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angels

Reducing meds advice

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Taking 40 citoplam doing well in therapy 7 good weeks one bad great improvement. Just decided id like to reduce my meds to 30 as i was thinking i dont want to have to rely on tabs for life. Two weeks at 30 felt anxiexty in my body and mind. Spk to a friend who is a nurse and she  said do 30 one day 40 next which i have been doing a feel better physically ocd still playing away parts of the day in the back ground. I am now doubting should i just stay at 40 or continue on. I hate that when i come down the dose ocd is stronger even with all tecniques. Will i have to stay on meds for life. Any one else getting better ocd wise but still on meds as management my ocd has been up at parts in the day and i am not sure if ocd doubting the meds. My ocd switches between lots of themes thank you xx

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Hi angels,

You certainly don’t have to stay on medication for life, people do... but it’s a really personal decision whether or not to come off them after weighing up all the pros and cons and what’s right for you and where you feel you are on your road to recovery. Seven weeks of continued improvement is a great achievement and if they’re helping you at 40mg...I would probably be tempted to maintain that dose for a little while longer while you continue with therapy. Maybe in a couple of months you can reassess and have a chat with your doctor about gradually reducing them again? 

The thing to also bear in mind with medication is it won’t take away the OCD itself and remove the intrusive thoughts and doubts...all the work and effort you’re putting into therapy are where the real inroads in overcoming the disorder are going to be made. If, and it sounds like they are, the medication’s helping you with that work I’m not sure I would rock the boat just for the minute until you feel a bit more confident about your progress.

I should add I guess, I’m just a fellow sufferer, it might be worth gauging your therapists thoughts too about this, and go from there?

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Hi @angels, I wanted to echo some of Hal's advice based on my own experience.  I have been taking meds for OCD for about 25 years now, I'm fortunate that they are very effective with few (if any) side effects (maybe some drowsiness, maybe some weight gain, but that could also be chalked up to my own bad habits :D).   I would also say, to answer your question, is that yes even though I've been on meds long term (and probably will stay on them long term) my conditions have also improved significantly over the years with the help of CBT and experience.  Being on medication doesn't mean just staying put at where the medication takes you.  In fact, in my experience, its vital to continue your recovery with CBT because even on medication you can have good periods and bad periods, and with the help of therapy you are in a much better place to handle the bad days.  

As far as being on medication long term, my personal view is that as long as they are helping me and not hurting me I don't mind staying on them.  Sure it would be nice if I didn't have to rely on them, but its a pretty minor hassle compared to the alternative for me.  Of course not everyones experience with medication is the same, and there is nothing wrong with trying a different path of recovery, its important that you do what you feel works best for you and what you are comfortable with.  Its your life after all!  People can and do manage their OCD recovery without medication or with medication on a temporary basis.  If thats important to you then you can pursue it, but I also second Hal's recommendation that you make sure you do so with the help of your doctor and therapist.  They can help you plan so as to maximize the potential for success and try and minimize difficulties along the way.

I also agree that it may be best to take things a little more slowly.  I've changed the levels of my medication various times over the years and in general I will try reducing my medication only after a fair stretch of stability and good times to make sure I'm in a good place to handle any possible relapses.  It might be best to wait a few months to make sure things are stable before trying to reduce your medication.  Of course the decision is ultimately up to you (and your doctor). Definitely speak to your doctor about changing your med levels, both so they can be prepared in case you have any difficulties, and so they can advise you on the speed with which you should taper down to avoid as many possible problems as you can.

Best of luck on your continued recovery, glad that things have been going well for you lately!

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22 hours ago, Hal said:

Hi angels,

You certainly don’t have to stay on medication for life, people do... but it’s a really personal decision whether or not to come off them after weighing up all the pros and cons and what’s right for you and where you feel you are on your road to recovery. Seven weeks of continued improvement is a great achievement and if they’re helping you at 40mg...I would probably be tempted to maintain that dose for a little while longer while you continue with therapy. Maybe in a couple of months you can reassess and have a chat with your doctor about gradually reducing them again? 

The thing to also bear in mind with medication is it won’t take away the OCD itself and remove the intrusive thoughts and doubts...all the work and effort you’re putting into therapy are where the real inroads in overcoming the disorder are going to be made. If, and it sounds like they are, the medication’s helping you with that work I’m not sure I would rock the boat just for the minute until you feel a bit more confident about your progress.

