KaKop

Although NAC has been mentioned for more than 10 years in the context of OCD treatment I have just recently found out about it. Since it is available as a food supplement and from what I have read is (relatively) safe, the question I have is how much to take daily. There is one study https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5483239/ In which 2.4g where administered daily ... around 60% more than the recommended dosage (as food supplementation) on my NAC package. I have no doubt about using more in case of OCD to be effective (if at all). Nevertheless, any personal experiences or other information with respect to daily dosage would greatly be appreciated. Kakop

Thanks for your response, Agrippina!

For a long time it had been my dream to possess a certain classic car. 14 years ago I (now 52) fulfilled my dream. My intention was to drive it, to fix stuff that fails etc. - as a hobby for the future. However, my OCD has ever since interfered with the enjoyment. When driving it I notice every strange sound, when fixing stuff for the first time I have fear to break something that can’t be easily replaced. After finishing a task intrusive thoughts come into my mind ... did I do it correctly, am I absolutely sure that I didn’t cause more trouble, I have to check again and again - mentally and physically - the obvious vicious circle that I’m aware of. Without, OCD I would judge the negative vs. positive experiences and based on the result I would either continue or quit this hobby. In my personal case, stuff that is important to me and that I’m responsible for always causes similar patterns. So, actually, the answer to the question to quit would be obvious. But then I would have given in to my OCD. Whereas other experiences that I’m not able to influence can be handled by me (death of my step mother) decently, such stuff caused me to up my medication. Aggravating to this is the situation of my father who has got verticulary dementia. I see him as my (unwanted) role model. He failed to cope with the difficulties/challenges learning computer and smartphone before his dementia and now - his mental capabilities are not that in decline hitherto - he considers himself as a life-long looser and stews on this most of the day. Oliver

I'm not sure which book mentioned the subsequent stuff but it is pretty interesting - and this book is not about OCD!!!: Your memory of the past is not fix - it is also plastic, i.e. every time you access a certain memory you change it. Like a book taken from a library and when putting it back in the shelf it has a bookmark or a little stain etc.. Depending on your current state of mind this alteration might be minimal or even to a greater extend. This becomes obvious when witnesses testify or describe a perpetrator. 5 witnesses and sometimes 10 descriptions over the course of a trial. So there is no absolute trust in your memory. The harder you try, the more agitated you become and the more distorted your retrieved and stored back memory of an event becomes. This has to be accepted because it is how our brain works. Oliver

@taurean What is your recommendation in the following cases: Other people consider the probability as - let's say 50:50 - but their recommendation is to wait until it occurs because it is not clear when this will be. What if the other's opinions is contradicting - some concur some negate that a feared event could come true. Oliver

I (50 now and having OCD for around 45 years in retrospective) just wanted to write down my thoughts having at the moment ... My OCD voice in my head promises me that if I only check this again or think about that other new aspect of an existing or new problem and how to solve/fix it I will be relieved and peace of mind is imminent. Despite knowing it better I often fall into this trap. Since my problem is certainty in conjunction with perfectionism seeking mostly in non-living things where obtaining information is possible. I'm not sure when 'normal' rational thinking ends and OCD rumination begins. All to easy my OCD voice has trapped me in a vicious vortex of thoughts spiralling downwards. Many hours wasted. Consider your beloved car (if this is the case, like me) and a malfunction so it makes sense to think what to do, e.g. fix it by yourself or have somebody do it. But in my head a cascade of thoughts are triggered. Memories of - in my opinion (and sometimes others, too) bad done jobs - come to mind jeopardizing the status quo of this thing. It is mentally so paralyzing and it is only an inanimated thing - but under my control, my exaggerated feeling of responsibility or its meaning to me. Another big OCD issue is our house where things were done improperly during construction, sometimes with tough financial consequences involving a lawsuit, sometimes more cosmetically, sometimes with consequences of unknown risk at the moment - maybe occurring in 50 years (not for me to experience :-) ). As already mentioned elsewhere I'm on Sertralin (150mg) and I wanted to start ERP by myself. The concept of ACT has been part of me for 7 years and a certain improvement can be attributed to it. Several private issues prevented me from starting ERP - my father (79) faces OCD and a very sever depression at the moment. Actually, all was prepared so that he would go in stationary therapy (for OCD). But he cancelled his appointment and continues his and - as a consequence - my mothers (86) suffering; her living with him is very tough. This has a certain impact on me, too. Unfortunately, I'm frail to new or recurring issues/problems as the above mentioned so it is hard to start with ERP. However, the last days have shown me to get started with it. Oliver

