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Dr. Bob is Robert Hsiung, MD,
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Posted by phidippus on February 10, 2015, at 15:51:37
In reply to Re: OCD Dont know where to go, posted by Bill82 on January 31, 2015, at 16:03:55
>I was about to try pregabalin but p doc decided against it die to adverse reactions to other GABA meds(benzos and lamictal).
Pregablin has nothing to do with GABA. It is a Calcium Channel blocker and glutamate antagonist. It would be ideal for treating your OCD.
Eric
Posted by phidippus on February 10, 2015, at 16:01:16
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 1, 2015, at 13:10:41
>Zoloft was at 50mg for 3 days haha.
It takes about 4-6 weeks for SSRIs to become effective.
Eric
Posted by phidippus on February 10, 2015, at 16:12:41
In reply to OCD Dont know where to go, posted by Bill82 on January 30, 2015, at 20:57:31
Have you done ERP?
Eric
Posted by Bill82 on February 10, 2015, at 18:05:01
In reply to Re: OCD Dont know where to go » Bill82, posted by phidippus on February 10, 2015, at 16:01:16
Yea they had discussed the bipolar stuff with the doc, but when I'm not on any meds at all as I am now, I don't have depression at all and have never been manic or overly attentive, irritable, creative ect. So not sure why I would treat something that dosnt exist in the first place. As for the the gabapentin, she said it not me haha, and I noticed from the begining she seemed kind of daft in terms of understanding the science. (Ex: giving the car fluid example for why you have ocd, inferring I'm running low on seritonin and it's that simple.) as for erp, I already do that on my own time but it is not enough, as when exsposing myself to the stimulus and resisting my compulsions, which I do a lot, it causes a lack of motivation and zest for life that I had before(ex: not doing my rituals I then feel like a piece of crap, I don't have any desire to do anything to) . Only residual symptom psychologically I have that I didn't have before is an inanity to pay attention to a certain task, in that I space out or get distracted, and not from my ocd, but from other things. As for the zoloft I know 3 days would do squat, but the effects I had from it made me quit early because I simply couldn't take it. But still not sure what to as ssri make me sad and blue(what they do mentally is make me brush off the thoughts and then I feel like crap similar to erp) antipsychotics as you said do nothing on their own. Really what I would like is to find away to remove some of the extreme inability to have confidence in anything, but most people say that's impossible sadly.
Posted by Bill82 on February 10, 2015, at 18:49:14
In reply to Re: OCD Dont know where to go » Bill82, posted by phidippus on February 10, 2015, at 15:48:45
And luvox month and a half maybe two, brintillex 4 months, prozac a week then rash and inability to go to bathroo so had to stop
Posted by phidippus on February 11, 2015, at 15:38:11
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 10, 2015, at 18:05:01
Suggesting you were by bipolar was just that: a suggestion. Its good that you're not.
>(Ex: giving the car fluid example for why you have ocd, inferring I'm running low on seritonin and it's that simple.)
Its not that simple, but low serotonin accounts for a majority of the problem. High dopamine and high levels of glutamate also play a big part.
>as for erp, I already do that on my own time but it is not enough, as when exsposing myself to the stimulus and resisting my compulsions
Resisting your compulsions is not really a part of ERP.
How do you do your ERP-how do you expose yourself to the stimulus?
>not doing my rituals I then feel like a piece of crap, I don't have any desire to do anything
What sort of rituals do you have?
OCD kind of works that way-it'll make you feel depressed when you don't do your rituals, but this feeling usually passes.
>Only residual symptom psychologically I have that I didn't have before is an inanity to pay attention to a certain task, in that I space out or get distracted, and not from my ocd, but from other things
Funny you should mention this, because dextroamphetamine has shown efficacy in the treatment of OCD-d-amphetamine might help your OCD and attention problems.
>what they do mentally is make me brush off the thoughts and then I feel like crap similar to erp
You basically feel guilty for not having the thoughts which makes you depressed?
>Really what I would like is to find away to remove some of the extreme inability to have confidence in anything
Does this lack of confidence come from your anxiety?
Eric
Posted by Bill82 on February 11, 2015, at 16:37:06
In reply to Re: OCD Dont know where to go » Bill82, posted by phidippus on February 11, 2015, at 15:38:11
Yea one of my obsessions is that I will become bipolar or schizophrenic so I think about it a lot...idk just want my damn life back haha
Yea I was looking at maybe a seritonin modulator instead since I get bad vocal tics on ssri.
Pretty much erp I do is I just choose not to do a compulsion and put it off until I hopefully forget about it. Problem is even if I forget about it I get triggered again.
Well might be tmi, but I have primarily sexual obbsessions, so rituals are replaying intrusive thought over and over on my mind until it feels right that I don't like it, dosnt sound too bad on paper but it has destroyed my life, unemployed havnt left my house in several months now. If I have a bad thought in shower or when I do my duty, I can get stuck doing same thing I was doing,(doing my male typical thing) which can last for at times up to 4 hours. I have scars from this sh*t it is just aweful.
