I apparently have very treatment-resistant OCD. My pdoc hasn't said it, but I have gathered this from my profound lack of insight into my obsessions, psychotic preoccupations, and the fact that OCD is not only interfering with life, but treatment as well.
I have tried novel strategies like memantine (30 mg), lamotrigine (400 mg), zonisamide (400 mg), topiramate (400 mg), etc. I've tried somewhat high doses of SSRIs (my pdoc hates prescribing anything at max dose) (fluoxetine 80 mg, fluvoxamine 100 mg (nightmare), escitalopram 10 mg (nightmare), sertraline 200 mg), SNRIs (venlafaxine XR 825 mg!!, duloxetine 120 mg, desvenlafaxine 150 mg, Fetzima (joke...)), Viibryd 40 mg, Trintellix 20 mg, etc., clomipramine 225 mg. I've tried various antipsychotics (typical and atypical) alongside SSRIs: fluphenazine 1 mg tid, perphenazine 4 mg tid, trifluoperazine 5 mg bid, haloperidol 1 mg tid to 5 mg x1, pimozide 2 mg bid, etc. Nothing seems to really help. Basically, if there's a way to treat it, I've probably tried and failed it or tried it partially due to conservative prescribing habits of my pdoc.
I have not tried low-dose clomipramine + SSRI, supratherapeutic doses of SSRIs (pdoc won't hear of it...), higher doses of typical antipsychotics (for acute psychotic preoccupations), certain antipsychotics (thioridazine, clozapine, etc.). I'm thinking about seeking a second opinion from another pdoc soon because my current pdoc is no longer helping me. She just keeps me on the same useless regimen and never wants to change anything, pats me on the back saying "you're better than you think you are," and sends me on my way. The office staff are severely understaffed, and one of them in particular always bitches me out after my sessions because it's so late, but it doesn't matter if I take 5 minutes or 55 minutes... she's going to bitch me out no matter what about it. She never says anything to the people who go back there and take two hours though. Just me, because I'm at the end of the day. It royally pisses me off and I'm about to snap at her, and I really don't want to (the office staff person). I'm also about to snap at my pdoc and ask if she'd rather the meds kill me or me kill me due to inadequate medication. I know meds aren't all there is in treatment, but she seriously has to budge for something to change.
I am seeing a therapist, but he's new and still getting to know me, so nothing has been done yet. He's taking notes and asking thorough questions though. I like him so far. He actually has a white dry-erase board in his office that he uses to illustrate things he's trying to convey to patients, and he's the only therapist with one in that whole office. I wish I could see my original therapist though. She's known me since I was 9 years old... She knows me like no other mental health practitioner knows me, and has the most extensive history on me. Last I saw her, she was in "partial retirement," which meant she blocked off half her office to this new guy (ex-pastor gone family counselor), disposed of all her notes on all her patients, sent half of her patients to this new guy, and kept the other half of her patients (mostly younger patients she said). I saw her twice or 3 times during that time, and she dismissed me after that. I wasn't really seeing her for my own purpose, but because of a problem I had I didn't know how to deal with. I tried calling her semi-recently when I was looking for a counselor several times, texting her, everything, and never got an answer, so I assumed she fully retired.
Anyway, I didn't mean to digress so much in this post.
So I've had the worst time since Wednesday, my depression spiraled out of control which lead to self harm and suicidal thoughts. In this state of mind I took it out on my dog who I love the most in this life. She really means the world to me, but I did get violent (that was Friday morning) by Friday night I was feeling like the worst thing on this earth. I cried so much, felt so much remorse and even selfharmed in order to pay for the damage I had done. Went to bed feeling better.
This morning I woke up feeling like crap again so lost and helpless which I can try to deal with but now I have very graphic intrusive thoughts about harming my dog. I'm so terrified since I can be very violent, I am not a bad person. I love all animals especially my dog who I adopted with so much illusion. Now I'm devastated and so scared. I don't know how to get through this, about three years ago I had really bad intrusive thoughts about death, but never about harming one of the beings I love most in my life. I'm scared some sick part of me got awaken since I want to be violent again with my dog. Anyone has been through this before? I have appt with my doctor by EOY, but in the meantime I want to find some peace of mind and of course not hurt my dog. I'm sorry for this awful post, I'm so sad, I love animals, do lots of activism and charity for them, I'm even vegan how did I end up in this situation with someone I consider my baby girl. I have 2 other dogs, but only my favorite one is triggering me to do bad things.
Help please! Again I apologize for being such a disgusting human being.
Sometimes out of the blue I get this feeling that I did something wrong and people will come to get me, because of this. Then I keep on reviewing what I did throughout the day and see that I did not do anything wrong. What causes this? Is this ocd or paranoia? How to prevent/deal/improve with this?
Sometimes out of the blue I get this feeling that I did something wrong and people will come to get me, because of this. Then I keep on reviewing what I did throughout the day and see that I did not do anything wrong. What causes this? How to prevent/deal/improve with this?
How do you distinguish between the Obsessive thoughts/ruminations that are due to depression and the "pure obsessive" type thoughts that are considered OCD?
I know that you don't have to be compulsive to have an OCD diagnosis (I think) but more & more I see my obsessive, negative ruminations taking over and I wonder if this means I have both OCD and Depression? My brain just gets stuck on a track loop....any sad trigger and I start having related obsessive thought patterns and I cannot escape the resulting mood/emotion that comes with it.