ability to function in a less stressful (than full-time) situation.
3. If it doesn't work, you can quit.What will best give you the answers you seek, is to give it a shot. Won't know till you try! :-)
Sostice
Posted by Solstice on May 18, 2011, at 10:17:24
In reply to meds + employment, posted by g_g_g_unit on May 18, 2011, at 8:43:31
> a) whether I am indeed catastrophising, as I suspect, my appraisal of treatment with anti-psychotics, and whether it would still be possible to work in mainstream society while taking one (sorry if that sounds ridiculous, but that's the nature of OCD, I suppose)?
I think you can work in mainstream society while taking an anti-psychotic. If an anti-psychotic relieves your symptoms sufficiently, then you'll likely be able to work in mainstream society Because you are taking an anti-psychotic.
> and b) whether it wouldn't be such a bad idea to push myself into some kind of part-time work at the moment? I am taking just 25mg of Zoloft, which has eliminated the worst of my fatigue, though I'm having some mixed-type symptoms and don't suspect I'll be kept on it. But my point is that my depression does seem to respond to treatment, and I am seeing a psychiatrist, so it's not like I'd be left hanging.. but then again, I do have this unfortunate habit of never knowing when to back off and stop stressing myself, so I donno.I like this option. I'd go for the part-time job because:
1. It can serve as a transition-type thing. Like learning to ride a bicycle before taking on a motorcycle.
2. A part-time job would be an experiment of sorts. You would be experiementing with your ability to function in a less stressful (than full-time) situation.
3. If it doesn't work, you can quit.What will best give you the answers you seek, is to give it a shot. Won't know till you try! :-)
Sostice
Posted by Phillipa on May 18, 2011, at 11:40:26
In reply to Re: meds + employment, posted by Solstice on May 18, 2011, at 10:17:24
OCD is considered an anxiety illness so your symptoms dont surprise me. It's a tough one also. Phillipa
Posted by B2chica on May 19, 2011, at 8:40:39
In reply to meds + employment, posted by g_g_g_unit on May 18, 2011, at 8:43:31
first of all you don't really sound like you are catastrophising anything. it sounds like you are in a tough spot and have understandable concerns about lack of job, ability to work, and medication side-effects.
i think we've all been there at one point or another so no worries there.Next. im not a doctor but i will tell you that i think the only meeds that have consistently worked the best for me are antipsychotics.
zyprexa is ALWAYS my saving grace. But now (after amazing anxiety and fear of trying) i am on a very small dose of perphenazine and it has knocked out both my anxiety (which includes obsessive thinking) AND any weirdness illusions and such that i've had in the past.i also am very high functioning.work full-time in a very fast pace environment.
i have worked well with both zyprexa and perphenazine.
however i have also tried risperdal, geodon, seroquel AP. and i had absolutely no luck on those.
So even though an AP may be right for you, its still a matter of finding the right oneGiven your state only you can determine if you are ready for part-time work. if you feel you can than go for it, start slow. however sometimes you just need a sabbatical until you get your meds figured out. So weigh that well before you decide.
and even if you aren't ready to workhave you thought about volunteering anywhere? that way there is no record of jobs lost, and if you cant handle it, i'm sure they will be thankful for the time you were able to put in
just a suggestion.b2c
Posted by creepy on May 22, 2011, at 20:36:37
In reply to meds + employment, posted by g_g_g_unit on May 18, 2011, at 8:43:31
Wow you sound a lot like me. I have C-PTSD which is also anxiety spectrum. I have always found it difficult to work and communicate with people on a daily basis without putting my foot in my mouth, or having a really bad day and getting fired. Mental illness sucks. Really.
Throw in chronic fatigue and what could be fibromyalgia, and it becomes really hard to get a job and keep it.
But I also consider myself too high functioning to take disability.
Im also really afraid of winding up on meds that make me seem weird (I was inpatient at a young age and that traumatized me to being 'broken') or slow me down so much I cant enjoy life.
Wish I had an answer.. =(
Posted by Questionmark on May 23, 2011, at 18:46:36
In reply to meds + employment, posted by g_g_g_unit on May 18, 2011, at 8:43:31
All of these concerns are understandable, and i could easily see myself thinking the same things (i have OCD as well). But no, these concerns should not prevent you from seeking treatment and do not need to worry you.
First of all, know that many people nowadays take some sort of psychiatric drug-- including many seemingly "successful" people. Also, you do not know that an antipsychotic will be helpful for you. However, if it turns out that that is the case, you can simply tell people (those you feel the need to tell at all) that it is an anti-anxiety drug (or "a drug for anxiety"), which will be the truth in its function for you.
Just remember, always start at low doses of medications as it is the best way to see if you can handle a drug and you can always titrate up.
... But yes you do not need to be so concerned about this.I wish i knew what advice to offer on the employment end but i am sorry to say i'm not sure.
PS Not exactly sure your particular issues, but you may want to consider Nardil. Not great for OCD (then again what medication is?) but amazing for depression and anxiety.