Had thought of that, my doctor I see now has also written a paper about it at one time I think, I am just scared to ask because of my previous abuse of benzos and don't want to come off as a junkie and lose another doctor. Also last night I actually tried to see how caffeine would do and I had a cup of coffee which I normally don't drink. Increased focus at first but then began to give me really bad jitters and worsened ocd till I fell asleep finally at 6am haha, maybe chronic dosing would be different, coffee is also a adenosine(spelling?) antagonist I beleive so it's probably different
Feel guilty like I'm begining to accept them and will soon find it's ok and my new life will begin.
Yea I'd say so....best way I can describe it is that it's an inability to take risks for some things if that makes since. For example think of something you would literally die to protect, and then wether you would risk that in any way. It's a paradox. I also feel like I'm always lying, so for example I feel like I am making something up when I wrote this to you and am stretching the facts and that I might not have ocd etc.
My ocd was also sudden onset pretty much occurring after I caught a mycoplasma infection. Before this I had pediatric lyme and seizures that went away after antibiotic treatment for years, and I might have had obsessive tendancies, my mom remebers me reporting lo and behold intrusive sexual and violent thoughts and hypochondriac things( like worrying I has testicular cancer) at the age of 5 6 but these disappeared after age 10 when the seizures stopped. In middle and high school all I had was goal oriented obbsessions, that were ego syntonic. Ie I loved playing football so I lifted and trained for football a lot. I was always a little bit of a worrier but not at all to the extent I am now.
So part of me believes I have always had ocd other part says it may be partially be immune mediated. I try to keep them in two seperate categories, so for now I am trying ivig therapy for the immune side, and focussing most of my attention on the belief I always had ocd.
Also I was on lamictal for a long time as a child for seizures, a year or so I think, and I guess I tolerated it well then, but I was also better then, and wasn't in the state I am now. As I have sexual based ocd one of the main things I worry about is I will become impotent or have my testosterone lowered, stupid I know but then again so is my brain haha. Might be a thought for the bipolar and glutamate side of it, but worry about impotence it may cause(no effects on testosterone I exhausted the internet on that haha)
Lastly just want to thank you and everyone else for helping me it means a lot. This is one of the main things I look forward to in the day is hearing your guys thoughts.
And last thing for eric, since you seem to know a lot about ocd I had a question about yours, do you notice when you first wake up in the morning, as in the first 5 minutes it's non existent? Like if you had a bad thought before you fell asleep after waking up it dosnt seem to catch hold nearly as bad? Was wondering because I have seen others say this and I know this is true for me too. Was wondering if it's in connection to why when you have a dream, while dreaming you beleive in it, but then when you wake up you say wtf? Possibly upon arrousal certain hormones chemicals are used to create this process? Maybe this is similar to how ocd works, In that you have a bad thought and it seems like the world is ending, you successfully delay thinking about it, 20 min later you look back and say ahh that was horse... I know this to be true at least with past obbsessions of mine too, like my hands sweating or that I had als, look at those thoughts now and say lol. Anyways thanks for your thoughts means a lot, also if this dosnt make since just let me know and I'll try to explain better.
Posted by phidippus on February 11, 2015, at 17:20:41
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 11, 2015, at 16:37:06
> Yea one of my obsessions is that I will become bipolar or schizophrenic so I think about it a lot...idk just want my damn life back haha
How old are you? If you're under 30 it could happen. Now there's some ERP for ya.
> Yea I was looking at maybe a seritonin modulator instead since I get bad vocal tics on ssri.
Seritonin modulators don't work very well for OCD. Do you think these ticks might be psychosomatic?
> Pretty much erp I do is I just choose not to do a compulsion and put it off until I hopefully forget about it.
That isn't ERP. ERP deals with the obsessive thoughts you have.
> Well might be tmi, but I have primarily sexual obbsessions
I have intrusive thoughts about molesting children, mostly those children related to me.
>so rituals are replaying intrusive thought over and over on my mind until it feels right that I don't like it
This is not a ritual, but an obsession.
>dosnt sound too bad on paper but it has destroyed my life,
Writing down obsessions is usually ineffective as a therapy, however recording your thoughts on audio and playing them back to yourself is a method of ERP.
>unemployed havnt left my house in several months now.
How do you subsist?
>If I have a bad thought in shower or when I do my duty, I can get stuck doing same thing I was doing,(doing my male typical thing) which can last for at times up to 4 hours. I have scars from this sh*t it is just aweful.
Am I to understand you masturbate for hours on end? That's more like an addiction.
>Also last night I actually tried to see how caffeine would do and I had a cup of coffee which I normally don't drink.
Studies show caffeine lessens the symptoms of OCD, but you need doses as high as 200 mg.
> Feel guilty like I'm begining to accept them
This is a common sentiment among sufferers of OCD. Thing is, you're not accepting the thoughts-you're reducing their power to frighten you. You're never going to accept the thoughts, but you don't need to have so many and they don't need to rule you.
