Norovirus fear

[leif]

I agree with dksea's posts...some great advice in there...just wanted to add that I too didn't do great on fluoxetine--I couldn't sleep well at all, and felt jittery though I do think it may have helped the ocd...anyhow after I came off it and relapsed I found I did much better on sertraline...so yes trying a different ssri might work for you too. it's interesting how different they are for each person.

I'm not overly happy about being on meds to control this but I am glad of them as I just couldn't seem to do it with cbt alone.

It's so hard when our lives become so limited by this--I really hope you're able to enjoy your dad's birthday!

[taurean]

I couldn't tolerate fluoxetine but I did manage to get on with Citalopram, and I think it balances my moods and gives me some resilience to stand up to OCD. 

But in my mix WAS also the core therapy of CBT including necessary ERP, The Four Steps, mindfulness and love kindness meditation. 

For me, we have to break the circle of distress which will quickly form around OCD's false, exaggerated or revulsive (vomit) suggestions via triggers. And that combination did that for me. 

It's all about finding a mix that works for any one individual. 

 

[taurean]

Why don't I have contamination or revulsion re vomit fears? 

OCD pushes its suggestions through on the basis that the threat only needs to be as low as 1% to trigger a catastrophic response. 

Non-sufferers judge threats in terms of rational risk and probability so just don't consider the "threats" of OCD as true. 

As for the revulsion theme, for such things as vomit, we might consider them unpleasant - perhaps even disgusting - but what we know about them tells us there is no threat or need for a phobic response or general avoidance; we simply note, then move on and forget.

We aren't being reckless - we are simply being rational based on knowledge previously learned, as a result of which the sentry in our head doesn't sound the alarm - nor do we focus in on the subject matter in a no let go manner. We note, then move on and forget. 

It follows that the goal for the sufferer is to work towards seeing the OCD "threat" as not a threat, in the same manner as a non-sufferer. 

Edited February 21, 2019 by taurean

[taurean]

In practice, I would say the threat level of OCD to a non-sufferer may be considerably, maybe infinitisemally depending on the subject matter, less than the 1% I simply used for illustration. 

To non-sufferers they simply don't perceive a threat, and the suggestion that there is one would be treated as nonsense. 

One of the elements that make contamination OCD so believable to sufferers is the "chain of contamination", but this concept doesn't appear to bother we non-sufferers from it - it doesn't appear to hit the rational believable credible spot that we seem to apply to such a concept. 

[BelAnna]

13 hours ago, dksea said:

I know it feels terrible, and scary, and like these things are impossible, I've been there, but just think of how much suffering you are going through on a daily basis, how little freedom you have now, all because of this vastly over-exaggerated worry?

That's true, it is definitely a struggle every day- I haven't thrown up for over a decade and most people only get stomach viruses at most once or twice a year so I know it's not worth wasting so many days over something that happens infrequently. The problem is that I understand that on a rational level but not on an emotional level- the anxiety is still directing my behaviour.

 I'm not saying the fear you feel is not real, of course what you feel is real and painful, but what you fear is not.  I really think that challenging that fear and reaching a better point would be so worth it for you and make your life so much better.  I can appreciate the desire for a vaccine for norovirus (or a cure for OCD) and I would be lying if I hadn't held out similar hopes at times, and thats ok to hope for something good, but odds are its not going to happen anytime in the foreseeable future.  In the meantime there IS an approach you can take that would give you back so much of your life.  

It would be wonderful if they created a Norovirus vaccine but I guess with immunity to most strains only lasting six weeks, it's probably not worth it for most drug companies!

Aye, its definitely going to be harder to tackle something thats been a part of your life for longer.  But keep in mind you won't have to beat it all in a day.  If you take a complete couch potato and ask them to run a marathon the next day the results are probably going to be a cross between comical and tragic.  BUT if you put that person on a plan, regular exercise, slow improvement, in time they could do it.  The same is true of OCD, you can beat it if you take it one step, one day at a time?  Sure, licking the card right now would be too hard for you, so start with something easier, just letting the card sit on a table in your house.  You can choose an out of the way table, something people don't usually use.  Or start by touching a coin.  Pick something small, and work your way up step by step.  What have you got to lose by trying?  You are already suffering so much from OCD after all, its not like all the avoidance is stopping the pain, its just changing it into a different kind of suffering that like the fear, you have gotten used to over time.  