Good luck to you.
> Hey .. so I've been having some OCD-like concerns about my condition and its management, which have been interfering with my ability to pursue employment, and I was just wondering if anyone could offer some advice.
>
> I've mentioned on here before that my family immigrated just over a year ago, and I've been unable to find a job during that period. I don't qualify for disability either until I've lived here at least another year. In our prior country-of-residence, I was working 9 hours a week - even while severely depressed - but found that since I had formed most of my relationships with my coworkers while relatively 'well', they were less attuned to the sudden decline in my sociability. It was a customer service role, and I found that I could perform the basics of my job without difficulty - i.e. affect a polite manner, etc. - but spontaneous interaction became extremely difficult.
>
> Prior to that job, I had always worked part-time, ever since being struck down by OCD at the age of 18. There was a period where I was freelance writing from home as well, but I eventually had to give that up.
>
> Unfortunately, my condition has deteriorated even further since immigrating, and I've found that symptoms like psychomotor retardation have become much more prominent. In fact, I spent a considerable portion of last year lazing around in bed. My social skills were even worse as a result of the decline in mental/physical energy, i.e. I sometimes struggled to project my voice, would go 'blank' even during routine phone conversations, etc.
>
> On top of that, I was/am still battling OCD and severe anxiety.
>
> Up until this point, my parents have only had a very superficial understanding of my condition, and have been pressuring me to find work, claiming that I'm just tired because "I'm out of shape" (despite the fact that I would routinely swim 1km most days before major depression). I received poor treatment during that first year - I was misdiagnosed as schizophrenic, etc. which further jeopardized things. I'm seeing a much better psychiatrist now, and am also in therapy for OCD, but even then, things are still difficult. I tried having a meeting with my psychiatrist and parents, but he never really went into the OCD, and I've found myself now having to write a letter which I plan to give to them explaining exactly how it manifests.
>
> Anyway, I've found that I have these (potential) misconceptions about medication, which are preventing me from applying for a suitable job. For example, I'll think (in an OCD sense) that I could end up on an anti-psychotic for anxiety (which I suppose isn't completely unrealistic at this point) and will be so emotionally and mentally numb/sedated that people will think I'm a freak - and therefore will refrain from applying from any customer service positions out of fear.
>
> Because I'm not capable of labor etc., ruling out any job where I interact with people doesn't leave very much. I've been looking at disabled-employment agencies, but they seem to primarily cater to intellectual disabilities. I went to one group meeting and - without wanting to offend anyone - found it really depressing, simply because most of the people there were afflicted with things like mental retardation, etc., and I feel like I'm more high-functioning than that.
>
> So I would appreciate hearing:
>
> a) whether I am indeed catastrophising, as I suspect, my appraisal of treatment with anti-psychotics, and whether it would still be possible to work in mainstream society while taking one (sorry if that sounds ridiculous, but that's the nature of OCD, I suppose)?
>
> and b) whether it wouldn't be such a bad idea to push myself into some kind of part-time work at the moment? I am taking just 25mg of Zoloft, which has eliminated the worst of my fatigue, though I'm having some mixed-type symptoms and don't suspect I'll be kept on it. But my point is that my depression does seem to respond to treatment, and I am seeing a psychiatrist, so it's not like I'd be left hanging.. but then again, I do have this unfortunate habit of never knowing when to back off and stop stressing myself, so I donno.
>
> option c) would be to pursue work at some kind of disability center until I'm more stabilized, though (again, please don't take offense to this) I wonder how it might affect my self-confidence.
>
> Thanks, and sorry this was so long!
>
Posted by g_g_g_unit on May 25, 2011, at 2:26:18
In reply to Re: meds + employment » g_g_g_unit, posted by Questionmark on May 23, 2011, at 18:46:36
> All of these concerns are understandable, and i could easily see myself thinking the same things (i have OCD as well). But no, these concerns should not prevent you from seeking treatment and do not need to worry you.
> First of all, know that many people nowadays take some sort of psychiatric drug-- including many seemingly "successful" people. Also, you do not know that an antipsychotic will be helpful for you. However, if it turns out that that is the case, you can simply tell people (those you feel the need to tell at all) that it is an anti-anxiety drug (or "a drug for anxiety"), which will be the truth in its function for you.
> Just remember, always start at low doses of medications as it is the best way to see if you can handle a drug and you can always titrate up.
> ... But yes you do not need to be so concerned about this.
>
> I wish i knew what advice to offer on the employment end but i am sorry to say i'm not sure.
>
> PS Not exactly sure your particular issues, but you may want to consider Nardil. Not great for OCD (then again what medication is?) but amazing for depression and anxiety.
>
> Good luck to you.
>Thanks for your reply. My concern doesn't so much lie with having to notify people that I'm taking an anti-psychotic as, I suppose, the sacrifices I'm making to stay 'well'. Neurontin is an example of a medication that erased my anxiety/panic, along with my soul - I can barely recall the 3 or so months that I spent on it. I think I just slept, ate and watched TV.