>I also feel like I'm always lying, so for example I feel like I am making something up when I wrote this to you and am stretching the facts and that I might not have ocd etc.
You tryuly are a Doubting Thomas. So what if you're lying?
> So part of me believes I have always had ocd
Some are born with OCD and others develop it, like me.
>
> As I have sexual based ocd one of the main things I worry about is I will become impotent or have my testosterone lowered, stupid I know but then again so is my brain haha.If you want to try some ERP, when you have thoughts like those, agree with them. Tell yourself you will become impotent. Do things to purposefully become impotent-like stick your crotch against the microwave.
>do you notice when you first wake up in the morning, as in the first 5 minutes it's non existent?
Yes I do.
>Possibly upon arrousal certain hormones chemicals are used to create this process?
Not hormones. OCD is a neurochemical process.
>Maybe this is similar to how ocd works, In that you have a bad thought and it seems like the world is ending, you successfully delay thinking about it, 20 min later you look back and say ahh that was horse...
Ideally, you don't want to delay thinking about it. You don't want to suppress the thought. Enjoy the thought, I dare you.
Eric
Posted by ed_uk2010 on February 11, 2015, at 17:27:12
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 11, 2015, at 16:37:06
>I also feel like I'm always lying, so for example I feel like I am making something up when I wrote this to you and am stretching the facts and that I might not have ocd etc.
That's very typical of OCD. They're often called 'obsessions of doubt', as you probably know.
>one of the main things I worry about is I will become impotent or have my testosterone lowered, stupid I know but then again so is my brain haha.
Sexual obsessions are common in OCD - and distressingly difficult to discuss.
I believe you need to practice 'acceptance'. Accept your obsession.... it's OK that you may have lowered testosterone. Although I expect your testosterone is perfectly normal, what would happen if it was low? Nothing serious really. If it was low at any point you could be prescribed testosterone replacement and you'd be fine. The consequences of having low testosterone would be far less severe than the consequences of OCD.
And the impotence. Accept it. Again, it's highly unlikely you have any medical reason for being impotent at your age. But most men would struggle to get an erection if they were in a state of psychological distress. So if you do experience distress, you may struggle too. But accept it. What are the consequences of not getting an erection? Again, they are less severe that the consequences of OCD. Having an erection isn't much benefit when you've got severe OCD. And think... millions of people live with erectile problems caused by medical disorders. Any erectile problems you have will be temporary and psychological. If you accept that you may be temporarily impotent when under stress, you would do yourself a favour. Most men would not get an erection when under immense stress. This is perfectly normal. The more you accept this is a normal feature of being a man the less anxiety you'll have.... and then you won't have a problem with erections anyway. Even if you did, it's not life-threatening, and it's treatable. So perhaps.... just think 'well, what if I was impotent?' What if you were? You'd still be here. You could be treated, you could live a happy life. Much happier than you are right now. Impotence is generally a lot easier to treat than OCD!
If I don't get an erection it normally means I'm not in the mood. I'm not always in the mood. A lot of people aren't. It doesn't imply a major problem, I'll be in the mood another time.
Sometimes, it's not possible to force the thoughts out of your head until you've considered..... are the consequences of the obsessions really as bad as the obsessions themselves? They almost never are. It would be easier to be impotent and not have OCD. It could be treated more easily. Hopefully, if you think this to yourself, the obsessions will reduce and you'll realise you don't actually have an erectile problem either.
Posted by Bill82 on February 11, 2015, at 17:54:32
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 11, 2015, at 17:27:12
Yea I have thought about that, haha, one of the main things that spikes me. Guess it gets back to the thing I said about not being able to accept or enjoy because it's a deal breaker to in that I just can't do it I guess, rather would just not exist or even exist with ocd than agree with it. As for the testosterone impotence thing it just prevents me from having motivation to try new meds I guess cause my mind can't see them as long term solutions? And as for the addiction aspect of it I have thought that, but then again I'm in serious pain and want to stop but just want to check To make it feel right. If it was addiction wouldn't it be ego syntonic? Do any medicines help to allow the person to get rid of the doubting or are they just for allowing for the person to disengage compulsions?
Posted by Bill82 on February 11, 2015, at 18:00:19
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 11, 2015, at 17:54:32
Also I do know about that I could go schizo or bipolar, but usually my sexual obbsessions are more pressing to me so I don't worry about it. I am fortunate enough to still have a place to live with my parents, and they have seen me go from normal to nut case, but only time will tell how long I'm allowed to stay.
And back to the morning thing I thought neurotransmitters or at least seritonin were a form of hormone?
Posted by ed_uk2010 on February 11, 2015, at 19:29:18
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 11, 2015, at 17:54:32
I think it's useful that OCD is being discussed on this board because it rarely is. It's often mentioned in passing... but the term 'OCD' is widely misused. I think there's a lot of misunderstanding about what OCD involves. OCD is not the same as extreme perfectionism, although some people have both; OCD is not the same as obsessional personality traits either.
