Jump to content

Recommended Posts

Hi 

I am new to this forum and have recently been assessed as having OCD by a mental health practitioner, they said I had an OCI score of 121. Over the last few weeks pretty much every minute I am awake I am thinking about OCD and cannot sleep as I am constantly thinking about OCD whilst trying to sleep. I am constantly doubting I have OCD and thinking I lied in the questionnaire. I am searching online about OCD continuously and a lot of things ring true but I don't have any issue with cleaning and germs and stuff like that. My house is very messy and I live in a kind of organised chaos and get upset if people move things and throw things away. I also have issues with certain numbers and times, magpies, drains and palms. I have to do certain things otherwise I feel like something bad will happen and get thoughts of headbutting or some other violence to people when I am close to them a lot of the time. I am also wondering if it is schizophrenia or autism. I am 41 and have always had this acute attention to detail,  issues with the numbers, superstition and overthinking things since I can remember but recently the COVID outbreak and big changes at work has made my brain intense with these thoughts consuming my mind. I have been prescribed fluoxetine 20mg but am also constantly thinking this has made my anxiety worse. I am on a waiting list for CBT but I am not sure if this means I have had a formal diagnosis of OCD or not, does anyone know if this is? 

 

Thanks!

Link to comment

The best way to find out would be to actually ask your doctor if you can, or if you have access to your patient records via your GP practice online services, to check that and see if there's an OCD diagnosis. I've personally found that some GPs can be very hesitant to attach a diagnostic label, especially where mental health is concerned, maybe because they're not mental health specialists, but maybe also because they're concerned that a mental health diagnosis will permanently bring stigma with it.

I've had doctors talk about obsessive-compulsive tendecies when discussing my mental health with me, but my actual diagnosis as it's written on my records, as far as I'm aware, is 'anxiety/depression with obsessive characteristics'. The 'depression' part is strange to me, because I don't really have any symptoms of depression, only anxiety, but I know some doctors consider anxiety and depression to be part of the same phenomenon. 

There's a lot of overlap between potential mental health health diagnoses, and they keep being revised and redefined. I've never argued in favour of a formal OCD diagnosis, because as far as I'm concerned, treating anxiety and obsessive-compulsive tendencies appropriately is more important to me than having the words on my patient record. I've also been considered for a possible schizophrenia diagnosis. As I understand it, there's a school of thought that people with OCD aren't always 100% able to recognise that irrational thoughts, feelings and fears aren't likely or fact. I was once told by a psychiatrist that this was a criterion (at the time) to tell apart OCD and schizophrenia. That doesn't mean you definitely don't have a different or additional condition like schizophrenia or autism, though, only a qualified specialist can assess you and make that judgement.

OCD isn't restricted to being about cleaning and germs. I've always had contamination fears, but was never remotely bothered about cleaning until very recently. It was more about analysing past events to reassure myself that I'd never come into contact with a couple of types of animal that could cause disease, and that these animals could never have got into wherever I was sleeping. Other people have OCD fears of hurting or harming others in some way, of intense misplaced guilt that they are responsible for something terrible.

Regarding fluoxetine, it works well for some (myself included), it works less for others, and it doesn't work at all for some. There are other SSRIs antidepressants that can be tried, but it's recommended that you give the medication 2-3 months to see if it's making a difference, as it can be slow to work. Increased anxiety for a couple of weeks is a symptom I do get when I start taking fluoxetine, but I've then found it starts melting away.

Edit: one thing a formal OCD diagnosis can do is mean you're considered for OCD-specialised therapy rather than more generic talking treatments

Edited by AmandaG
Additional information without making multiple posts
Link to comment

Hi @OCD 1, welcome to the forums.  I am sorry you are struggling, and I hope you find your time here helpful.

OCD is, at its core, a disorder of doubt.  In a "normal" brain (someone without OCD) a person will have a thought, their brain will evaluate whether its something to worry about, and as soon as it is sure enough that its not important, it signals that its ok to move on.  In an OCD sufferers brain, unfortunately, the brain sometimes doesn't signal that its ok to move on, even though it should.  Basically for any given thought there is a minimum level of "sure" that a person needs to be.  Depending on how important the event is that level changes of course (one needs to be more sure they didn't leave their baby in a car vs. didn't leave their hat in a car) but its never 100%.  We often think we are 100% sure about something, but in reality we never actually are (we can't be, the universe doesn't work that way).  But OCD sets the minimum threshold to 100%, an unachievable level, and so no matter how hard we try, we feel doubt.

