Medication

[sufferer]

Hello all.

I saw my dr today and he practically threw medication at me, and pretty much ignored my request for counselling.

I think often meds are given too easily, and I'd prefer not to take them if I'm honest.

Has anyone got better without medication? Any tips gratefully received. I've forgotten all my cbt from years ago.

I just desperately want to feel better 

[Guest OCDhavenobrain]

That is how it works. Most doctors just describe meds. Go for CBT

[taurean]

Yes plenty of people can get better purely by diligently learning, then working, CBT. 

As you will see from reading other threads the problem that holds people back from this is not doing the necessary work, not believing therapy rather than the OCD. 

The best CBT for OCD therapist in the world will not have an effect if the sufferer refuses to follow the therapy. 

 

[sufferer]

16 minutes ago, OCDhavenobrain said:

That is how it works. Most doctors just describe meds. Go for CBT

I would, but he glossed over my request for cbt. Maybe I'll call them back tomorrow.

 

5 minutes ago, taurean said:

Yes plenty of people can get better purely by diligently learning, then working, CBT. 

As you will see from reading other threads the problem that holds people back from this is not doing the necessary work, not believing therapy rather than the OCD. 

The best CBT for OCD therapist in the world will not have an effect if the sufferer refuses to follow the therapy. 

 

Thanks Taurean.

I remember cbt worked really well the last time. Sadly now forgotten as it was 10 years ago. Are there any books that teach cbt do you know?

[gingerbreadgirl]

There are lots of really good ones sufferer - break free from ocd by Paul salkovskis is a good place to start  brain lock is good as well. Pulling the trigger by Adam Shaw is also a fantastic book. 

[Guest OCDhavenobrain]

2 minutes ago, sufferer said:

I would, but he glossed over my request for cbt. Maybe I'll call them back tomorrow.

 

Thanks Taurean.

I remember cbt worked really well the last time. Sadly now forgotten as it was 10 years ago. Are there any books that teach cbt do you know?

Please do. Demand to get CBT

[Angst]

My take on medication is that it numbs emotional pain. And therefore can help us over a period of time.

In the UK there is the ‘disease model’ of psychiatric medication. This is the belief that there is some sort of chemical imbalance in the brain causing a mental illness and the medication can solve this imbalance.

As an alternative model known as the ‘drug model’ where pills can provide relief from mental suffering with perhaps a degree of indifference to things which are causing distress. In this model the pills will not cure mental illness but might help in the shorter term. Many say - including me - that a combination of pills with therapy can be helpful.

The body which recommends treatment in the UK indicates that in the vast majority of cases of OCD. CBT should be the first option chosen.

Edited April 29, 2019 by Angst

[Guest OCDhavenobrain]

I have to be more cynical and say that they do this because it is cheaper. And many doctors (of sole strange reason) seems to lack experience with patients with OCD.

Edited April 29, 2019 by OCDhavenobrain

[Angst]

Doctors may recommend pills because they are cheaper or because of resource restrictions on the number of therapists. It depends on the context. The majority of the earth’s population have no access to many forms of medical treatment. I think especially in the case of psychological treatments.

I am  eager to learn about other countries health regimes. I think in Sweden you have socialised medicine as in Canada. In the UK we have a mixed economy of socialised medicine with a private sector. In the US a largely insurance based medical system with socialised medicine for certain groups such as the elderly.

In Sweden would doctors ration treatment options because of cost considerations? We cannot hypothesis in sufferer’s case because she does not cite her country of residence. In the UK there is a difference between England and Scotland on how you could access CBT if denied it at the GP level.

[Caramoole]

I think many/most doctors offer medication as the easiest, most instant option in the absence of being able to offer a quick referral for psychological therapy.  Understandable perhaps but not the best solution.

6 hours ago, Angst said:

My take on medication is that it numbs emotional pain.

That may be so, if you're lucky.  The opposite can also be true, that it can increase anxiety and emotional pain to intolerable levels.  That has been my experience with all medications with the exception of one.  Even with that one there was minimal benefit, it numbed things slightly but did little to improve the big picture and was stopped because it apparently had some cardiac implications (despite being told originally it was safe).  I then had to undergo a lengthy (and challenging withdrawal)

I would go back to your GP and politely, but firmly, ask for a referral for some psychological therapy.

It is possible to use self-help therapy, which I have done.  There are excellent resources available these days from books, videos, information on the web etc etc.  But you have to be prepared to heed, work at and implement the advice.  It isn't enough simply to read about it.....you have to walk the talk, repeatedly....but it can be done, even self-directed.  I stand testimony to that.......I don't consider myself cured because I can find myself challenged sometimes, but I am in control 95% of the time (and keep learning and improving on that).  Why??  I first encountered OCD 43 years ago.  It wasn't diagnosed for 20 years.  Much of it became entrenched, habitual.....response behaviour becomes automatic (despite being flawed) and so it goes on...and on.  It is possible to change the "automatic" response.  It takes discipline and a willingness to accept that we can change things and resist habitual patterns of behaviour.

