Jump to content
CrazyBoards.org
dancesintherain

OCD treatment basics - or just basics overall

Recommended Posts

Right at the end of my session--of course--I mentioned to my therapist that my psychiatrist was pretty sure that I had OCD (to add to the diagnoses). His response - "Oh, I can see that."

Unfortunately it ended and I didn't get a chance to ask for more detail.  But he's been really flexible around diagnoses before in terms of not wanting to do something too quickly and such things.  The majority of our time was spent on eating/weight/emotional eating related issues and despite the conversation, when I asked whether it amounted to an eating disorder, I got the classic "tell me why it matters."  So--it's a pretty big contrast to have such quick agreement on one that I wasn't really expecting. 

I'll ask him for more information.  But, ironically, I find myself asking me his question--why does it matter?  And I think the answer's the same that I gave him - whether it impacts treatment.  So I think that's at a minimum what I need to know.  How's OCD typically treated?  Is there something that would stop the obsessive thought spirals?  (medication or therapy)

Also, any good resources for just learning the basics?

Share this post


Link to post
Share on other sites

He may be wanting you to focus on treatment and not get too attached to a diagnosis. However, if you do have ocd then you need a specific treatment plan. Therapy is usually the first place to start. It depends on what kind of ocd you have. If you just have obsessive thoughts then the therapist will basically use CBT skills to talk back to the thoughts and label them and try and stop the cycle. If you have a specific compulsion then you will work on how to not give into the compulsion and once again use CBT skills. Also exposing yourself to an environment that brings out your ocd (a dirty bathroom for example). I took a two month group ocd course and this is what we did. In terms of medication, the first route are the SSRIs. If those don't work, you can try an older medication used for ocd called clomipramine and also augmentation with an antipsychotic can help. Good luck.

Share this post


Link to post
Share on other sites
41 minutes ago, dancesintherain said:

Right at the end of my session--of course--I mentioned to my therapist that my psychiatrist was pretty sure that I had OCD (to add to the diagnoses). His response - "Oh, I can see that."

Unfortunately it ended and I didn't get a chance to ask for more detail.  But he's been really flexible around diagnoses before in terms of not wanting to do something too quickly and such things.  The majority of our time was spent on eating/weight/emotional eating related issues and despite the conversation, when I asked whether it amounted to an eating disorder, I got the classic "tell me why it matters."  So--it's a pretty big contrast to have such quick agreement on one that I wasn't really expecting. 

I'll ask him for more information.  But, ironically, I find myself asking me his question--why does it matter?  And I think the answer's the same that I gave him - whether it impacts treatment.  So I think that's at a minimum what I need to know.  How's OCD typically treated?  Is there something that would stop the obsessive thought spirals?  (medication or therapy)

Also, any good resources for just learning the basics?

Do u have a med history with regards to SSRIs or similar? 

Share this post


Link to post
Share on other sites

Not much.  Zoloft was a sugar pill, Lexapro gave me akathisia, effexor (SNRI?) worked but I was taken off of when I landed in the hospital because I was manic.  Don't know that it sent me manic, but better to be safe than sorry.  I think that's actually it.  I've bounced through AAPs like they're candy, but basically kept away from ADs.

(CNO I'll reply to you in a bit--thank you!)

Share this post


Link to post
Share on other sites

Luvox is an SSRI targeted towards OCD specifically, I've heard mixed reviews on this site...but if you've had manic reactions before it *might (ymmv)* be less likely to cause a manic swing than a TCA 

Share this post


Link to post
Share on other sites

It’s hard. I’ve suspected OCD for years but just got the diagnosis formally confirmed this year. I struggle mostly with obsessions and the only things that really work for me are obsessional flooding (purposely thinking about it really really hard until my brain gets bored) or conversely radical acceptance and allowing the obsession to pass while continuing to go about my normal business. 

My compulsions are mainly checking related and mental compulsions. If I really wanted to work on them it would have to be from an ERP lens but I’m not really interested right now.  And some of them, like repeating words over and over again, aren’t really that amenable to ERP anyway. 

Share this post


Link to post
Share on other sites

like everyone else has said, the route is usually high dose SSRIs/SNRIs and low AAP adjuncts. having bipolar and taking ADs is tricky. as far as that goes, i wonder if @aura would want to contribute? i think she's written about treating ocd when you can't use ADs.

my pdoc has called me "obsessive spectrum". he said it's not really ocd, but not all of my symptoms are covered by ocpd, my primary diagnosis. i relate a lot to pure-o. either way, my cocktail is pretty typical of that of someone with ocd, and the treatment we've done is about reducing obsessiveness, so i do use the label.

my ocd is more obsessive than compulsive, but i do have some compulsions. in my experience, medication did most of the heavy lifting with my ocd stuff. a more sedating AD shut down a lot of my anxiety, which always triggered obsessing and ruminating. once we found the right dose, the risperidone adjunct vanquished most of my intrusive thoughts and some of the more bizarre ocd-related behaviours (needing to walk a certain way, fixations on numbers and time, inability to tolerate an environment that wasn't "right"). what i was mostly left with after medication was the roots of my anxieties -- fear of being imperfect, fear of risk, catastrophizing, fear of failure, all that fun stuff. therapy has been immensely helpful with lessening those fears, mostly by exposure and gathering experiences of things turning out okay when i've been afraid something would happen.

for me at least, the therapy happened after the symptoms were more under control, but you can go the other way too. therapy can be a lifesaver when ocd isn't responding to meds, or when medication options are limited.

i did a lot of reading back through old CB threads when i got my diagnosis (still do, heh). basic google searches were handy, too. ocd canada has a good page on ways ocd can manifest.

that's enough writing!! i definitely recommend poking around old threads and seeing what resonates. new diagnoses are good -- it means your team has more tools to understand what's going on. hope you're well. :-)

Share this post


Link to post
Share on other sites

thank you all!  Sorry for the lack of personal replies--good info to digest.  I was skeptical, but I did some basic reading and was like "oh."  And then it made sense.  I just was resistant because my last therapist (who was amazing) disagreed with my psychiatrist.

Share this post


Link to post
Share on other sites

I have found a combination of exposure therapy, CBT, and medication (Paxil 60mg for me) has helped immensely. There are also workbooks that are helpful.

Share this post


Link to post
Share on other sites

@echolocation I'm actually taking an SSRI right now - Luvox - and it has been really helpful. Exposure therapy also helps, but I'm having trouble seeing long term progress.

Share this post


Link to post
Share on other sites

thank  you both :-)

I'm not sure how much I'll need as far as exposures are concerned.  I understand that it's really good for it.  But I don't have many compulsions...it's nearly all obsessive thinking.  I wasn't familiar with the flooding and hadn't really thought about RA. 

0Unless this whole eating mess is a compulsion in response to the obsessive thinking.  That's something to discuss with pdoc and tdoc..

Edited by dancesintherain

Share this post


Link to post
Share on other sites

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now

×