That is why, for example, even though your post demonstrates you clearly meet the criteria for OCD and have been diagnosed as such by a mental health professional, you keep feeling doubt about whether or not you have OCD.  The thought "what if I lied in the questionnaire" is an attempt by your brain to reconcile the fact that you have been diagnosed with OCD against the doubt you feel in your mind that you have OCD.  After all, if it was true, you shouldn't feel doubt right?  Thats how we are trained to think, but the reality is you CAN have doubt AND something can be true.  Its frustrating, and hurtful to have to live with OCD, we have to unlearn some behaviors and learn others, but it can be done.

Lets take a look at some of your specific concerns.
 

11 hours ago, OCD 1 said:

I am searching online about OCD continuously and a lot of things ring true but I don't have any issue with cleaning and germs and stuff like that.

As has been said by others above, OCD is not the same as extreme cleaning or fastidiousness.  Some sufferers DO exhibit that behavior, but it is not required.  OCD affects each person a little differently, so while it can be a relief to share similar traits with a fellow sufferer, not matching another one doesn't mean you don't have OCD.
 

11 hours ago, OCD 1 said:

I also have issues with certain numbers and times, magpies, drains and palms. I have to do certain things otherwise I feel like something bad will happen and get thoughts of headbutting or some other violence to people when I am close to them a lot of the time.

These are all examples of the type of thoughts and worries that can get stuck in the minds of an OCD sufferer.  One thing to realize is that almost everyone gets these type of thoughts, the difference is that people without OCD don't pay much attention to them, if they even notice them at all.  Our brains are incredibly complex, processing massive amounts of input and information at the same time and trying to make sense of it all.  Lots of thoughts are happening all the time in the brain, but in a non-sufferer the brain filters a lot of it out automatically.  The difference for a sufferer is not having the thoughts, its that the thoughts don't get cleaned up normally and we get stuck with them.
 

11 hours ago, OCD 1 said:

I am also wondering if it is schizophrenia or autism.

Its  perhaps possible, but I'd focus on the OCD diagnosis now.  If you've been evaluated by a mental health professional they would have also considered other conditions that you might also be having problems with.  Its more likely these are just more intrusive thoughts that OCD is causing to stick around, try your best to set them aside and not focus on them.
 

11 hours ago, OCD 1 said:

but recently the COVID outbreak and big changes at work has made my brain intense with these thoughts consuming my mind.

Unfortunately stress can exacerbate OCD symptoms, and certainly COVID-19 has been causing a lot more stress in the world than usual.
 

11 hours ago, OCD 1 said:

I have been prescribed fluoxetine 20mg but am also constantly thinking this has made my anxiety worse.

While medication CAN help with OCD, it is not a magic bullet.  It usually takes time for the medication to become fully effective up to 6 weeks in some cases.  Even if you are on the right medication you might not be on the right dose level yet.  One downside of the medication is that in the short term it can seem to increase anxiety.  While this effect fades for most people as your body adjusts to it, some others need to try a different OCD medication due to the side effects of one they might be currently on.

Also due to how each individual responds somewhat differently to the different OCD medications, it can be a bit of a trial and error process to find both the right medication and right dose.  try your best to hang in there and give the medication time to do its work.  Of course if the symptoms become too strong to deal with you can and should talk to your doctor.
 

11 hours ago, OCD 1 said:

I am on a waiting list for CBT

Thats great, CBT is the primary treatment for OCD and unlike medication you don't have to worry about side effects.  I hope you are able to access therapy soon.  But keep in mind that the key to success for CBT will be applying the skills you learn to your daily life.  Its not something where you goto a meeting very week for awhile and then voila you are cured.  The meetings are there to help guide you and train you for the work, work only you can do.  The better and more consistent you are in using what you learn, the sooner you'll be able to take control of your life back from OCD.  I know its not easy to deal with, but there is help AND hope.  Hang in there1

Link to comment

Hi forum, 

Hope everyone is doing well. i really appreciate your support before!

I'm still struggling since my last post, continual doubting of the OCD diagnosis and checking online for answers is taking most of my day. Though can seem to function normally when absolutely required in my job, though need to build up courage and feel drained after doing these tasks. Then this leads me to constantly question that I am faking the OCD and depression. GP confirmed I had severe depression and OCD after another appointment. It also still feels like the fluoxetine is making me more anxious, am getting urges to gamble increasingly more. The lottery, luck and superstition has always been a thing for me which I think is the OCD but now getting these strong urges to gamble a lot more. I really want to unstick my brain and move on from the thoughts of the OCD diagnosis but it keeps on coming back continuously. 

