Diazepam vs SSRIs (plus bad GP!)

[Cigarette Smoking Man]

Hi everyone

I've suffered from OCD for 15 years. In 2007 I had six months of CBT which I found to be fairly useful. The clinical psychologist offered me SSRIs at the time but I turned them down because I was worried about side effects.

I'm a writer and musician, and I find these activities help my OCD and bring me a lot of enjoyment - these things are a big part of my life.

I hate the idea of taking a drug that makes it difficult for me to continue doing these things that bring me so much happiness.

OCD is with me all the time, but every once in a while I'll hit a really bad patch terrifies the life out of me. This happened both before and after my CBT.

On two occasions over the past year, when things have gotten really bad, I've been to see two different GPs, both of whom have prescribed diazepam. I tend to take 2-3 doses of 4-6mg for no more than three weeks.

I find this drug helps me get beyond the really bad patches. I've never had any real trouble stopping taking it, and suffer very few side effects.

I understand the addictive qualities of the drug, and I know it shouldn't be taken over long periods of time. I feel I've always treated it with respect.

I am now at a stage where I am visiting a new GP, armed with the NICE guidelines, intending to request further CBT. The question of SRIs is going to arise again.

My question is: is there any real problem with me simply taking diazepam whenever I hit a really bad patch (say every three - six months), alongside more CBT?

If not, is there any real need for me to risk the potential side effects of SSRIs?

I've had a fair amount of experience recently with GPs not reading my notes, having only a limited knowledge of OCD and just doling out drugs in preference of referring me back to the clinical psychologist.

Because of this I want to be fully informed before I go to my next GP appointment. Maybe this new GP will be much more clued-up - I hope so.

Either way, I would really appreciate any help or advice you could offer. I guess my main concerns are:

1. Making the wrong decisions re medication and CBT due to poor GP guidance

2. Taking the decision to take SSRIs and losing the ability to continue with my music and writing.

On a final note:

Sometimes I feel very alone with this illness and this makes me very sad. I've felt a lot stronger due to the respect and understanding I've received from the people on this forum. Thank you.

CSM

[Guest stormy]

Hi,

I take an SSRI and dont feel anything but normal and cannot see why taking the meds would stop you doing what you enjoy but help you to relax.

The only side effect ive had is an hour or so after taking it in the morning i feel a little tired but thats only at the beginning of taking it and if its increased. Other than that I can do everything i always did, and more because im happier.

Hope this helps

Stormyx

[Cigarette Smoking Man]

Thanks Stormy, that is reassuring to know. I'll bear this in mind when I see the GP.

CSM

[Guest LeddiB]

Hello CSM,

I'm afraid my experience is quite different from Stormy's (I must stress, though, that it is *my* experience - we all react differently to medications); all of the SSRIs I've tried have given me side effects that are hugely depressing, which kind of defeats the object. They do calm me down and give me a bit of distance from the eye of the storm, so to speak, but they also cause me to feel most of the time as though there's a thick pane of glass between me and my thoughts, feelings, imagination, creativity, intellect, motivation etc. - I know they're there, but they're just out of reach. As if my brain were in another room. I have very little desire to do anything, really, and I also find it difficult to connect my thoughts and imagination with my emotions - I'm an actress, so this is a big problem for me.

I feel as though I lost my twenties and early thirties to ocd on the one hand and to drug side effects on the other, and in fact, most of my "ocd breakdowns" happened while I was taking the drugs. Seroxat, which I took for several years, made me want to sleep all the time; I didn't even realise it was the drug until I came off it - I just thought I was lazy and self-indulgent and hated myself for it. In fact, I didn't realise that any of the side effects I mentioned were down to the drugs until quite recently; as a child I was so full of promise, but for years I've felt like not only have I failed to realise any of that potential, it's disappeared completely. Of course, it's good to know that the drugs have played a huge part in this, but the sad thing is that I don't seem to be able to go for long without them before the ocd spins out of control. Talk about rock and a hard place. Can't live with them, can't live without them!

*Again, though, I must emphasise that this is only *my* experience - so many people here swear by SSRIs and aren't troubled by side-effects.*

I am, however, resolved to ask to try some different medications - thankfully, there are other options - in the hope of finding something that gives me the positives with fewer of the negatives. As I said, though, everyone reacts differently to these drugs - you might be like Stormy and have no problems at all; just because I struggle with SSRIs in general, it doesn't mean you will/would. Also, there are a number of different SSRIs; one might not work for you, but another one might.

There are so many options for you - diazepam & CBT, an SSRI & CBT, all three, another type of medication & CBT, etc.- so try not to worry too much. Nothing is set in stone, either - if something doesn't work for you, you can always try something else

Good luck,

Leddi x

Edited May 5, 2010 by LeddiB

[Cigarette Smoking Man]

Hi Leddi

I am so sorry to hear you are struggling so much with your SSRIs. It sounds positive to me that you are considering trying alternative medication options. As you say, there seem to be many options out there - I'm sure you'll find something that will help you feel better in the longer term.

I guess I just wanted to try and head out on the right path, in the absence (so far) of good GP support. I do find that my relationship with diazepam is working OK, at least for now. When I have a serious OCD breakdown like I had a few weeks ago it really helps me fight through it.

Medication-wise, I would be happy (I mean that in a relative sense!) to keep going this way, but I just don't know whether this is the right way to continue to deal with the problem, even with more CBT.

As you say, it's largely down to me to make the best decision I can which is why it's very useful to hear accounts from different people to help me judge the risks and potential side effects of changing my medication.

I understand entirely about having lots of potential at a young age and feeling as though you've failed to fulfill it, largely due to your OCD. Sometimes it makes me feel jealous of those who seem to just sail through life, unrestricted by anything. I'd give anything to live like that.

Thanks for your help, and good luck with the new meds (and the acting, of course!)

CSM