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1 hour ago, dancesintherain said:

Anyone experience harm OCD?  I hadn’t heard of it before but am wondering if it applies.  It’s on the list of things to discuss with my tdoc, but curious about firsthand experiences.

Can you expand a little? Harming self or someone else? Or both? 

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image.thumb.png.0234662fb963231cf656df6b5b2b398d.png

 

https://www.google.com/url?sa=t&source=web&rct=j&url=https://healthcenter1.com/wp-content/uploads/2020/10/HCA_YBOCS_Editable.pdf&ved=2ahUKEwilytqM27r4AhWbUGwGHZcKCDQQFnoECEIQAQ&usg=AOvVaw1lPeTu5ubDH_3khAw5S3td

 

"Harm OCD" isn't official to my knowledge. It is officially OCD and harm is just a recurring theme 

 

ybocs above has section on themes. It is mostly to get you to identify thoughts relevant to section 2

 

section 2 is graded as in pic and is questions like how much time per day on any of section 1?

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28 minutes ago, dancesintherain said:

For me at least, fear of harming children.

though I am torn between whether what I recently experienced was command hallucinations to kill myself versus intrusive thoughts.

Your team sound good and should know what questions to ask 

 

Most don't and average OCD dx takes 19 years of either misdiagnosed or not identifying 

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BTW it shouldn't matter too much between hallucinations or intrusive thoughts 

 

Intrusive thoughts will be helped by APs. But have the advantage of responding to SSRI and SNRI

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sorry to keep posting

 

i realised it matters with chris

 

cbt for psychosis will make ocd thoughts worse

 

erp therapy for ocd is gold standard. Confront and deliberately trigger thoghts, but don't react and thereby give them power

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2 hours ago, dancesintherain said:

For me at least, fear of harming children.

though I am torn between whether what I recently experienced was command hallucinations to kill myself versus intrusive thoughts.

Have a very close family member who was hospitalized for incessant fear of harming others.. led to ocd Dx 

Edited by Iceberg
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4 hours ago, DogMan said:

Most don't and average OCD dx takes 19 years of either misdiagnosed or not identifying 

would this hinder treatment to a great degree if the person was misdiagnosed with having gad instead of ocd in any significant way  given that many of the drugs used to to treat gad are also used to treat ocd, e.g., the ssri/snri families? at least from a pharmacological standpoint, i wouldn't think so, but perhaps on the therapy side, certainly?

 

i have obsessive ruminations that some psychiatrists have bordered on classifying as part of an ocd diagnosis, but have always opted to go with gad instead and i'm assuming only because i present with no compulsions. @CrazyRedhead, does your gad overlap with your ocd in any way that would make it difficult for a clinician to distinguish between the two?

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44 minutes ago, basuraeuropea said:

would this hinder treatment to a great degree if the person was misdiagnosed with having gad instead of ocd in any significant way  given that many of the drugs used to to treat gad are also used to treat ocd, e.g., the ssri/snri families? at least from a pharmacological standpoint, i wouldn't think so, but perhaps on the therapy side, certainly?

 

i have obsessive ruminations that some psychiatrists have bordered on classifying as part of an ocd diagnosis, but have always opted to go with gad instead and i'm assuming only because i present with no compulsions. @CrazyRedhead, does your gad overlap with your ocd in any way that would make it difficult for a clinician to distinguish between the two?

even mental compulsions?

 

reviewing thoughts is a mental compulsion. Holding onto one thought, questioning the thought and trying to tease as much out of the thought as possible for answers that never come

 

hence psychosis focused cbt being potentially bad, it holds the thought and rationalises with it (eg giving counter arguments to delusional intrusive thoughts). Which is bad for ocd

 

GAD would depend on the approach, at a guess. I'd think most anxiety related stuff would have relevance

 

 

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9 hours ago, basuraeuropea said:

 @CrazyRedhead, does your gad overlap with your ocd in any way that would make it difficult for a clinician to distinguish between the two?

No, I don't really think they overlap, for me personally, at least....I was first diagnosed with GAD/panic disorder, way before the OCD diagnosis......

My OCD definitely presents with distinct compulsive behaviors, mainly checking things over and over to make sure appliances are off, doors and windows locked, and compulsive hand-washing, when i think i have touched something that's contaminated.

So, technically I guess my compulsions of repeated checking, and excessive  hand-washing, led to my OCD diagnosis.

@dancesintherain, there are actually 2 types of "Harm OCD"....One subtype of harm OCD is the fear of causing harm to others, ....The other subtype of harm OCD,  is the fear that some type of harm will come to a loved one.

There are many types and subtypes of OCD, but IMO, they all cause great distress to the sufferer....I would not wish OCD on anyone.

Edited by CrazyRedhead
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8 hours ago, DogMan said:

reviewing thoughts is a mental compulsion. Holding onto one thought, questioning the thought and trying to tease as much out of the thought as possible for answers that never come

this is where it gets confusing for me because yes, i do review thoughts a whole ton, but i'm not sure what the difference is between that and ruminations, which are also the reviewing of thoughts to the point of distress. the obsessive rumination does tend to focus on anything that may be a source of anxiety and can create a vicious feedback loop, worsening anxiety/panic if not stopped. because i don't respond to antipsychotics well at all and i do respond to antidepressants okay enough, i don't know if the diagnosis makes much of a difference though in terms of pharmacological treatment. i'm contemplating switching from escitalopram to fluvoxamine for this very reason, however.

1 hour ago, CrazyRedhead said:

No, I don't really think they overlap, for me personally, at least....I was first diagnosed with GAD/panic disorder, way before the OCD diagnosis......

gotcha, so you have clear compulsions and so the delineation is clear for you.

and yes, mental illness is such a terror that i wouldn't either wish it upon anyone.

Edited by basuraeuropea
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20 minutes ago, DogMan said:

@basuraeuropea my understanding of when mental rituals became compulsive 

More than 1 hour a day 

Prevention of thought reviewing etc causes distress 

Sufferer is aware that this preoccupation is excessive

i would have to think about this. currently, 'obsessive rumination' is controlled well enough, but panic disorder is not. i know that if i touch lexapro this would not be the case, however. i'm thinking of proposing a switch to fluvoxamine in the hopes that i can stabilize the anxiety disorders on a lower than equivalent dosage of fluvoxamine than escitalopram, e.g., less than 300mg/day of fluvoxamine. i don't know if this will work, though.

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thanks everyone for all the thoughts.  helpful to hear perspectives.  I don't have a good sense of which one it would have been for me (or both...joy of all joys).  I'll discuss with Chris tomorrow depending on timing (processing the hospitalization likely takes priority). 

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So he thinks it’s a possibility.  Not as what caused this hospitalization (that sounds like command hallucinations), but in general when I talked about not driving for fear I’d hit/kill someone, not standing at the top of stairs or by a window out of fear that I’d kill myself, avoiding naked baby pictures of my niece and nephew out of a fear that I’m a pedophile, etc.

he talked about doing some exposure type stuff when I am further out of this psychotic episode.  The specific example was standing at the top of the stairs that are by his office together.

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