OCD normally revolves around thoughts (the obsession) which are unwanted, intensely repetitive, intrusive and either shocking (sexual, religious), anxiety-provoking (disease, contamination) or difficult to explain (symmetry and similar preoccupations). In general, the thoughts revolve around the idea that something awful or appalling could happen (such as infection from contamination) or sometimes that the sufferer themselves will be condemned as a result (sexual, religious etc). Compulsive behaviors often occur in an attempt to either suppress or 'disprove' the obsession, but the constant doubting makes it necessary to repeat the compulsions over and over and over again. Repetitive thought processes 'mental rituals' may occur in isolation (pure-O), or physical rituals and compulsions may be present(classic OCD). Either way, the obsessions and compulsions take up a huge amount of time.
Common types of OCD include:
Obsession: Fear of disease, bacteria or contamination.
Compulsion: cleaning, washing - the most well known type of OCD among the general public. The many other types are much less known.Obsession: Out of character, unpleasant sexual thoughts (abuse, incest, rape) or intrusive violent thoughts (injury, death).
Compulsions: washing, touching, praying, counting etc.Obsession: religious profanity.
Compulsions: praying, repeating religious passages, counting etc.Obsession: bodily dysfunction, perceived deformity.
Compulsions: touching, checking (eg. in the mirror), comparing, measuring.Obsession: doubting (car not locked, house not locked, window left open?).
Compulsions: checking, opening/closing doors, switching lights on and off. Rituals to be performed on leaving rooms/house/car.Obsession: symmetry, possibly a special type of OCD.
Compulsion: reordering, rearranging etc.>Yea I have thought about that, haha, one of the main things that spikes me.
In general, a major characteristic of an obsession in OCD is that it will be based on the worst or more unpleasant thoughts possible. Especially in sexual/violent OCD. The thoughts are ego-dystonic.
>Guess it gets back to the thing I said about not being able to accept
Accept what? That you might be impotent?
Accepting the fact that you *will* struggle to get an erection some of the time (which is normal) is a major way in which you can reduce the power of the obsession. Reducing the power of the obsession will eventually allow you to realise that you're not impotent at all.
>would rather just not exist or even exist with ocd than agree with it.....
What could you never accept or agree with?
Here is an example:
Obsessions in sexual OCD may be related to abuse, incest, homosexuality, pedophilia or rape, amongst other things.... unpleasant, unwanted, intrusive thoughts, ideas or images. This does not mean the sufferer actually wants to abuse someone; as you know, it means that the thoughts of abuse keep coming into their mind, against their will (ego-dystonic). The thoughts will feel appalling, frightening and abhorrent, this is the very nature of OCD, that the thoughts are not based on reality, the mind is creating the most unpleasant scenarios possible, torturing itself, causing doubt - is it OCD or is it real? The obsessions cause a huge amount of distress precisely because they are totally unwanted and out of character.
In this situation, 'acceptance' would refer to the acceptance that these thoughts are occurring as part of the OCD, and that it *is* OK because no one is actually going to be hurt in any way. The thoughts are part of the illness. The sufferer is not a bad person. If they were, they wouldn't be distressed by the thoughts! The very fact that the thoughts cause so much distress proves that they are OCD. The understanding and acceptance that no one is going to be hurt means that the thoughts lose their power. Once an obsession loses its power over the sufferer, the obsession will eventually go away.
>And as for the addiction aspect of it I have thought that, but then again I'm in serious pain and want to stop but just want to check To make it feel right. If it was addiction wouldn't it be ego syntonic?
Yeah, if you're masturbating to try to prove to yourself that you're not impotent, it's not an addiction, it's a compulsion. In OCD, the compulsion is occurring to try and suppress the obsession that you might be impotent.
So... you might be impotent sometimes. So what? You may indeed. Lots of people are. Until you accept that this is a possibility, you'll continue to try and disprove it by your compulsive behavior. Acceptance may be the route to health. And in health, you won't be impotent.
>Do any medicines help to allow the person to get rid of the doubting or are they just for allowing for the person to disengage compulsions?
SSRIs help some people reduce the doubting. But sometimes, like Phiddipus says, it is necessary to accept certain aspects of the obsessions in order for them to lose their power. Once they've lost their power, they will eventually go away.
>bipolar, schizophrenia
Nothing you've said so far is suggestive of either condition. Your symptoms sound highly typical of severe OCD only.
Take care. And be kind to yourself.