Is this a common occurrence in OCD and are there any ways to un-stick the thoughts?  I am still waiting on the CBT and am hoping this can work! 

Link to comment
6 hours ago, OCD 1 said:

Then this leads me to constantly question that I am faking the OCD and depression

Trust me, you’d have to actively try very hard, and have incredibly in-depth knowledge of OCD, to fake it well enough to convince a trained mental health professional. It’s not something you are gong to do by accident :)

Further, many OCD sufferers continue to be able to function somewhat in their daily lives. Hiding the effects of our OCD from others becomes part of the pattern for many sufferers. Having OCD doesn’t require complete inability to live your life.

Doubting you even have OCD is a common problem. Unfortunately “proving” to yourself with certainty is not possible in those cases precisely because the level of certainty OCD demands when dealing with intrusive thoughts is impossible to meet.

You don’t HAVE to prove it, you can choose to act on the fact that based on professional medical opinion you probably have OCD. It’s ok to have doubt, you don’t have to be certain.  Choose to go with the probable answer.

6 hours ago, OCD 1 said:

Is this a common occurrence in OCD and are there any ways to un-stick the thoughts?

It’s not just a common occurrence, its the whole problem of OCD. If the thoughts didn’t get stuck, you wouldn’t have OCD to begin with. 
CBT can help you learn how to deal with these stuck thoughts and get them unstuck. While waiting for formal therapy you can pick up a book or two on self guided CBT. 
Medication can also help for many people, unfortunately it can take time (6-8 weeks in some cases) to feel the full effects and it may only provide partial relief.  
 

6 hours ago, OCD 1 said:

It also still feels like the fluoxetine is making me more anxious, am getting urges to gamble increasingly more.

How long have you been taking the medication?

Link to comment

Hi Dksea 

 

thanks for your support! yes I think I must have been hiding the OCD for a long time and just felt it was normality, however, it then reached a point where it became intense. Feeling slightly better today though but still getting these niggling thoughts a lot of the time. been on fluoxetine 20mg for 6 weeks now though still generally low mood and high anxiety, with some weird sporadic bouts of  positivity and excitability 

Link to comment

@OCD 1 do you feel a need for objects to be symmetrical and exact? 
 

I get really bothered and upset if people move certain things that belong to me. Not everything but only certain things and and it distresses me until I put them back as they were. I hate it as I am not someone who is materialistic & shallow otherwise. 

Edited by Lost in Thought
Link to comment

Yes a lot things need to be symmetrical and exact. sometimes this helps in my line of work though but the attention to detail and intensive pickiness probably annoys some of my colleagues a lot! I live in a permanent state of organized chaos in all parts of my life, if people decide to tidy up my things or change my systems/planning processes that really annoys me and causes distress as it takes a long time for me to reconfigure things. This distress is then further amplified when people say to me I am unorganized or messy as I know exactly where things are in the "mess" and am very organized in my own system and probably a lot more organized than them as I constantly recheck things though this does cause things to be put off! 

Link to comment
9 hours ago, OCD 1 said:

been on fluoxetine 20mg for 6 weeks now though still generally low mood and high anxiety, with some weird sporadic bouts of  positivity and excitability 

While 6 weeks is generally enough time to get a good idea if the current medication and dosage level are good, it can take a little longer in some people.  20 mg is on the low end of the range for fluoxetine (general range is from 20-60 mg) and OCD generally takes higher doses than depression to see relief.  Sounds like something to discuss with your doctor at your next check in.  I wouldn't be surprised if they recommend trying a higher dose.  Good luck.

Link to comment

Hi dksea

 

thanks for your message. yes I am not sure if the dosage is correct as not having much effect. Does a higher dosage potentially increase side effects? I seem to have had most of the adverse events listed in the PI, though not sure if that is the OCD thinking this. I would like to look into psilocybin and potentially ketamine as some studies seem to have shown effectiveness quicker than SSRIs.