Recently, I came across an information regarding SSRIs and the way they work. Actually, there are 2 models trying to explain this: Low levels of e.g. Serotonin - monoamine theory https://www.cochrane.org/CD001765/DEPRESSN_selective-serotonin-re-uptake-inhibitors-ssris-versus-placebo-for-obsessive-compulsive-disorder-ocd Enhancing neuroplasticity https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624993/ Apparently, both can't explain the effect completely. Nevertheless, in my case Sertralin helps. But you can't omit a therapy (ERP, ACT, CBT). I consider SSRIs as door openers in case of severe OCD impact on daily living. Oliver

Yes! The only side effect in my case is tiredness. But it is acceptable for me.

I have read many self help books on OCD, GAD, perfectionism etc. Most of them contain worksheets to complete. Although most of them have valuable information and techniques I rarely use the worksheets beside going through them mentally. I'm interested in what those of you do who also read such books. Oliver

I have been taking SSRIs - Sertralin (Citalopram before) for 6 years and - after a couple of weeks the body/brain needs to adjust to it - the side effects are bearable. I have given up living without it because of genetic predisposition and epigenetic factors in my case the Serotonin level in my brain is too low. SSRI helps that the Serotonin remains longer in the brain, e.g. between the nerve cells to level out the impaired Serotonin production. To me there is no difference to other medical conditions like diabetes or high blood pressure that require medication, too. Long story short how about giving it a try? Oliver

I've just searched here regarding binaural beats and found only a few entries (one by me from 2013). Recently, I rediscovered binaural beats and had a look at https://www.ncbi.nlm.nih.gov/ I listen to alpha binaural beats when I take a nap during lunch time or while riding a commuter train. Here is another study regarding alpha binaural beats in conjunction with anxiety: https://www.mja.com.au/journal/2011/195/11/original-sound-compositions-reduce-anxiety-emergency-department-patients So it is one more OCD tool for me and easy to employ. Is there anybody active here who has experimented with bb or uses it currently? Oliver

Roy, thanks for your opinion. The idea of grouping is interesting and I’m thinking about modifying my idea of using one slide show to one per group. As mentioned there are so many things at home that can cause OCD thoughts and compulsions that using one or two of them per ERP session would take a very long time to be done with all of them. Regards Oliver

My last therapy was 6 years ago. It was ACT based but didn't comprise ERP. I practice meditation almost every day to train mindfulness in order to realize as soon as possible when OCD thoughts appear. The longer they are present and I'm not aware of them the more it gets possible that ruminating continues for hours and compulsions (mental or physical checking) occur. I identified the missing ERP as the crucial part and my intention last fall was to develop my own ERP program. I was very reluctant to tackle this out of fear of worsening my mood. But after reading "Everyday Mindfulness for OCD", which also emphasizes ERP (beside Mindfulness) I started my first tentative ERP trials according to this book. You may be asking why not with a therapist? Well, it is not easy to find a suitable one here in Germany and you have to be patient until you will be able to start because of their waiting list - mostly several months. The ultimate ERP treatment I devised for myself looks as follows: I take pictures of those things that have caused OCD thoughts and compulsions (and there are at least 50 around at home - my major OCD battle field) and compile a slide show that I then watch in my ERP session. Actually, I thought about playing a curious boulevard journalist who investigates a person's OCD triggers when tacking the picture with the goal to identify as many as possible for his new headline and to become a Purlitzer Price nominee - not to get caught in OCD thoughts during this activity, which I really fear and which prevented me from doing it. After the ERP session I perform sports trying to concentrate on the exercises. As far as I have read it is normal to feel uncomfortable/anxious or an impulse to do compulsions during ERP. To those of you with ERP experience, did your OCD and/or depressive mood increase in the beginning phase of ERP? As mentioned in my initial posting I increased my Sertraline. This was because I felt more depressed and ruminating more, which I attributed at least partially to my initial ERP experiments. Oliver