Posted by Bill82 on February 11, 2015, at 21:21:36
In reply to What is OCD? For those that don't know...., posted by ed_uk2010 on February 11, 2015, at 19:29:18
Yea I havnt mentioned my main obsession resolving sex but it is one of the classic ones and you mentioned it on the page. I masturbate to check that I am not arroused to the thoughts, which can last for hours. As for impotence, that was one of my previous obsessions and actually partly how this all started emotionally for me. I was in college and was really drunk and couldn't get it up. Was worried what this meant. At the time I really like a girl and started to worry that this may affect my relationship with her. So I would spend hours worrying that I would be impotent low t had a varicocele, my varococile would lower my t levels eventually, ssri would only worsen the problem....etc. then at this point through reasearch I knew I most likely had an anxiety disorder and ocd for a lot of the pictures. Ironically, at first I saw the obbsession I had now and laughed saying wow that is weird how could you doubt that. Then the thought got stuck in my head that since I had ocd I too could develop that type, and after a day or so of worrying my topic changed and ocd exploded. Since then I have left school, then work, and now struggle to exist at times haha. The girl is long gone and at times I ponder if I want to be celibate after all this sh*t, but I am still almost instinctually aversive to anything that could impact my libido. This is disregarding the main obbsession I have now which is what truly is unbearable, and only reason I havnt named it exactly is I am scared if I write it someone may see it or it may come true ect. Pretty dumb but idk maybe that's why they say so many people go without treatment. In accepting my obbsession I feel it would ruin the ability for me to ever love again, and it greatly depresses me, and takes the life out of everything else I enjoy. However if I combat the compulsions, my desire and drive for my past life still lives, so that is why I say I balance between the two. As for what you say acceptance truly is at the end, I do tell myself that all the time, but I continually doubt it and still wonder what if ect. On top of all this I am also unfortunate to be particularly med sensitive. Although part of me thinks I am making it up and lying or imagining the symptoms they still exist physically. So I have been having trouble finding something that is tolerable atm. I have been able to push through the thing with the ocd and impotence side effects of meds, but I get other things like vocal tics and shouting for no reason and dripping that just becomes unmanigible. I hope that clears some of the stuff up, sorry I was not more clear I just can't seem to be clearer even though I know I'm being stupid haha. Also I agree with you that more people should know about this, as a lot if people who don't tank as bad as I did( of me if I was still ocd about being impotent or having aids) would or will most likely just keep it that way and not seek help for the same reason I am not specific here. They do t want to take the risk as it could potentially destroy the life they love. This can lead to even worse ocd and even substance abuse which can be end all. But thanks for the time to put forth that description it will help a lot in other people understanding what exactly is ocd.
Posted by ed_uk2010 on February 12, 2015, at 12:36:52
In reply to Re: What is OCD? For those that don't know...., posted by Bill82 on February 11, 2015, at 21:21:36
Hi there,
We are often guilty on this board of using a lot of medical/psych terminology such as OCD, dysphoria, bipolar, anxiety disorder etc without qualifying what it really means to us or how horrible it feels. I think you've done really well to describe the distress you're in. It's a lot easier to just say OCD without explaining anything, but if no one knows what you mean, it's difficult to advise or help. Through an improved understanding of your illness, you can gain insight into the workings of your own mind, and begin the journey toward health.
>Yea I havn't mentioned my main obsession resolving sex but it is one of the classic ones and you mentioned it on the page. I masturbate to check that I am not aroused to the thoughts, which can last for hours.
I understand. Classic sexual/violent OCD is always based on the worst thoughts the sufferer can think of. That is the very nature of OCD. The obsession either terrifies or appalls the sufferer (ego-dystonic). You don't need to name your specific symptoms on here. That could cause you more anxiety and isn't necessary. The diagnosis is not in doubt.
>I was in college and was really drunk and couldn't get it up. Was worried what this meant.
People with OCD can often trace back the origin of a particular obsession. The symptoms can begin with a sort of 'horrible realisation' that a certain scenario is possible. The feature of OCD is the person can't brush the unwanted, and often frankly ridiculous thoughts away. It's almost like a form of self-punishment. There is a constant doubt.... what if, what if, what if it's real? What if this happens, that happens etc
>SSRIs would only worsen the problem....
SSRIs rarely affect testosterone levels, but they do produce sexual side effects quite often because serotonin is involved in controlling orgasm/ejaculation and (to some extent) libido.
Am I right in assuming that you fear SSRIs may invalidate the 'usefulness' of your compulsion because they may interfere with your ability to use it to 'disprove' your obsession? (Does that even make sense!?)
>I ponder if I want to be celibate after all this sh*t,
>In accepting my obsession I feel it would ruin the ability for me to ever love againThere's different forms of 'acceptance'.
Here is a invented scenario with typical symptoms...
A young woman has sexual-theme OCD involving recurrent intrusive images and thoughts about having sex with her family members. Her compulsion involves constantly going to the bathroom to check her pulse rate. She believes that if it's fast she must be 'aroused' and that thought is terrible for her. She will then need to measure it again. If it's normal, she has to check it again, 10 times, to 'prove' to herself than the thoughts are 'false'. Sometimes, she checks it 100 times to be sure. She does this for about 4-5 hours a day. She feels she can never do anything which raises her pulse rate, so she rarely leaves her home. She wants a boyfriend but the horrible unwanted thoughts make this seem impossible. She starts to hate her life.