Yes, that's true- I think probably doing something like handling a coin (before handwashing) would be something that I could manage as the threat of Norovirus seems much more remote but my anxiety level would still increase significantly. 
 

I understand this fear, I faced it myself, and it was hard to deal with, but the OCD is lying to you when it tells you you can't do these things.  The reality is you can do them, there will be initial levels of fear and anxiety, but they don't actually stop you from doing anything if you don't let them.  Compare it to someone who smokes and tries to stop.  They get a STRONG feeling, an urge, a demand to have another cigarette.  They genuinely feel like they need it.  But the reality is they don't need it, in fact its better for them NOT to have it.  OCD is like that, though flipping craving for avoiding, it tells you you CANT, when the reality is you can.  It requires some serious hard work, and you can take it in small steps, but you can do it, you are stronger than you know!

That's a really interesting analogy and ties in with the idea that my fear-response is taking over at the moment rather than my more rational thinking!  I'm inspired by how well you are doing with the emetophobia too.

 

13 hours ago, dksea said:

Is your psychologist treating you using CBT?  Are they specifically for anxiety disorders or a different type of treatment?  Also, if things are this severe, this limiting on your life, I'd strongly strongly suggest you do as much as you can to see the doctor and talk with them about trying another SSRI.  Its unfortunate that you had a difficult time your first go around, but a different one might work better and give you the edge you need to really start tackling this problem!

My Psychologist is using a mix of CBT, EMDR and counselling psychology techniques. I might see if I can get a referral from my Psychology to the Psychiatrist at the CMHT to discuss medication options but I think he'll probably say I'd have to visit the GP.

 

Thanks so much for your helpful replies .

[BelAnna]

20 hours ago, leif said:

I agree with dksea's posts...some great advice in there...just wanted to add that I too didn't do great on fluoxetine--I couldn't sleep well at all, and felt jittery though I do think it may have helped the ocd...anyhow after I came off it and relapsed I found I did much better on sertraline...so yes trying a different ssri might work for you too. it's interesting how different they are for each person.

I'm not overly happy about being on meds to control this but I am glad of them as I just couldn't seem to do it with cbt alone.

It's so hard when our lives become so limited by this--I really hope you're able to enjoy your dad's birthday!

That's interesting Leif and good that sertraline was better. Why are you unhappy about being on meds? Do they still cause side effects? 

16 hours ago, taurean said:

Why don't I have contamination or revulsion re vomit fears? 

OCD pushes its suggestions through on the basis that the threat only needs to be as low as 1% to trigger a catastrophic response. 

Non-sufferers judge threats in terms of rational risk and probability so just don't consider the "threats" of OCD as true. 

As for the revulsion theme, for such things as vomit, we might consider them unpleasant - perhaps even disgusting - but what we know about them tells us there is no threat or need for a phobic response or general avoidance; we simply note, then move on and forget.

We aren't being reckless - we are simply being rational based on knowledge previously learned, as a result of which the sentry in our head doesn't sound the alarm - nor do we focus in on the subject matter in a no let go manner. We note, then move on and forget. 

It follows that the goal for the sufferer is to work towards seeing the OCD "threat" as not a threat, in the same manner as a non-sufferer. 

Thank you Taurean. 

I am so terrified of sickness and do find it so unbearably unpleasant that I won't accept tiny risks when it comes to contamination with stomach bugs. Seeing vomit on the ground is not just disgusting but a potential threat- in that it is reasonably like to contain viral particles (unless it's alcohol related, pregnancy related or travel-sickness related vomit!), which would make me sick.

There might be an evolutionary purpose behind Emetophobia as staying away from anyone who is vomiting, is one way of avoiding contagious diseases, some of which would have in the past proved fatal, even if they are just unpleasant and short-lived these days.

I do overestimate risk because if my estimation of risk was accurate then people would get sick more frequently than they do. I know that I should just go about life like a normal person but I'm not really sure how to go about it! 

14 hours ago, taurean said:

In practice, I would say the threat level of OCD to a non-sufferer may be considerably, maybe infinitisemally depending on the subject matter, less than the 1% I simply used for illustration. 

To non-sufferers they simply don't perceive a threat, and the suggestion that there is one would be treated as nonsense. 

One of the elements that make contamination OCD so believable to sufferers is the "chain of contamination", but this concept doesn't appear to bother we non-sufferers from it - it doesn't appear to hit the rational believable credible spot that we seem to apply to such a concept. 