Hi, I (50) haven't been in this forum for almost 6 years. As mentioned in the title I have got several topics with respect to OCD. However, I have been doing rather ok over the years applying Acceptance Commitment Therapy exercises and taking Sertraline (currently upped to 150mg). The topic I'd like to get your opinions about is my quirky perfectionism OCD: Personal "things" that are very meaningful/important to me have to be almost perfect or if I discover imperfections my thoughts revolving around questions if and how to fix these and why it is like it is and I have to check them oftentimes. And when I actually fix an issue on such a "thing" I can only stop when it feels right, which is very time consuming. Afterwards I ruminate over the fix resulting being unsatisfied. Sometimes I try to improve the fix. This all creates or amplifies a negative attitude towards such "things" and as a consequence I'm not really able to enjoy them. As a consequence this undermines my joy of life and depresses me. BTW: Things that don't mean much to me couldn't care me less. I'm not really orderly - my wife regularly complains about this. Normally, my job doesn't bother me, too. So I'm not a perfectionist in every aspect of my life. Regards Oliver

Hi, I haven't been visting this forum for a couple of months. As mentioned in one of my initial postings I have been suffering from OCD for many, many years. The OCD topics have varied over the years. Summarized: all that has been important to me caused OCD troubles like checking behaviour of devices in the new flat I moved in. obsessive thoughts regarding violating traffic rules and subsequent punishment. Obsessions and Checking behaviour during the construction of our house and afterwards. Actually till now. From medical side I take 200mg Sertralin. After vicious dreams in the initial phase of taking it - starting dose was 50mg and gradually increasing it to 200mg - I now don't experience any severe side effects. The only thing is increased sweating at night, which I attribute to Sertralin. If somebody is surprised of the dosage, SSRIs for OCD suffers are applied up to twofold of the normal highest dosage. This rules out Citralopram, which may cause fatal heart side effects if dosage is upped to 60mg. According to my Psychatrist Sertralin is safe here. Currently I consult a psychologist who is recommend for OCD and who is also experienced in ACT (see below) By chance I stumbled on the 4 steps methode in a book on neuroplasticity. Additionally I came across ACT (Acceptance and Commitment Therapy). Similar in both is the concept of the internal observer. ACT stresses et al a value-oriented life. First you have to identify your values, of course. Each action should be according to your values. You can't control your thoughts but your actions - rather less in the beginning if you suffer from OCD. Further concepts that come into play are mindfulness and self acceptance and - most important to me - living in the moment. I have been wasting too much time in thinking about the future and the past. But this can't be changed by pure realizing this. All this led me to the conclusion that I not only need an approach to address my OCD but a holistic one addressing my whole life. The most important aspect is 'Living in the here and now'. I practise awareness exercises that address this. I can say that the more I'm able to stay in the present moment, activate the internal observer in crucial OCD situations the better I feel. Please consider this post as my personal approach, which I want to share as a potential inspiration. I don't dissuade from other treatments, concepts, therapies. There are many ways to Rome. Each of us needs to find his own one that helps him/her. Regards KaKop The most inspiring books for me: Brain Lock - Jeffrey M. Schwartz Happiness Trap - Russ Harris Present Perfect: A Mindfulness Approach to Letting Go of Perfectionism and the Need for Control - Pavel Somov (He addresses his book for OPCD but I consider it an interesting read for us OCD sufferers, too, who are interested in Mindfullness, Acceptance et all)

I was councelled by a psycholgist who confirmed my OCD. Since I didn't make real progress and paid him by myself I decided to go to a psychatrist to get a referral to a state health fund paid psychologist. The psychatrist also confirmed OCD. I looked for a specialized OCD psychologist - who was recommended by an OCD sufferer organization. I was totally astonished since he said that I don't have OCD but GAD - according to him I have too many worring topics. Since his therapy is ACT based, which I'm confident to be helpful for me, I decided to stick with him. In the second session he asked in more detail and after answering that there's an inner voice that tries to seduce me to perform checkings and the stress created by not following this voice he got convinced that it's OCD. Have you told what exactly happens in your mind during an OCD 'attack'. Kakop

I think a good psychatrist knows better what to do. According to mine Sertralin, which I also (currently 200mg) take, can be used up to 400mg daily - more than mentioned in the description - in case of severe OCD. SSRIs like Sertralin for OCD often rquire to be used in higher than "normal" dosage. I assume that a normal may GP not have this information. Kakop

Acceptance and commitment therapy (ACT) Though not a therapy initially considered for OCD ACT is now also used for OCD. One applied concept is mindfulness, which is also used in Jefferey Schwartz's 4 Steps. What I especially like about ACT is that it addresses not only your core problems (anxiety, OCD etc.) but also incorporates the concept of your personal values - (try/learn to) act according to your values. I think it is worth to be considered even by people without any serious problems. KaKop