 

 

Link to comment
59 minutes ago, OCD 1 said:

Hi dksea

 

thanks for your message. yes I am not sure if the dosage is correct as not having much effect. Does a higher dosage potentially increase side effects? I seem to have had most of the adverse events listed in the PI, though not sure if that is the OCD thinking this. I would like to look into psilocybin and potentially ketamine as some studies seem to have shown effectiveness quicker than SSRIs.

Unfortunately the only way to know what the effects (both good and bad) will be are to try it. Individuals reactions to SSRIs vary quite a bit so there is no way to be sure otherwise. 
While I completely understand wanting a quicker/easier/more effective solution, research into treatments such as using ketamine are very limited at this point. I imagine in most countries it would be difficult if not impossible to be prescribed something like that legally, and trying to find the right balance using illicitly obtained drugs whose potency and purity you don’t know and likely won’t even be consistent is likely to cause more harm than good. I really recommend sticking with the SSRIs and working with your doctor to find the right drug and dosage combination. It may not be quick but it’s far safer than untested, unregulated alternatives. 

Link to comment

Hi dksea

have taken both psilocybin (magic mushrooms) in Holland and ketamine in the UK. From personal experience previously without knowing I actually had OCD I think they both had profound and positive effects. Ketamine even more so when used in very small doses than psilocybin, however, taking psilocybin in a safer and more controlled environment would probably have made the effects more positive rather than wondering around the streets of Amsterdam! The ketamine experience in a small dosage kind of felt like it reset my brain. I have seen a small study for ketamine https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3799067/ which indicated positive results. Ketamine is available off label in the UK for depression and there are clinical trials ongoing for psilocybin for treatment resistant depression. They are also looking into investigating OCD & psilocybin but need funding: https://www.orchardocd.org/research/faqs-about-the-psilocybin-study/. Unfortunately I am not sure of the situation in Japan I think there is very strict drugs policy there. 

 

 

Link to comment
  • 2 months later...

3 months in since my "diagnosis" my brain feels like it has been on a rollercoaster ride. not sure if it was the fluoxetine or the OCD  but was still getting bouts of the same obsessions, compulsions, intrusive thoughts etc and new ones. GP had upped dosage to 40mg which I am not sure if worked or not. Had a couple of holidays which seemed to help though driving long distance was quite intense at the time (continuous thoughts of crashing the car/running people over) and then on return from holiday anxiety went up massively I think from this long distance drive! Decided to stop taking the fluoxetine for the second holiday so that I could drink - the holiday was good and even though I was getting OCD thoughts whilst I was on holiday I could manage as I have previously done all my life - though now the symptoms seem to be increasing again and wondering if I should start taking the fluoxetine again as at the moment it feels like the same as on fluoxetine without some of the side effects. I don't really want to ask the GP as they will just say to take the fluoxetine again, still waiting on the NHS CBT and have access now through work, but the OCD is stopping me from getting the free work CBT! From obsessively researching OCD I believe may have an ADHD co-morbidity - I was wondering how common is this? 

Link to comment

thanks BelAnna - this is problem I think is causing the increased anxiety for me at the moment as management at work are ramping up the pressure to do things their way and it's overwhelming me to a point I cannot do anything even though I have been the most productive at work ever over last few months with my own processes that I have in place to cope with the magical thinking OCD things. 

Edited by OCD 1
Link to comment
9 hours ago, OCD 1 said:

Decided to stop taking the fluoxetine for the second holiday so that I could drink - the holiday was good and even though I was getting OCD thoughts whilst I was on holiday I could manage as I have previously done all my life - though now the symptoms seem to be increasing again and wondering if I should start taking the fluoxetine again as at the moment it feels like the same as on fluoxetine without some of the side effects. I don't really want to ask the GP as they will just say to take the fluoxetine again


Well in general its not a good idea to start and stop medication on your own.  SSRIs (especially fluoxetine) take awhile to both build up in your body to effective levels and decline from them so its unlikely you'll experience significant change in a short period.  Also, there can be withdrawal side effects, so its better to come off them slowly rather than simply stop and start.

If you don't want to take the medication at all, even if the doctor recommends it you don't have to take it, that decision is ultimately up to you, but I think you know that the right thing to do is talk to your doctor about this.  Even if you decide you want to stop using the medication (which is up to you) you should still follow their advice on how to do that.

Link to comment

Create an account or sign in to comment

You need to be a member in order to leave a comment

Create an account

Sign up for a new account in our community. It's easy!

Register a new account

Sign in

Already have an account? Sign in here.

Sign In Now
×
×
  • Create New...