Yes you're right, non-OCDers would probably treat these trigger situations as though they present no risk. 

My problem is that a lot research shows that the 'chain of contamination' really does occur- with microbes spreading up to six times from item to hand to item etc. The reason that people ever get sick with norovirus is that they ingest tiny viral particles from the vomit or poo of sufferers (fecal-oral spread). The way that this often happens is by the virus spreading from someone's poo to their hand, to the toilet flush, to the toilet door handle, to someone else's hand, to their mouth! It seems like nonsense to non-OCDers and yet it is true! 

[daja]

I hope you enjoy your Dad’s birthday BelAnna. 

[BelAnna]

1 minute ago, daja said:

I hope you enjoy your Dad’s birthday BelAnna. 

Thanks Daja, it's been nice  

[taurean]

1 hour ago, BelAnna said:

 

I am so terrified of sickness and do find it so unbearably unpleasant that I won't accept tiny risks when it comes to contamination with stomach bugs. Seeing vomit on the ground is not just disgusting but a potential threat- in that it is reasonably like to contain viral particles (unless it's alcohol related, pregnancy related or travel-sickness related vomit!), which would make me sick.

There might be an evolutionary purpose behind Emetophobia as staying away from anyone who is vomiting, is one way of avoiding contagious diseases, some of which would have in the past proved fatal, even if they are just unpleasant and short-lived these days.

I do overestimate risk because if my estimation of risk was accurate then people would get sick more frequently than they do. I know that I should just go about life like a normal person but I'm not really sure how to go about it! 

Yes you're right, non-OCDers would probably treat these trigger situations as though they present no risk. 

My problem is that a lot research shows that the 'chain of contamination' really does occur- with microbes spreading up to six times from item to hand to item etc. The reason that people ever get sick with norovirus is that they ingest tiny viral particles from the vomit or poo of sufferers (fecal-oral spread). The way that this often happens is by the virus spreading from someone's poo to their hand, to the toilet flush, to the toilet door handle, to someone else's hand, to their mouth! It seems like nonsense to non-OCDers and yet it is true! 

The answer of course, on behalf of the non-contamination sufferers, is that they might not  know because they wouldn't have carried out such compulsive research

I think I knew about the microcobes in colds flu and norovirus, now you mention it. But it would still be low threat on my radar, nothing to sound an alarm. This has to be your target. 

In OCD we fear the theme, say we cannot tolerate it. But we must in order to recover, and it can very definitely be done with CBT. I have the T-shirts 

My erstwhile local hospital, Whipps Cross in East London, had sufferered outbreaks of norovirus and was applying strict health care procedures as a result. 

When I needed to attend it for an X-ray, and another time a blood test, did this strike fear into me? No. I simply made sure I complied with those rules and gave it no further thought. 

I think we are back at the "exaggeration of risk" or at least excessive focus on risk element to contamination  OCD. 

As an insurance broker, risk was a concept I was dealing with every working day. Without risk I would have had no job, no salary, and now no pension. It held no fear for me and I would advise on avoiding, managing and offloading known risks within my specialities. I didn't fear them. I dealt with them. 

And I almost felt pride when a client called me a "necessary evil", though I would have preferred it if he had left out the "evil" 

Edited February 21, 2019 by taurean

[PolarBear]

You know, all this talk about rhreats and evolution is just nonsense. I'm sure you've convinced yourself of these things but at the end of the day there are 7 billion prople on Earth and a small minority have an irrational fear of vomit.

There is no threat from vomit on the ground unless you are going to do something with it that the other 7 billion people wouldn't. 

[leif]

3 hours ago, BelAnna said:

That's interesting Leif and good that sertraline was better. Why are you unhappy about being on meds? Do they still cause side effects? 

No the side effects aren't bad at all. I think I might have had some weight gain, but not too bad and it might not even be the meds but just ageing!

I just always like not relying on meds--I tend to a more natural lifestyle. It was very anxiety provoking to try them, but I must admit I don't see any bad effects from them and would rather be on them than struggling as bad as I had been when I relapsed without them!

[taurean]

I think a good perception of what meds can do is act as "water wings" to hold the sufferer afloat in a sea of distress, balance mood swings and enable them to be able to engage with CBT therapy. 