Hello, here is an interesting web talk on ACT and OCD: http://webtalkradio.net/2012/11/05/act-taking-hurt-to-hope-struggling-with-obsessive-compulsive-disorder-ocd/ Kakop

Steve, you may have a look into ACT - Acceptance and Commitment Therapy. There's a book 'Th Happiness Trap' offering concepts like mindfulness and awareness together with exercises. I'm trying to apply them. If all goes well my next therapy is based on ACT. KaKop

@Benjamin, I don't question your system. Every individual system that is based on sound techniques deservs to be taken seriously. There may be parts or the whole that help other sufferes. However, in my opinion you bear some kind of responsibility when offering a book (the Kindle version is supposed to be available by the end of August). And to me a personal - one-time successful - system doesn't qualify to earn money with it. If you will get positive feedback by others applying it ... then why not publishing a book, Your chosen title makes a claim - it is eye-catching and creates high expectations. Kakop.

Benjamin, Firstly, it is great that you tackeled your OCD successfully. I've had a short look on your internet site and what you wrote there on your regime. Unfortunately I have got some critisim: I don't like the title "One minute solution" - to me it's a marketing phrase Does your personal system - that has helped you - justify to be sold as a book without proof to have helped others? I sometimes wake up in a panic mood - I doubt that this would be a good situation to start with exposure. Exposure every hour - sounds good but I think you can only do it after you have gained a certain level not to be consumed by it for a long time - otherwise you are not able to accomplish your work. When I go to sleep I'm happy when I experience peace of mind. I personally listen to my binaural beats (to accomplish this peace of mind) followed by a self-hypnosis script created by my incorporating the 4 Steps and ACT (most time I'm already asleep when it runs ;-) ) Summarized: I think everybody has to pick up the best things for him/herself by experimenting. Making these individual methods available to others - great! Maybe here in the forum or on a homepage. But as a book? Kakop

Very interesting discussion. Since I'm an newby in the treatment of OCD I can't contribute that much. After rethinking my initial question regarding working around = avoidance my explanation why it is different is this: Preceding the working around or refocus is the relable and reattribute. By doing this you put your thoughts deliberately in the right context - you acknowledge them as intrusive and caused by OCD. Then you can refocus. Doing only refocusing would be avoidance. @Ashley: You mentioned Refocusing is only to be doen after exposure. Unfortunately, I haven't found this relation in Jeffs Book. Kakop

One Part of Jeffery Schwartz's 4 Steps is - after acknowledging that an intrusive thought is caused by OCD - to (try to) do something enjoyable in order not to give in to your compulsions. In CBT (with ERP) you deliberately expose yourself to the stressor. So we have "Working around" vs. "Exposition"? Aren't these approaches contradictory? Is "Working around" not similar to "Avoid"? Kakop

I'd like to know if there is anybody here who has a similar OCD issue as mine. We had our house built until 2 years ago and the construction phase was very difficult because the architect and his construction observer didn't do a good job in observing the executed work. So I had to become an construction observer, too. Form that on I have become obsessive with everything that is missalingened or cracking etc. in our house. When something in this regard comes into my mind (by seeing or just remembering) I have to check and recheck if it is ok or not or should be better .... . When I identify something to be wrong my mind goes crazy. The respective thought hounds me only to be replaced by another one. As you may guess the weekends are especially critical since I spend most of my day at home - knowing many places there being "not right". Actually, I can't really enjoy it and my wife suffers from my behaviour and mood, too. At first - after moving in our house - I attributed my feelings to the stress. Only after stopping using Citalopram, which I had been taking since 2006 and stopped 2 months ago - I've come to realize that it was not only stress but also OCD. This OCD topic replaced my former one (fear of skin cancer with checking my moles). I have a therapist whom I chose due to the mentioned stress. I discussed with him to apply the 4 steps. My therapist thinks that we need to clarify what my described fear and feeling of insecurity excatly is in such a moment of obsessions and checking compulsions. Knowing this would perhaps alleviate my symptoms. But I can only describe that they are there. Additionally I have an appointment with a psychatrist next week - I suppose that I start with meds again. I think that I need my problem area to be "perfect" in order to be able to feel safe and secure. Kakop