flourella

I have a similar fear regarding something which invariably causes death, can remain dormant in the body for decades after infection, and for which there is no test even after a person has started to display symptoms. If it makes you feel any better, when I was assessed by the specialist OCD service at Springfield a few years ago I told them all about about this particular issue of mine and they still thought that I could improve with treatment there. I ended up declining the place due to my own very severe (and varied) fears of contamination making it impossible go on to the ward, but they gave me some hope (for a while!) where I had previously had none. I do have comorbidities that apparently really do reduce my chances of meaningful recovery regarding my OCD, but that specific element of the OCD itself was not deemed to be insurmountable by experts in treating the condition, so no reason to think it would be in your case. I don't know what treatment you are having, and where, but what you have here is the opinion of just one psychologist.

I am sorry that this is causing such worry for you, but I think this paragraph here is key. Not everyone with psychosis has no insight at all but, as you say, you can rationalise these fears and resist taking what would seem to be reasonable steps to protect yourself (lots of people have a fire extinguisher at home, after all). I'm not telling you that you shouldn't be concerned about this though, whether it's within the realms of normal, part of your OCD, or something else as is your fear. I do think you should tell your GP, CPN, psychiatrist, or whoever you see about your mental health. Don't know if this will be helpful, but I have had my supposedly delusional beliefs since I was high school age. I won't detail what they are because they are generally persecutory and reading about them might not help if there is any overlap with your thoughts. But they are things that I know not think, or worry about as a possibility. Hearing from anyone, including the psychiatrists who diagnosed me, that these things are not just unlikely but literally impossible does not reassure me or make me doubt what I experience. I was first diagnosed as having a "psychotic element to (my) presentation" in my early 30s, more than 10 years after first approaching a GP to say I thought I might have OCD. I hadn't mentioned them in all that time because I didn't think they were relevant to my mental health concerns. The beliefs came up in therapy during a conversation about my day-to-day life and the psychologist suspended the therapy to have me reassessed by a psychiatrist, while I wondered what was going on.

Howard is right as well. Most people get intrusive thoughts and most people feel paranoid at times. I answered in terms of "OCD or psychosis" partly because that's what you asked, partly because I myself have both, and partly because I assume you do have a diagnosis of OCD if you are posting here, and performing compulsions in response to worries or doubts seems it would be part of that.

Hi. It is possible (but pretty rare, I think?) to have OCD with poor insight which may cross into delusion, and it's also possible to have OCD and a separate psychotic disorder. I have been previously diagnosed with the former and that was recently changed to the latter. But fear of developing psychosis is also a quite common OCD theme and what you've written this here sounds like it's more likely to be that, to me at least. The very fact that you're asking the question here suggests that you are mainly worrying about the negative effect these thoughts and compulsions are having on you, and of becoming psychotic, rather than being afraid of people or organisations or whatever that you really believe are out to get you. For example, you write that you are performing compulsions to alleviate the anxiety surrounding the thought, rather than taking measures to put these mystery people off the scent or otherwise protect yourself from harm. That suggests that you don't really believe that people are tracking you. The idea is entering your head, and you are compelled to neutralise the worry it causes in classic OCD style by such things as asking someone else what they think about it. Is that correct, and does it work? Delusions don't really occur in a given moment, like an intrusive thought, then dissipate with a compulsion, at least not in my experience. And now it seems you are worrying about being delusional as well, and seeking reassurance about that here. Sorry if I've misinterpreted what you are saying. If it's concerning you, you should absolutely describe it all to someone who can either make an assessment, or refer to someone who can.

Hi Indecisive7. Good to hear from someone who has undergone treatment at one of the centres. How did you find it? I hope it made a difference to you. I suppose I'll have to wait and see what they each make of the delusional disorder. I haven't actually seen the referral criteria you outline. I thought I'd read that Springfield don't take patients with a diagnosis of an acute psychotic disorder, though I obviously wouldn't say that's what I have and neither would the mental health team. The psychiatrist did say he would have me take medication for it ideally, but that he won't make me. So if he's happy to have it left untreated hopefully the national services will be, or at least one of them, so I have a chance! It's complicated because I had these supposedly delusional beliefs and OCD when I was a child (and the bulimia from late teens) but they were entirely separate until my early 20s, when I got messages transmitted into my mind confirming worries I already had about a particular environmental danger. That's when my contamination fears started and all the rituals regarding hand washing, eating and drinking, etc. I think that there is plenty to work on in terms of the time spent washing, the limitations on my ability to store food and drink in my home, and my being unable to use plates and cutlery, etc, without having to go near the beliefs that led to the development of those problems. And I still have other OCD themes such as checking, counting, intrusive thoughts of horrible things happening, etc, that remain unrelated to the delusions, so I'm hoping at least one of the clinics will agree that there is enough OCD stuff to work on without having to "cure" the "psychosis". The lack of an inpatient option is definitely one of the positives of OHSPIC for me. That's the one I really want to try, but I've read threads here where at least two posters say they have struggled to convince their CCGs to fund it. Anyway, thanks for replying, and your good wishes.