I should add I guess, I’m just a fellow sufferer, it might be worth gauging your therapists thoughts too about this, and go from there?

Thank you so much for both of your advice i really appreciate you both taking the time to reply.  my anxiety is high this evening i have decided to go back up to 40 as i was feeling alot better than i have been feeling past few days i fear ive set myself back abit and my ocd is higher this evening. My ocd has also latched to the last conversation i had with my therapist we where talking about the best approach to deal with certain triggers.  For example we discussed things that trigger my ocd stress or something someone say etc just examples and she was telling me to not get into the topic and shut it down which i totally agree with.  The example was a stressful situation at work i was dealing with a crisis situation at work and i spoke to a few people about it job related stressful job but i love it. One girl i felt was being judgemental of me it was triggering my ocd. I had a session with my therapist that evening i see her every 8 weeks its going  really well.  We discussed that it would be benefical not to enter into the conversation with her again. I felt if you go to someone with an issue and they ask you how you are to say ok thanks and shut them down after is too abrupt for me. Id rather give a little then shut it down nicely my therspist has my best interest at heart.. i think my ocd has had a field day this evening and is over anaysing her  words..  she is offering advice only.. my ocd flared up as in do i have to say it like she said ..My ocd started questioning what if i dont want to say it the way she said...What if i dont do it her way... does she ecpect me to do it exactly like she did i know this is my ocd at play but i am finding it hard to switch off.  It is very silly as i know she does not mean like that when i said id rather say it like this she said i worry you might over analyse if you dont shut it down. I like to sail my own ship and i think maybe ocd is taking this all too literal i feel anxious i had been doing great i just want to belive in me do things my way and continue to use my tecnuque and get back on track.sorry such a long winded post i feel i am looking for reassursnce to say the therapist is giving you suggestions but obviousbly u do it your own way in how i say it and how i deal with suiting my personality and morals.

 

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16 hours ago, angels said:

i think my ocd has had a field day this evening and is over anaysing her  words..  she is offering advice only.. 

I reckon you’re spot on, and having that insight to see this is OCD up to its usual sneaky tricks shows just how well you’re doing to see this for what it is.

Try tho’ not to use how anxious you feel to gauge how well you’re doing...feeling less anxiety one day and more the next isn’t a sign you’re losing ground in your recovery, it’s how well we can resist carrying out the compulsions that are a sign of progress, and even there we’ll have good and bad days. 

With this specific situation and your colleague, could you adopt a flexible attitude? The best response from an OCD treatment perspective will be to throw caution to the wind and see where the conversation leads...if she says something you’re unhappy about you can try to not avoid it or steer the conversation onto something else and then get back on with work things. 

That’s when the urge to analyse, replay and question if it was the right way of handling it from your therapist’s point of view is going to strike, but you have the OCD’s number on this...try waving the thoughts aside, some imagery may even also help by imagining the conversation tied to balloons floating and disappearing into the sky:balloon: and try to stay focused on the task in hand.

The key is flexibility and trying new ways out to handle this. See how you go, but don’t beat yourself up if you do find yourself going over what was said...it takes time and loads of practice.

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8 hours ago, Hal said:

Try tho’ not to use how anxious you feel to gauge how well you’re doing...feeling less anxiety one day and more the next isn’t a sign you’re losing ground in your recovery, it’s how well we can resist carrying out the compulsions that are a sign of progress, and even there we’ll have good and bad days. 

This is brilliant advice which I think all of us can benefit from remembering.  Don't set your goal to be "I will never be anxious again!", thats impossible, everyone feels anxiety.  Instead, set your goal to be something like "I'll try to deal with anxiety more appropriately" or "I won't let anxiety control my life", etc.  

As Hal says, there will be good days and bad days, remember OCD recovery is a marathon, not a sprint!

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Anxiety is necessary for survival so we want to get it to a more normal amount.  

A lot of things can affect it. Being tired, thyroid abnormalities caffeine, alcohol, nicotine. I don’t know these things about you but it’s important to pay attention to our body if we want to control our anxiety. 

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Thank you so so much for taking the time to support me i really appreciate all your advice xx

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Btw, don’t be afraid of anxiety.  It’s necessary for survival & it’s how we protect ourselves. We don’t need too much tho. Sort of adjust the sensitivity.  

Edited by Handy

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