How can she help herself to get well again? On SSRIs, she notices that her pulse doesn't rise as much. She fears that she can't use her pulse rate as a 'measure' anymore, and stops the meds.
Her doctor advises her to try to resist the compulsive checking because it doesn't actually make her feel better for more than a second, she simply has to do it again to be sure. She understand his advice and tries to follow it but can't. She is compelled to check. She feels that if she is a 'bad' person, her life is not worth living, so she has to check and check and check.
So, she tries to change her thoughts. What can she possibly accept or change?
Are the thoughts bad? No. And she is not bad either! The thoughts are unwanted and horrify her. She needs to accept that she is not a 'bad' person. If she was, she wouldn't have spent years hating the thoughts.
How can she come to terms with the thoughts? She needs to accept that the thoughts are OCD. Other people with OCD have bizarre unwanted thoughts too, she is not alone. She needs to accept that since none of her thoughts will ever 'come true', the content of her obsessions don't really matter. NO ONE is being harmed by the OCD except herself. Her family certainly aren't being harmed. They just want to see her well again.
How can she stop the compulsive behavior? Like the masturbation, it isn't helping her. She will not be able to resist the compulsions until she accepts that they are futile. This will be hard to accept because she currently uses them to suppress her anxiety briefly. She needs to let her pulse rate rise in many different circumstances and see that it's not really anything to do with arousal in most circumstances, and even when it is - nothing happens and no one is hurt.... certainly not her family. The thoughts are hurting no one except herself. If the thoughts are not hurting her family, do they really matter? No. They are horrible but they are just thoughts created by the illness. And they won't go away until she lets them lose their power over her.
>Celibacy
Depending on your type of OCD, what would happen if you think.... well, what if I did become celibate? Maybe think to yourself 'I will become celibate until I'm well', and that will be OK. Would that reduce your anxiety?
>doubt it and still wonder what if ect. On top of all this I am also unfortunate to be particularly med sensitive.
True, and you've not had much luck with psychological therapies so far either. The success (or otherwise) of psychological treatment depends a great deal on the type of therapy and the therapist themselves. Is there a different psychologist you can see?
>Although part of me thinks I am making it up and lying.....
Obsessions of doubt?
>So I have been having trouble finding something that is tolerable atm.
Does your doctor have any suggestions? I wondered whether you discussed the possibility of trying an SSRI such as sertraline (Zoloft) at below the normal dose range, since you seem hypersensitive for whatever reason....
Psychological treatments can be of great benefit if you have the right therapist. A bad experience with one tells you little or nothing about how you'll do with another. You can also do self-help psych therapies using information in books or online. There is an increasing amount available.
Take care and write back.
Posted by phidippus on February 12, 2015, at 13:51:24
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 11, 2015, at 17:54:32
>it's a deal breaker to in that I just can't do it I guess
I'm sure you can do it. It probably just causes you a lot of anxiety.
It IS the most effective way of treating OCD.
>As for the testosterone impotence thing it just prevents me from having motivation to try new meds I guess cause my mind can't see them as long term solutions?
I've been on ADs for OCD for many years. There is no doubt they can be a long term solution.
>just want to check To make it feel right.
What exactly does that mean?
>If it was addiction wouldn't it be ego syntonic?
Not necessarily.
>Do any medicines help to allow the person to get rid of the doubting or are they just for allowing for the person to disengage compulsions?
Serotogenic antidepressants help with both.
Eric
Posted by phidippus on February 12, 2015, at 13:54:16
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 11, 2015, at 18:00:19
>I thought neurotransmitters or at least seritonin were a form of hormone?
Serotonin is a neurotransmitter.
Testosterone is a hormone.
http://www.differencebetween.com/difference-between-neurotransmitters-and-vs-hormones/
Eric
Posted by phidippus on February 12, 2015, at 14:17:43
In reply to Re: What is OCD? For those that don't know...., posted by Bill82 on February 11, 2015, at 21:21:36
>I masturbate to check that I am not aroused to the thoughts, which can last for hours.
Am I to understand you flagellate your flaccid penis for a long time in hopes of not gaining an erection?
What kind of sexual thoughts do you have? Tell me how much anxiety it causes to describe your thoughts.
There are ADs that don't cause sexual disfunction: Viibryd and Mirtazapine.
Eric
Posted by Bill82 on February 12, 2015, at 14:53:52
In reply to Re: OCD Dont know where to go » Bill82, posted by phidippus on February 12, 2015, at 13:54:16
Well I know it's a neurotransmitter, but I thought all neurotransmitters were offshoots from hormones originally in terms of evolution. Cause seritonin a greatest concentration is in the gut, and there I beleive it has a lot of hormonal seeming activity along with it's neuro transmission aspect
Posted by Bill82 on February 12, 2015, at 15:08:22
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 12, 2015, at 14:53:52
For me to describe them it causes a lot of anxiety, enough to make my once successful life into the state I am now where I don't do much at all most days except sit around and research ocd/neuro chemistry to instill hope.