Thanks for replying. I have read that Oxford will offer home visits in some circumstances, but I'm actually more interested in outpatient treatment, where I would visit the clinic. As difficult as that would be, I think it would be easier than letting someone into my home, at least at first. Do Springfield not do a full course of treatment at home or as an outpatient? They did suggest last time that they would want to see me as an inpatient, but that I might need a few visits initially to get me to the point where this was possible (though I don't think it ever will be); however, that doesn't necessarily mean that they never treat people just as outpatients. Does OCD UK not have any information on treatment of OCD with the comorbidities I mention? I also have a fair few other conditions as well, but they are related to OCD so things like health anxiety, trichotillomania, etc. I'm worried that the diagnosed psychosis will mean they'll all refuse to even assess me. Or is that only for patients in acute psychosis, or with symptoms including formal thought disorder, disorganised speech, that sort of thing (which I have never experienced)? I'd really like to hear the experiences of people who have similar, quite complex issues if possible. The referral hasn't yet been made. I'm waiting to hear back from the recovery team with whatever they have learned since our last appointment. Do you think any of the clinics will even have a conversation about the specific case of a patient not yet referred?

Hi. I don't really post here, because I'm not very good at online conversations and can't give any advice that meets the standards of that given by so many of the regulars, so have nothing to offer anyone. But I read the threads in this section most days. I have a question now though and hopefully someone can help me. Sorry for the length of this! I was referred to the ward at Springfield a few years ago and put on the waiting list for inpatient treatment with possibly some home visits beforehand, but ended up declining the opportunity. I have had several lengthy runs of therapy with local NHS services and live in charity-run supported accommodation, but have no ongoing support from the mental health team. Around 18 months ago I requested a referral to be assessed for autism, and was diagnosed in December 2021. In light of this I asked for yet another re-referral to the mental health team to see if local services could offer anything different, even if it was just a repeat of their highest-intensity CBT but this time taking the autism into consideration. I have had several appointments since, seeing a nurse, psychiatrist, and clinical psychologist, and the only thing they will offer is another referral to the national services. The last time I spoke to them they said they would get in touch with them all to try and discuss my case before making any referral. They don't seem to have made any progress so I thought I'd ask here what people who might know about these things think. One thing is that as well as autism I also have a new psychiatric diagnosis, Persistent Delusional Disorder. I was described as having a psychotic element to my OCD in 2011, but refused to go on the prescribed anti-psychotic medication (I don't take any medication for mental illness) and it was never really mentioned again. Nothing changed in these beliefs, though. According to this latest report I am psychotic and have poor or no capacity in regard to these "delusions", though I am still not being forced to take medication for them. So I don't, because I don't believe I am delusional! But I am worried that this and/or the fact I am now known to be autistic will preclude a referral to anywhere. The psychosis was not mentioned during my assessment at Springfield so I assume it was left off the referral, but it's been indicated that now I have an official psychotic disorder it will be mentioned this time. I have never been acutely psychotic, or hospitalised, and the latest report says I do have good insight into my OCD and autism. Does anyone have experience of treatment at one of these centres with psychosis? Or autism?? I live in the north west of England, so not close to any of the clinics. I would travel to any as an outpatient, even though that would mean I couldn't eat and drink all day and present other difficulties regarding dealing with clothing etc afterwards (at least at first! Trying to be realistic about my current state, but optimistic that treatment can make a difference in time). I don't want to go and stay anywhere as it's just not possible with my contamination issues. I was kidding myself last time. I'd have to be cured on crossing the threshold. So being referred to Springfield again would only work if they will do all the treatment at home or as an outpatient. Do they offer this? I'm not sure I would be accepted at the ADRU anyway because of bulimia and other quite bizarre eating habits I have due to the OCD and (alleged) delusions. But is CADAT a good option for outpatient treatment? I believe I live too far away for home visits to be a possibility. OHSPIC is the one that really interests me. Partly because it's quite new and didn't exist last time, but mainly because the possibility of tailoring an approach which takes autism into consideration is mentioned in the FAQs. I can't see where any of the other services' websites mention autism at all. I'm concerned about the funding route, though. I have the impression that CCGs will turn down funding if any alternative is available, and being able to secure national funding for a different service offering treatment at the same level would give them great opportunity to refuse. Also the clinic might not have a great track record of success simply because it will have seen relatively few patients in the relatively short time it's been open, making it look less attractive in that way. Are my fears well-founded? I don't know anything about the Hertfordshire one or the Priory, and for some reason don't have them in mind as real options. Perhaps because they aren't often mentioned here. I believe the Priory has an extra step to any referral(?) and also get the impression it is inpatient only(?). Does anyone know anything about either of them? Thanks for any insight or information.