The SSRIs are also anti-depressants so can aid with the "secondary depression" that is commonly a consequence of OCD. 

If they happen to do more than that for a particular sufferer, that's great. 

But they are essentially a longer term option, and a structured withdrawal programme is needed to reduce, or eventually come off, them - they take a long time to build up in the body's systems, and a long time is needed to gradually work their way out. 

I am planning to tackle this withdrawal process starting in the Spring. Ostensibly it shouldn't be a problem as I am only on a lowish dose of 20mg Citalopram (the max usual dose given in UK for someone of my age (68)) but reactions are so specific individually. 

[dksea]

17 hours ago, BelAnna said:

Yes, that's true- I think probably doing something like handling a coin (before handwashing) would be something that I could manage as the threat of Norovirus seems much more remote but my anxiety level would still increase significantly. 

Yes, its likely you'd experience anxiety, at first, but then thats the goal, to experience and ride out the anxiety, to train your brain that its not worth it to be anxious in that situation.
One thing that OCD sufferers have to face is that anxiety, as unpleasant as it is, won't actually hurt you.  Basically you have to decide you are willing to accept some anxiety now, in exchange for less anxiety later.  Kinda like how a person who starts excercising will feel like **** at first, tired, sore, uncomfortable, but if you push through that and keep doing it regularly, before long the things that used to be really hard for you become much much easier, to the point where you don't even much think about them at all.  

I'm not in great shape now myself, but I do recall back to high school when I did school sports. I remember one particular drill.  We would run a half lap around the track (200 m) and then walk back across to where we started, and have to run again.  We'd do sets of these in a certain time limit.  You'd have maybe 30 second to rest in between each run, which included the walking back to the start part.  When I was in my first year of high school (9th year of school, about 15 years old) I would really struggle. I'd always be near the end, always having a hard time keeping up.  Fast forward a few years until I was a senior (12th year) and I was one of the people leading the way, no longer gasping for breath.  It was still challenging but nowhere near the same way it had been when I started.  It felt so good to be able to look back and see how far I had come.  I think the same about OCD.  Especially at the beginning it seems insurmountable, like you'll never be able to do these things to get better.  And at first, even the basic stuff is hard.  But if you can just push past that initial resistance, it can really open up possibilities for you.  I highly encourage you to setup an ERP hierarchy, it would be great if you can work on this with your therapist, and start taking steps to challenge your OCD little by little.  It would give you so much of your life back, some of which you probably don't even realize you are missing out on after so long struggling with this.

[taurean]

Hi BelAnna. 

You WILL need to go through the ERP hierarchy process in order to get better. 

It matters not which themes of OCD we have - the sufferer needs to work through that process. 

Have I done it? Yes. 

Was it easy? No. 

Is it the best thing I ever went through? No, but it's right up there as Dksea says, it's short-term pain for long term gain.

I struggled with the news. Unpleasant headlines used to leap out of the print and stick in my mind.

I struggled watching TV in case I got spooked by a sudden violent-themed trailer. 

I couldn't watch films with any kind of violent content. 

I had problems travelling because of posters and news screens. 

And now? None of those things are a problem. And if a trigger should pop up, I can gently ease it away without focusing on it. 

I needed to first understand the cognitive side. Harm OCD was targeting my true core values and alleging the opposite could be true. 

Then I was able to gradually work up the hierarchy of ERP, experiencing the anxiety, repeating the exposures in targeted - then freely-encountered untargeted - timings until the anxiety disappeared. 

With contamination issues, it's all about an exaggerated reaction to a nil or minimal threat. We have to realise that first, then work the ERP. Without this cognitive understanding, and acceptance, it is not going to work. 

I was helping a school worker recently who feared a discarded plaster (band aid in some territories) on the floor would harm the cleaner then possibly others. 

To us that seems a nil or impossibly unlikely scenario, but to her it was a potential catastrophe. 

This catastrophic thinking element of OCD is what we must disconnect in ERP to stop cycles of anxiety perpetuating. 

[BelAnna]

On 21/02/2019 at 23:31, taurean said:

The answer of course, on behalf of the non-contamination sufferers, is that they might not  know because they wouldn't have carried out such compulsive research

I think I knew about the microcobes in colds flu and norovirus, now you mention it. But it would still be low threat on my radar, nothing to sound an alarm. This has to be your target. 