And that's a very good parallel edu, thanks for that. Problem I guess with mine at least it seems so to me is that I just can't seem to let go of the doubt, possibly because I have been so tormented and had so much trauma all I do is stay in a stasis like mode of doing the same thing over again because my mind views it this way as at least not changing anymore. In other words dealing with it in order to acheive some resemblance of stability. And as for the doc I will see him again in about two weeks. I will get the DNA tests then(was wrong they won't be being mailed to me) and will also possibly hear of what he wants to try next. So far he has tried deplin and memantine. He is an expert in the field of ocd(a lot of the ocd papers you read he most likely contributed) so hopefully he's got something up his sleeve. We shall see I guess. He mentioned something about lamictal, and seeing my side effects from ssri I think he is venturing away from that class. For now I am not on anything except for minocycline and nac. Minocycline seems to help somewhat but I'm betting it may be more placebo. Could also be the ivig therapy I am receiving, at the dose of 2g/kg once a month.
Posted by ed_uk2010 on February 12, 2015, at 15:25:18
In reply to Re: OCD Dont know where to go, posted by Bill82 on February 12, 2015, at 15:08:22
I thought you'd tried Lamictal? Was it a long time ago and would you re-try it? Perhaps you've not taken it since childhood.
Posted by Bill82 on February 12, 2015, at 15:33:16
In reply to Re: OCD Dont know where to go, posted by ed_uk2010 on February 12, 2015, at 15:25:18
I had tried it a few months back, but had also been on it a while when I was ypunger. A few months back it made my ocd seemingly worse because I had no emotions(that's what it felt like). You could have told me my house burned down and I would have said ok, or that I had won the powerball and I wouldn't have really cared. This back door spikes my ocd because i was worried I was begining to accept the thoughts and I didn't like that I guess. Does lamictal help ocd at all? I think might have gotten somewhat agitated when going on twoards 50 75mg after titrating. I remeber getting really ticked off easily, especially at my drs. It would certainly help bipolar if I have minor bp2, but not sure about ocd. What are your thoughts on it and it's side effect to benifit ratio?
Posted by phidippus on February 12, 2015, at 15:40:37
In reply to Re: What is OCD? For those that don't know.... » Bill82, posted by ed_uk2010 on February 12, 2015, at 12:36:52
> >In accepting my obsession I feel it would ruin the ability for me to ever love again
I had an obsession with suicide for a long time. As exposure therapy, I would pretend to kill my self with a knife. To add humor to the proceedings, I would go all out, don a bandana and pretend to commit hari kari.
With proper exposure therapy you are not accepting your obsession, but rather reducing its power to cause you anxiety. As you reduce the anxiety of your obsession, your compulsions will wane.
> Her doctor advises her to try to resist the compulsive checking because it doesn't actually make her feel better
This is erroneous advise. The compulsive checking is born of the fearful thoughts she is having, therefore the focus of therapy should be on lessening the anxiety she has about the thoughts she is having. Once the fear of the thoughts is lessened, checking rituals will seem unimportant.
> So, she tries to change her thoughts. What can she possibly accept or change?
Bad move. Trying to change her thoughts is only going to cause more anxiety and increase the frequency of her thoughts. Her brain needs to be trained to have the thoughts and regard them as inconsequential. Acceptance comes when she can have the thoughts without consequence.
> How can she come to terms with the thoughts? She needs to accept that the thoughts are OCD.
This is often not enough for OCD sufferers. Many people with OCD can identify their thoughts as OCD but still experience a great deal of anxiety. The key to accepting OCD thoughts is to embrace them as a good idea.
> How can she stop the compulsive behavior?By reducing the anxiety she has about her OCD thoughts. Medication can also help.
>If the thoughts are not hurting her family, do they really matter? No. They are horrible.
What are you talking about? These are wonderful thoughts. ;)
> True, and you've not had much luck with psychological therapies so far either.To be honest, I don't think he's had proper ERP nor do I think has he committed to proper therapy
> >Although part of me thinks I am making it up and lying.....
>
> Obsessions of doubt?OCD is called the doubting disease.
One thing I wanted to mention about medication and OCD. I find that OCD sufferers have a difficult time taking medication because of side effects. It happens a lot they get strange side effects and a lot of them, which makes me wonder just how much their anxiety is playing in the genesis of these side effects.
I would like to see someone with OCD take an SSRI for 6 weeks then tell me how they feel.