It's hard not to yearn for the person I once was - or at least could have been - and every moment I spend out amongst 'normal' people feels like torture because I'm constantly confronted by my own inadequacies. Sorry for the emotional outpouring, but I'm just not feeling very well at the moment. Maybe it's a symptom of depression. I just don't know how to move forward and accept that life will never be what I intended. I hope that doesn't sound childish or egotistical.
Anyway, I suffer from OCD, ADHD and what I'm beginning to suspect might be BPII. I'm taking Zoloft at the moment, but I think it's making me manic. My psychiatrist actually wants to put me back on Nardil - I tried it about a year and a half ago and found that nothing else cleared up my anhedonia, depression, etc. quite like it. But it also made me anxiety worse (possibly due to sleep deprivation). He suspects that if I remain on it longer (I was on it for 12 weeks last time, and kept tinkering with the dose) an anxiolytic effect should eventually appear.
Do you find Nardil impairing as far as attention, memory, etc. goes?
Posted by g_g_g_unit on May 25, 2011, at 2:34:53
In reply to Re: meds + employment, posted by Solstice on May 18, 2011, at 10:16:21
> I think you can work in mainstream society while taking an anti-psychotic. If an anti-psychotic relieves your symptoms sufficiently, then you'll likely be able to work in mainstream society Because you are taking an anti-psychotic.
>Sorry, I can see how that question might sound a little insensitive on paper, but that's the nature of OCD.
> > and b) whether it wouldn't be such a bad idea to push myself into some kind of part-time work at the moment? I am taking just 25mg of Zoloft, which has eliminated the worst of my fatigue, though I'm having some mixed-type symptoms and don't suspect I'll be kept on it. But my point is that my depression does seem to respond to treatment, and I am seeing a psychiatrist, so it's not like I'd be left hanging.. but then again, I do have this unfortunate habit of never knowing when to back off and stop stressing myself, so I donno.
>
> I like this option. I'd go for the part-time job because:
> 1. It can serve as a transition-type thing. Like learning to ride a bicycle before taking on a motorcycle.
> 2. A part-time job would be an experiment of sorts. You would be experiementing with your ability to function in a less stressful (than full-time) situation.
> 3. If it doesn't work, you can quit.
>
> What will best give you the answers you seek, is to give it a shot. Won't know till you try! :-)
>
> Sostice
>
>I spoke to my parents, which helped get them off my back. I'm going to continue working for my dad part-time (which I hate, but I have no other choice for the time being) and also volunteer one day a week.
Posted by g_g_g_unit on May 25, 2011, at 2:38:39
In reply to Re: meds + employment, posted by B2chica on May 19, 2011, at 8:40:39
Thanks, I really appreciate hearing you story. It's given me more hope and helped ease my fear of anti-psychotics a little. Yep, I think I am going to try volunteering one day a week at my mom's work.
> first of all you don't really sound like you are catastrophising anything. it sounds like you are in a tough spot and have understandable concerns about lack of job, ability to work, and medication side-effects.
> i think we've all been there at one point or another so no worries there.
>
> Next. im not a doctor but i will tell you that i think the only meeds that have consistently worked the best for me are antipsychotics.
> zyprexa is ALWAYS my saving grace. But now (after amazing anxiety and fear of trying) i am on a very small dose of perphenazine and it has knocked out both my anxiety (which includes obsessive thinking) AND any weirdness illusions and such that i've had in the past.
>
> i also am very high functioning.work full-time in a very fast pace environment.
> i have worked well with both zyprexa and perphenazine.
> however i have also tried risperdal, geodon, seroquel AP. and i had absolutely no luck on those.
> So even though an AP may be right for you, its still a matter of finding the right one
>
> Given your state only you can determine if you are ready for part-time work. if you feel you can than go for it, start slow. however sometimes you just need a sabbatical until you get your meds figured out. So weigh that well before you decide.
> and even if you aren't ready to workhave you thought about volunteering anywhere? that way there is no record of jobs lost, and if you cant handle it, i'm sure they will be thankful for the time you were able to put in
> just a suggestion.
>
> b2c
Posted by g_g_g_unit on May 25, 2011, at 2:45:39
In reply to Re: meds + employment, posted by creepy on May 22, 2011, at 20:36:37
> Wow you sound a lot like me. I have C-PTSD which is also anxiety spectrum. I have always found it difficult to work and communicate with people on a daily basis without putting my foot in my mouth, or having a really bad day and getting fired. Mental illness sucks. Really.
> Throw in chronic fatigue and what could be fibromyalgia, and it becomes really hard to get a job and keep it.
> But I also consider myself too high functioning to take disability.
> Im also really afraid of winding up on meds that make me seem weird (I was inpatient at a young age and that traumatized me to being 'broken') or slow me down so much I cant enjoy life.
> Wish I had an answer.. =(
>Yeah, I feel caught between a rock and a hard place. My mind and wit are my only assets - neither of which tend to end up preserved on meds. Without either I'm just some quiet weirdo.
This is the end of the thread.
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