Did your doctor really agree with this logic? The maximum daily dose of citalopram is 20mg, as you say, and for escitalopram it is 40mg. That doesn't mean that the latter has the capability to be twice as effective, just because you can take up to twice the gram weight in a day. I've no idea how much sertraline you were taking, but I'm sure you know that that drug has a maximum daily dose of 200mg. 200 is obviously a much higher number than 20 or 40, but you can't compare the weight in mg unless you're considering different doses of the same medicine. Not saying that a change of medication is not a good idea for you, but the fact that the maximum dose of what you're currently taking is only in the low double figures is not a reason to do it!

I already avoid being around people (quite easy because I don't work), wash my hands a lot, clean packaging of food and other things brought into my flat, keys, bank cards etc, and have separate indoor and outdoor clothes, so I don't know what else I can do to prevent me from getting it. I am a bit worried about my dad, even though he is only in his mid-60s and in good health. My main concern is around the behaviour of other shoppers in supermarkets and possible interruption of the supply chain. I have not been able to use cutlery and crockery or do any cooking for more than 15 years, and I have been unable to store food and drink in my flat for the 12 years of living here. I can only take food and drink that can be consumed straight from the packaging without being touched, and, to compound the limitations in my choice, only certain countries produce "safe" food in my eyes and the UK isn't one of them! If I don't leave the house on a particular day, I don't eat or drink anything at all; typically I can only face going out and all the rituals around cleaning the items and consuming them once every other day, but fairly frequently go three days without. I am increasingly desperate in fear that I will have to go on hours-long tours (on foot) of every shop in my large town to try and find something suitable for me to drink and fail because others have cleared the shelves. When I get home from the shops, I put the items in a plastic "holding box" while I wash my hands, change clothes, wash my hands, then clean items and put them on the coffee table, wash my hands again, then open and consume. (Each hand washing takes a minimum of 20 minutes, so the official guidance to wash for 20 seconds for effective cleansing is darkly amusing to me) I have a second box in which I have put a small stock of five, one-litre cartons of long-life plant-based milk and two boxes of cereal bars that I can eat, but I haven't touched them yet and I can't be sure that, should I need to due to lockdown, empty shops or illness, I will actually be able to eat and drink them. It might be that when it comes down to it, I will just see them as contaminated and have to throw them away. Sorry about the length and detail of this, but I have no one to talk to and I get the feeling that this forum is the only place where people might understand anyway. I also get the impression this is the only thread for discussing COVID-19 so I'm just blurting it all out here. The potential this has for impacting all of our lives is quite staggering, however long it lasts.

I have just bought the book. I had totally forgotten, till I came to pay, that the Christmas before last my brother gave me a gift card for Google Play, so it didn't even cost me anything! I'm going to sit down with it in the next few days. My ultimate goal is to get back into employment, but goodness knows what kind of work I could ever get. I'm 38 with no degree (and dropped out of no fewer than three in my late teens and early twenties, so no hope of funding for one) and have only ever worked menial jobs, the last of which was nearly 15 years ago. Dream career would have been in vulcanology or palaeontology. No chance of that now! I like organising things, so maybe admin or low-level accounts work (I'll get there just in time for computerisation to fully take over, ha!) Or event planning? I dunno. More realistic goals would be pretty much the kind of things snowbear suggested. I imagine being able to have a drink, maybe even a cup of tea, just because I've decided I fancy it, not because I'm dying of thirst because I haven't drunk anything for 30 hours. Or making a hot meal, using pans and utensils and everything. Or washing and eating a piece of fruit... All without having developed a battery of new rituals and referencing systems for doing it "properly". Hardly outlandish fantasy, is it?! Or it shouldn't be.