I still learn every day  and (dare I say) demystify the power of OCD.  I personally have found that rumination (constant trying to work it out/endless internal dialogue) is the number 1, greatest enemy.  Resisting and stopping these internal dialogues have been the most important and beneficial thing......and with repetition, it can be done.  Working it out in our heads "seems"" to be a sensible solution.....it isn't, we have to snuff those conversations, those internal debates out.  It's so easy to get pulled into the trap.  This week I've had a situation (quite a normal one & not a mental health issue) that has found me pulled back into rumination.  The effects are much the same, anxiety & obsessiveness and OCD-like type feelings.  By recognising, resisting, changing the default-mode....you can quite quickly change the outcome.  But you have to actively make those changes...don't accept you have OCD and this is your lot........that's just your brains default, go-to mode.........challenge that default mode and work very hard to stop the habit of rumination (trying to work it out in your head).  Your mind  is  working overtime  to find a solution to protect you.....sadly, it tends to go into the opposite mode and causes more harm than good.  Actively work on resisting rumination and other (comfort finding) compulsions and you will see the benefits.

Whatever someone's "flavour" of OCD is......fear of contamination, harm, disaster, illness or any other......there will be an over-whelming urge to think about, work it ou (rumination/internal dialogue)  Stop....work very hard at not engaging in that conversation and the why's and wherefore's.  With r40-odd years of  experience of this enemy, that would be my advice.  Firmly, ask for help from your GP.....but in the meantime, don't underestimate  your own power.  Even with therapy, that's what will make you succeed.  Trust in yourself.land start Woking today on the rumination/internal conversation issue..  You csn beat this. 

 

[sufferer]

11 hours ago, gingerbreadgirl said:

There are lots of really good ones sufferer - break free from ocd by Paul salkovskis is a good place to start  brain lock is good as well. Pulling the trigger by Adam Shaw is also a fantastic book. 

I'll look into all of these - thanks gingerbreadgirl.

 

11 hours ago, Angst said:

My take on medication is that it numbs emotional pain. And therefore can help us over a period of time.

In the UK there is the ‘disease model’ of psychiatric medication. This is the belief that there is some sort of chemical imbalance in the brain causing a mental illness and the medication can solve this imbalance.

As an alternative model known as the ‘drug model’ where pills can provide relief from mental suffering with perhaps a degree of indifference to things which are causing distress. In this model the pills will not cure mental illness but might help in the shorter term. Many say - including me - that a combination of pills with therapy can be helpful.

The body which recommends treatment in the UK indicates that in the vast majority of cases of OCD. CBT should be the first option chosen.

That's interesting Angst, thank you. When I have taken tablets in the past it has been reasonably short term to help me through a major blip. I would prefer to try without this time though. I'm in the UK (Wales) and had cbt before (10 years ago). The dr yesterday just asked if I had thoughts of self harm and gave me a prescription. No other questions asked.

[Angst]

I think - not certain- that if you are in Wales then the route to NHS CBT is still via your GP. If in England you could self refer for NHS treatment. I have preferred GP to see if I have mental health problems. She is sympathetic and listens.

[sufferer]

8 hours ago, Caramoole said:

The opposite can also be true, that it can increase anxiety and emotional pain to intolerable levels.  That has been my experience with all medications with the exception of one.  Even with that one there was minimal benefit, it numbed things slightly but did little to improve the big picture and was stopped because it apparently had some cardiac implications (despite being told originally it was safe).  

 

Thanks so much, Caramoole.

I have found this in the early stages of taking certain meds in the past. Most recently I had to stop taking Mirtazipine and Fluoxetine (on separate occasions) as they made me so much worse. I couldn't even bear to 'ride out the storm'. 

Side effects are the main reason I don't want to take meds now. I suffer from health anxiety as it is. I can only imagine this would exacerbate the issue.

8 hours ago, Caramoole said:

It is possible to use self-help therapy, which I have done.  There are excellent resources available these days from books, videos, information on the web etc etc.  But you have to be prepared to heed, work at and implement the advice.  It isn't enough simply to read about it.....you have to walk the talk, repeatedly....but it can be done, even self-directed.  I stand testimony to that.......I don't consider myself cured because I can find myself challenged sometimes, but I am in control 95% of the time (and keep learning and improving on that).  Why??  I first encountered OCD 43 years ago.  It wasn't diagnosed for 20 years.  Much of it became entrenched, habitual.....response behaviour becomes automatic (despite being flawed) and so it goes on...and on.  It is possible to change the "automatic" response.  It takes discipline and a willingness to accept that we can change things and resist habitual patterns of behaviour.