Eric
Posted by Bill82 on February 12, 2015, at 16:29:24
In reply to Re: What is OCD? For those that don't know.... » ed_uk2010, posted by phidippus on February 12, 2015, at 15:40:37
I just got off vortioxetine for 4 months, I had constant drips of urine from my penis along with vocal and motst tics. My ocd was also greatly unchanged except for the ability to disengage from compulsions and space out. After stopping the medicine y tics stopped along with my dripping(mostly) and my ocd has remained mostly unchanged once again for over a month. Only thing that has changed in this time is my activity level, while starting the sSri I was still going in public, on the last month of the ssri(or seritonin modulator and reuptake inhibitor to be precise) I was where I am now where I am not leaving my house at all and pretty much sit and think all day. Similar thing happened with luvox except I experienced priapism for the first few days but decided to just push through it, as it was only partially inflated at all times) and I also had no drips then. On prozac I experienced a rash within 2 weeks covering the areas around my mouth, all over my genitals, my armpits and backs of my knees and joint of my arms along with the inability to urinate except unless I applied direct pressure to my bladder and squeezed the urine out. I also had other side effects but I ruled those out as I feel as if they have a high rate of placebo effect(ie the sexual side effects they caused along with cognitive deficits and anxiety increase) and as I said earlier I feel like I am lying a lot so I try to only complain perse of the physical ones when I see the doc(or at least the ones that I literally cannot tolerate). I also had tics on prozac and luvox and lexapro. Tics were primarily shouting mid sentance or jerking my head to the right in a certain way as if I was sneezing. I suppose I could re trial paxil but I was told by my parents I was prescribed that when young(as a dr said I had add and minor anxiety) and within days started to wash my hands for no reason compulsively. When paxil was withdrawn I stopped washing. I do agree though that in the over attentive ocd mind it is easier to imagine side effects that are not real, and for that reason I do potentially think some of mine could be that, but I don't think the tics, urination problems, priapism or decreased and flat mood I got could be attributed to them as these were all sustained for the entire duration of treatment. There is the possibility of nefazadone I guess but not sure if it's marketed anymor
Posted by Bill82 on February 12, 2015, at 16:34:43
In reply to Re: What is OCD? For those that don't know...., posted by Bill82 on February 12, 2015, at 16:29:24
Also of note, alchohal dose dependently abolishes both my compulsions and obbsessions. But as my dad was an alchoholic and I often drink way too much I refrain from drinking at all times unless I am literally going nuts(last drink was over a month ago). Alchohal also has a rebound effect in worsening my ocd gravely the next day. Alchohal to my understanding inhibits glutamate and encourages GABA in some way giving it's depressive effects. It also effects dopamine and other receptors, but it's depressive effects are primarily due to Glutamte and GABA. When on benzos I experience the same uncanny urge to take "just one more" until the bottle is gone and I wake up the next day with extreme ocd and withdrawls. However unlike alchohal when in benzos my ocd is unchanged. This has lead me to wonder about glutamate involvement, and is why I have proposed trailing some glutamatergic agents. I could be wrong but I don't see the disadvantage to this. I also beleive minocycline may have slightly helped calm some ocd, but this is most likely placebo.
Posted by ed_uk2010 on February 12, 2015, at 16:36:47
In reply to Re: What is OCD? For those that don't know.... » ed_uk2010, posted by phidippus on February 12, 2015, at 15:40:37
>To add humor to the proceedings, I would go all out, don a bandana and pretend to commit hari kari.
You certainly did go to some effort there!
>With proper exposure therapy you are not accepting your obsession, but rather reducing its power to cause you anxiety.
Yes, exactly. Accepting it isn't necessarily the right word. But you are allowing the obsession to occur, while not performing the compulsion.
>As you reduce the anxiety of your obsession, your compulsions will wane.
Indeed, once an obsession loses its power, it's no longer an obsession.
>Her brain needs to be trained to have the thoughts and regard them as inconsequential. Acceptance comes when she can have the thoughts without consequence.
Yes, that's what I mean by acceptance.
>This is often not enough for OCD sufferers. Many people with OCD can identify their thoughts as OCD but still experience a great deal of anxiety.
True. The boundaries are often blurred by doubt, however.
>The key to accepting OCD thoughts is to embrace them as a good idea.
But, is it possible to think they're a good idea? For example, the woman in my example could allow herself to think the disturbing thoughts and realise that nothing bad actually happens as a result, the thoughts are being allowed to occur as 'exposure'. She's not accepting them as 'good', she's accepting them as harmless.
>How can she stop the compulsive behavior?
>By reducing the anxiety she has about her OCD thoughts. Medication can also help.True.
>If the thoughts are not hurting her family, do they really matter? No. They are horrible.
>
> What are you talking about? These are wonderful thoughts. ;)This is the question. Does she need to think they are wonderful as part of the exposure therapy? Can't she simply accept their occurrence as being harmless? Wonderful might be pushing it because she will never believe it.
Accepting them as harmless creations of her OCD, on the other hand, seems more achievable. If exposure to the thoughts allows her to view them as harmless, the compulsion will be easier to extinguish.
>I find that OCD sufferers have a difficult time taking medication because of side effects. It happens a lot they get strange side effects and a lot of them, which makes me wonder just how much their anxiety is playing in the genesis of these side effects.
Yes, I agree and this is an issue in other types of anxiety too. Panic disorder pts tend to be most sensitive to ADs because any different/unusual bodily sensations are interpreted as being the start of a panic attack.
Thanks for your post.
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