In OCD we fear the theme, say we cannot tolerate it. But we must in order to recover, and it can very definitely be done with CBT. I have the T-shirts 

My erstwhile local hospital, Whipps Cross in East London, had sufferered outbreaks of norovirus and was applying strict health care procedures as a result. 

When I needed to attend it for an X-ray, and another time a blood test, did this strike fear into me? No. I simply made sure I complied with those rules and gave it no further thought. 

I think we are back at the "exaggeration of risk" or at least excessive focus on risk element to contamination  OCD. 

As an insurance broker, risk was a concept I was dealing with every working day. Without risk I would have had no job, no salary, and now no pension. It held no fear for me and I would advise on avoiding, managing and offloading known risks within my specialities. I didn't fear them. I dealt with them. 

And I almost felt pride when a client called me a "necessary evil", though I would have preferred it if he had left out the "evil" 

Thanks for your help Taurean. Yes I guess non-sufferers wouldn't have done any research- I sort of wish they would as it might reduce the spread of infection though! 

That's true- my CBT for this hasn't really helped much so far. It's great that you were ok when you visited the hospital during an outbreak. 

That sounds like a really interesting career- I would love it if it was possible to do a realistic risk assessment in all the situations that I face but then that's just because I cannot cope with any doubt due to the OCD! 

Also haha, does sound like you were necessary but not evil! 

On 22/02/2019 at 00:55, PolarBear said:

You know, all this talk about rhreats and evolution is just nonsense. I'm sure you've convinced yourself of these things but at the end of the day there are 7 billion prople on Earth and a small minority have an irrational fear of vomit.

There is no threat from vomit on the ground unless you are going to do something with it that the other 7 billion people wouldn't. 

Hi Polarbear,

No, there really is a school of thought that some phobias evolved because they were valuable to the species. For example being phobic of snakes and spiders would reduce the chance of being killed by a poisonous spider/snake and being phobic of heights would reduce your chance of falling to your death. Similarly being phobic of vomit or blood might reduce your chance of coming into contact with a serious infection (even today things like Ebola cause vomiting, bleeding and can prove fatal). 

Realistically, of course, in the developed Western world, vomiting does not pose a serious threat, unless you're severely immunocompromised! 

On 22/02/2019 at 02:24, leif said:

No the side effects aren't bad at all. I think I might have had some weight gain, but not too bad and it might not even be the meds but just ageing!

I just always like not relying on meds--I tend to a more natural lifestyle. It was very anxiety provoking to try them, but I must admit I don't see any bad effects from them and would rather be on them than struggling as bad as I had been when I relapsed without them!

That's really good that the meds do not cause many side effects.

I can see your point about living a natural lifestyle but if there was a drug that helped my OCD, without serious side effects then I would love to take it! 

On 22/02/2019 at 04:10, taurean said:

I think a good perception of what meds can do is act as "water wings" to hold the sufferer afloat in a sea of distress, balance mood swings and enable them to be able to engage with CBT therapy. 

The SSRIs are also anti-depressants so can aid with the "secondary depression" that is commonly a consequence of OCD. 

If they happen to do more than that for a particular sufferer, that's great. 

But they are essentially a longer term option, and a structured withdrawal programme is needed to reduce, or eventually come off, them - they take a long time to build up in the body's systems, and a long time is needed to gradually work their way out. 

I am planning to tackle this withdrawal process starting in the Spring. Ostensibly it shouldn't be a problem as I am only on a lowish dose of 20mg Citalopram (the max usual dose given in UK for someone of my age (68)) but reactions are so specific individually. 

That makes sense- it would be wonderful if SSRIs really got rid of the OCD rather than just treating the depression that goes alongside it. Have you found them helpful for you anxiety?

I hope things go well when you do withdraw from Citalopram. 

On 22/02/2019 at 07:21, dksea said:

Yes, its likely you'd experience anxiety, at first, but then thats the goal, to experience and ride out the anxiety, to train your brain that its not worth it to be anxious in that situation.
One thing that OCD sufferers have to face is that anxiety, as unpleasant as it is, won't actually hurt you.  Basically you have to decide you are willing to accept some anxiety now, in exchange for less anxiety later.  Kinda like how a person who starts excercising will feel like **** at first, tired, sore, uncomfortable, but if you push through that and keep doing it regularly, before long the things that used to be really hard for you become much much easier, to the point where you don't even much think about them at all.  