I understand this. My OCD was always contamination based, and after over a decade of behaving a certain way (hand washing etc) I decided to challenge it. I am now struggling to know what is normal behaviour, and what isn't. As I've challenged it, my OCD has moved on to something much worse 

 

8 hours ago, Caramoole said:

Whatever someone's "flavour" of OCD is......fear of contamination, harm, disaster, illness or any other......there will be an over-whelming urge to think about, work it ou (rumination/internal dialogue)  Stop....work very hard at not engaging in that conversation and the why's and wherefore's.  With r40-odd years of  experience of this enemy, that would be my advice.  Firmly, ask for help from your GP.....but in the meantime, don't underestimate  your own power.  Even with therapy, that's what will make you succeed.  Trust in yourself.land start Woking today on the rumination/internal conversation issue..  You csn beat this. 

 

I wasn't even sure my new 'flavour' was ocd at all (health worries, thinking about death, existential angst) and even have longed to go back to the days when contamination was my main concern (although I remember how awful that was). But I've spent so much time thinking, and googling, that I guess that could be classed as rumination.

My problem is that unlike the threat of 'I saw a bloody plaster in the street, could I have aids now?' that used to worry me, the thing I worry about now is real and WILL happen one day. I don't know how to get past this  I'm just so fed up of this knot in my stomach.

[sufferer]

3 hours ago, Angst said:

I think - not certain- that if you are in Wales then the route to NHS CBT is still via your GP. If in England you could self refer for NHS treatment. I have preferred GP to see if I have mental health problems. She is sympathetic and listens.

It was the GP that referred me last time. I'll try again.

[sufferer]

I rang the DR to ask if I could be referred for CBT, the receptionist read out that the dr had written 'patient not keen on counselling' in my notes, which is the opposite of what I said 

Still got my Sertraline here. Still not sure whether to take them or not.

[Guest OCDhavenobrain]

Change doctor. He can't be serious. Ditch him. SSRI or not, only you can make that decision. But do not expect magically benefits

[sufferer]

Luckily there are other drs at the surgery so I just won't see him again. He clearly didn't listen to me at all.

[Handy]

SSRIs work by raising serotonin but exercise does that too. On several forums people talk about exercising & it always works to combat ocd.  I think of anxiety as energy & exercising uses that energy up. Voila!

[Caramoole]

9 hours ago, sufferer said:

Luckily there are other drs at the surgery so I just won't see him again. He clearly didn't listen to me at all.

He clearly didn't listen.  Make another appointment with a different GP and clearly state "I'd like to be referred for CBT as I think it would benefit me"  I've experienced this nonsense for over 40 years and have never been given a referral.  For me, it doesn't much matter as because of such, I learned self-Reliance and education......however, it shouldn't have to be that way, you deserve that support as a right as laid down in NICE Guidlines.  Politely (but firmly) kick some butt!

[PolarBear]

1 hour ago, Handy said:

SSRIs work by raising serotonin but exercise does that too. On several forums people talk about exercising & it always works to combat ocd.  I think of anxiety as energy & exercising uses that energy up. Voila!

Not voila.

SSRIs do not raise serotonin levels, per se. They selectively stop the reabsorption of serotonin, making more available. It does not cause more serotinin to be made.

Exercise is a good thing but it is no substitute for CBT, with or without meds, in combating OCD.

Edited May 6, 2019 by PolarBear

[sufferer]

8 hours ago, Caramoole said:

He clearly didn't listen.  Make another appointment with a different GP and clearly state "I'd like to be referred for CBT as I think it would benefit me"  I've experienced this nonsense for over 40 years and have never been given a referral.  For me, it doesn't much matter as because of such, I learned self-Reliance and education......however, it shouldn't have to be that way, you deserve that support as a right as laid down in NICE Guidlines.  Politely (but firmly) kick some butt!

I have told them that he got it wrong and asked that he refer me. It just made me so cross that he clearly hadn't listened at all.

 

7 hours ago, PolarBear said:

Not voila.

SSRIs do not raise serotonin levels, per se. They selectively stop the reabsorption of serotonin, making more available. It does not cause more serotinin to be made.

Exercise is a good thing but it is no substitute for CBT, with or without meds, in combating OCD.

I started taking my meds today. I figure that whilst I worry about the health implications of taking them, surely there are also health implications to being in a constant state of anxiety. Swings and roundabouts I guess. 

Will eagerly await cbt referral too.

9 hours ago, Handy said:

SSRIs work by raising serotonin but exercise does that too. On several forums people talk about exercising & it always works to combat ocd.  I think of anxiety as energy & exercising uses that energy up. Voila!

Thanks Handy. I am trying to get fit, so fingers crossed it'll help.

[Handy]

Quote

I started taking my meds today. I figure that whilst I worry about the health implications of taking them, surely there are also health implications to being in a constant state of anxiety.

The body is not made for being in a state of anxiety for long periods. So given time, the anxiety decreases. 

 

[PolarBear]

ROFL. Where do you come up with this crud? I was anxious for 40 years. Sure it ebbs and flows but I rarely if ever reached a point of not being anxious.

[KaKop]

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

[Handy]

22 hours ago, PolarBear said:

ROFL. Where do you come up with this crud? I was anxious for 40 years. Sure it ebbs and flows but I rarely if ever reached a point of not being anxious.

From this forum.  

Edited May 7, 2019 by Handy