Oh dear, one of the places I saw a recommendation for a book was this very thread and I forgot. Thank you for reminding me so graciously instead of just (correctly) pointing out that I should be paying more attention. I will look into it! I also like the suggestion of coming up with some reasonable goals. As I was reading your post I was thinking, well, of course I want all those things. For starters. But I haven't ever really committed to the idea of working towards any particular objective. I admit I have become defeatist and if I am thinking about this stuff, it's in terms of the things I can't do now. I know that's going to have to change before I start therapy.

snowbear, what a bombshell of an idea to drop on a person out of the blue. "Tackling" my OCD to "improve" my life? What?!! Surely now I'm on a waiting list for treatment, I can sit around until I reach the top and then things will just magically change?(!) To be serious, I am not currently under the CMHT and nothing will be happening until I start seeing someone from Springfield. Are you suggesting I try self-help books? I know that there are some recommended on this forum, but I'm not going to lie, I'm not sure self-help would work for me. Not for my issues around food and drink. Maybe for some of the checking and not being able to stop doing something (eg, placing objects on a surface, putting on certain items of clothing) till it feels "right". I'm not totally averse to trying. If I were to give it a go and read one book on the subject, which do you think would have the most chance of making a difference to me? (from your own opinion or consensus here) Or, if you weren't thinking about books at all, do you have any other suggestions?

Just thought I'd give an update on my situation. I went to the clinic today and had a mammogram and ultrasound that confirmed the lump is a fluid-filled cyst. I'm so relieved! The staff were brilliant about my OCD: cleaned the surfaces again even though they'd been done before I came in, washed their hands and put on new gloves in front of me, etc. I was given the assurance that any needles would be single-use, but I wimped out of having the cyst drained so I could avoid them altogether. I'm just going to leave it. I've had to do a load of washing myself, changing clothes, cleaning shoes, washing keys, etc, but it's really been OK. Thank you again for being so nice to me when I was worrying about it. Especially Bodger, for telling me about your experience. I feel kind of embarrassed that it turns out there's nothing wrong with me. Physically, at least!

Hi Waywardmind. Sorry to hear you're having what seems to be a significant flare-up of OCD symptoms. I've only just joined this forum and have only talked a bit about my contamination issues, due to a physical health concern I am currently experiencing. But I have had plenty of checking and counting rituals over the years and always use words and phrases to "reference" these. I think I have something similar to, if not the same as, your "tics". I've never called them that, because I thought tics were involuntary, more akin to seizures than compulsions, though I could be wrong. The worst I had was when I was a teenager: I had a "need" to close my eyes really tight, so that my face was totally screwed up, then clench my teeth so that it felt like top and bottom rows were going to splinter into each other, then have a quick, huge intake of breath so it felt that my lungs were going explode. If any of these didn't feel "right", I'd have to do them all again, sometimes over and over, wherever I was when I felt the urge to carry out the actions, including out in public. The frustration if I failed to do it properly could cause me to have panic attack too. These days I have one where I tilt my head right back and bring up my shoulders so the back of my neck is squeezed. I do it to try and "break up" intrusive thoughts and it does work, at least temporarily. I have definitely strained muscles doing it though: my neck is almost always hurting. Don't know if that is exactly what you mean? As for your lengthy wait to access treatment, that is never how it's gone for me, and I wonder if your GP simply doesn't understand the extent to which this is currently affecting you. It sounds from your post that you really need an assessment now. Haven't got time to describe how it works in my area, and I don't know what advice to give to help you access potential treatment quicker, so hopefully others will be along soon with more useful replies.

BelAnna, I'm not sure by which route I was referred and am being funded. The ADRU hasn't even been mentioned to me, so I assume the referral was made directly to Springfield. I just googled "Bethlem grounds" and it does look lovely! Springfield has some nice buildings and seemed peaceful, at least. Perhaps 24-hour staffing is the best way to go with me and my bulimia. Though I'm not thrilled about their stance on medication either... Bodger, I can hardly believe I have found someone who has gone through something so similar. Although, of course, cancer is only a worry of mine at the moment, and I can at least walk into a hospital as things stand. It sounds as though you have been terribly limited by your OCD at times. I hope that your surgeries and whatever other treatments you needed for the cancer have been successful. Receiving that diagnosis must be a terrible shock to all patients, but to have to face the treatment with such a fear of contamination can only make it much worse. I've never heard of psychoncology, but I'm glad that they could put measures in place to enable you to go through with your operations. I'm getting way ahead of myself, but I've already been worried about hospital food! In fact, a few times in the last week I've been seized by the notion that if I do have cancer, I'll just leave it to do as it will, rather than put myself at (what I know is a tiny) risk of contracting CJD from hospital equipment. Seriously! I do, however, now feel more confident that I can talk to the staff at the clinic, and that they will be willing and able to carry out the tests in a manner I can deal with. Thank you so much for that.