I'm not in great shape now myself, but I do recall back to high school when I did school sports. I remember one particular drill.  We would run a half lap around the track (200 m) and then walk back across to where we started, and have to run again.  We'd do sets of these in a certain time limit.  You'd have maybe 30 second to rest in between each run, which included the walking back to the start part.  When I was in my first year of high school (9th year of school, about 15 years old) I would really struggle. I'd always be near the end, always having a hard time keeping up.  Fast forward a few years until I was a senior (12th year) and I was one of the people leading the way, no longer gasping for breath.  It was still challenging but nowhere near the same way it had been when I started.  It felt so good to be able to look back and see how far I had come.  I think the same about OCD.  Especially at the beginning it seems insurmountable, like you'll never be able to do these things to get better.  And at first, even the basic stuff is hard.  But if you can just push past that initial resistance, it can really open up possibilities for you.  I highly encourage you to setup an ERP hierarchy, it would be great if you can work on this with your therapist, and start taking steps to challenge your OCD little by little.  It would give you so much of your life back, some of which you probably don't even realize you are missing out on after so long struggling with this.

Thank you Dksea. Yes I do need to face the anxiety- is it bad that my immediate response to "as unpleasant as it is, it won't hurt you" is that the anxiety will not, but vomiting might? 

I understand what you mean about accepting some anxiety now, in exchange for less later though. 

I have written ERP hierarchies a few times with various therapists and I haven't made a huge amount of progress but maybe it is worth starting again with that. I would love to stop feeling the terror that I feel whenever anyone mentions a sickness bug! 

On 22/02/2019 at 09:01, taurean said:

Hi BelAnna. 

You WILL need to go through the ERP hierarchy process in order to get better. 

It matters not which themes of OCD we have - the sufferer needs to work through that process. 

Have I done it? Yes. 

Was it easy? No. 

Is it the best thing I ever went through? No, but it's right up there as Dksea says, it's short-term pain for long term gain.

I struggled with the news. Unpleasant headlines used to leap out of the print and stick in my mind.

I struggled watching TV in case I got spooked by a sudden violent-themed trailer. 

I couldn't watch films with any kind of violent content. 

I had problems travelling because of posters and news screens. 

And now? None of those things are a problem. And if a trigger should pop up, I can gently ease it away without focusing on it. 

I needed to first understand the cognitive side. Harm OCD was targeting my true core values and alleging the opposite could be true. 

Then I was able to gradually work up the hierarchy of ERP, experiencing the anxiety, repeating the exposures in targeted - then freely-encountered untargeted - timings until the anxiety disappeared. 

With contamination issues, it's all about an exaggerated reaction to a nil or minimal threat. We have to realise that first, then work the ERP. Without this cognitive understanding, and acceptance, it is not going to work. 

I was helping a school worker recently who feared a discarded plaster (band aid in some territories) on the floor would harm the cleaner then possibly others. 

To us that seems a nil or impossibly unlikely scenario, but to her it was a potential catastrophe. 

This catastrophic thinking element of OCD is what we must disconnect in ERP to stop cycles of anxiety perpetuating. 

I'm sorry you had such a difficult time with OCD. It's brilliant that you were able to engage with CBT so well and that you are so much better now. 

That's true that the cognitive aspect of CBT is as important as the behavioural element. I probably do need to collect evidence to suggest that my fears are exaggerated etc. 

Thanks again for helping with this! 

[taurean]

15 minutes ago, BelAnna said:

That makes sense- it would be wonderful if SSRIs really got rid of the OCD rather than just treating the depression that goes alongside it. Have you found them helpful for you anxiety?

Some people do find the drug does more than act as water wings. 

I think for those there is something missing within their clinical makeup that the drug restores, and they need to be on them in order to remain recovered. 

Such persons understand that benefit and have no problem continuing to take the drug. 

It didn't do anything with my OCD- induced anxiety. But for others it does. 

However it does the water wings and, by engaging with therapy, the anxiety went away anyway. 

Is there a danger that when I take the water wings away I will relapse? 

Well I am simply aiming at first to successfully reduce to 10mg. Then I plan to leave a gap and consider my position. Hopefully in due course I can become SSRI free, but if not, then so be it. 

[leif]

6 hours ago, BelAnna said:

That makes sense- it would be wonderful if SSRIs really got rid of the OCD rather than just treating the depression that goes alongside it.

 

6 hours ago, BelAnna said:

I can see your point about living a natural lifestyle but if there was a drug that helped my OCD, without serious side effects then I would love to take it! 

 I didn't have depression along with the ocd and the meds did help the anxiety and ocd symptoms. I had tried to just do cbt without the meds but I just couldn't seem to do it. When I did the meds combined with cbt I improved a lot--and yes no bad side effects. I would always encourage a person to try the cbt without meds first but at some point it's definitely worth looking at. For me, my ocd was so bad I was literally caught in compulsions all day long and could hardly fit in any time to even eat or sleep...I don't think it's wise to let it get that bad otherwise we need to work back through a lot of bad habits/compulsions we've built up.

It does seem we're all different when it comes to meds but it is worth considering.

 

[dksea]

On 22/02/2019 at 07:21, BelAnna said:

My problem is that a lot research shows that the 'chain of contamination' really does occur- with microbes spreading up to six times from item to hand to item etc. The reason that people ever get sick with norovirus is that they ingest tiny viral particles from the vomit or poo of sufferers (fecal-oral spread). The way that this often happens is by the virus spreading from someone's poo to their hand, to the toilet flush, to the toilet door handle, to someone else's hand, to their mouth! It seems like nonsense to non-OCDers and yet it is true! 

Yes chain of contamination exists, but that’s not the issue. The issue is you are allowing the OCD to vastly exaggerate both the level of risk you face AND your ability to avoid that risk from the actions you are taking. 

It’s very likely that you are being exposed to potential health threats in a myriad of more real ways that you don’t even realize/think about all while getting extreme anxiety about avenues of infection that pose virtually zero risk (such as touching a greeting card). 

We have an axiom in the software test industry called the 80/20 rule.  Basically the general guideline is that 20 percent of your work/effort will find 80% of your bugs.  Meanwhile the other 80% of effort is required to find the remaining 20%. Basically this is a version of the law of diminishing returns, that the more you work on something the less benefit you get.  OCD is like this taken to the extreme, people will spend a huge amount of effort, like 99%, trying to eliminate a tiny amount of risk, say like 0.001%.

Does chain of contamination exist? Sure, it’s a key factor in the germ model of disease. It’s why you should wash your hands after using the toilet, before preparing or eating food, etc.  But the degree to which one needs to focus on the chain differs dramatically based on situation and an objective analysis of the situation you find yourself in, worrying about possible contamination from a greeting card would conclude that the level of risk does not match the level of anxiety and mitigation you have come to believe is necessary.  Because of OCD you are not accurately evaluating the cost/benefit in this situation  

 

[dksea]

On 24/02/2019 at 08:21, BelAnna said:

That makes sense- it would be wonderful if SSRIs really got rid of the OCD rather than just treating the depression that goes alongside it. Have you found them helpful for you anxiety?

I also didn’t/don’t suffer from depression, I take SSRIs solely as treatment for my OCD symptoms and for that they have been quite effective. If OCD is like a stuck gear in my brain, the SSRIs act like an oil, allowing things to function much more smoothly. I wouldn’t say I’m 100% symptom free, I’m not cured, but I’m close enough to “normal” the vast majority of the time that I can live a life without having to spare much thought for my OCD. 

Medication isn’t for everyone, for various reasons, and it’s still important to apply CBT in your recovery, but it can be a life changing tool. 

[taurean]

49 minutes ago, dksea said:

If OCD is like a stuck gear in my brain, the SSRIs act like an oil, allowing things to function much more smoothly. 

I had hoped the meds would do that for me, but they didn't.

However I learned how to switch from the active "doing" part of the brain, where all our obsessions and compulsions occur, into the benign "just being" part of the brain, where we operate in mindfulness - in the present in the moment - and that broke the lock in the brain for me.

With OCD it really is a matter of finding something that works for us individually. 

Edited February 25, 2019 by taurean

[dksea]

3 hours ago, taurean said:

I had hoped the meds would do that for me, but they didn't.

Aye, its unfortunate our understanding of neurology and neuropharmacology is still so limited, both in general and relative to other areas (aspirin works pretty much the same for almost everyone, etc.).  Perhaps someday we will be able to create pharmaceuticals that are more consistent broadly and/or custom targeted to each individual.  Or, of course the holy grail, being able to cure the condition completely.  Until then at least we have some tools like CBT that provide fairly decent relief for most.