Intrusive thoughts and exhaustion

[Caffledup]

Hi 

My husband had had OCD for most of his life, he thinks. He has continual intrusive thoughts and sometimes his checking behaviours can affect his routine but he always works hard not to allow this to affect others (usually successful).

He takes his medication (and sometimes breakthrough meds for anxiety) but doesn't find his CBT works, feels he is too weak and can't keep doing it. He has always used alcohol overtly and covertly. But for a few years he has been stronger and able to manage his thoughts much better, was happier in himself and drank only is we were out having a meal. 

We have, personally, had a very stressful 2 years - I have had cancer and his mother is increasingly unwell and unsafe at home. His siblings continue to expect him to support her and do for her and pick up the pieces when things go wrong (as we live closest), when he disagrees with how they are handling things. We both work in the NHS (which we find enormously rewarding, but very stressful) and then Covid! 

Unsurprisingly, we have both struggled and still do but he is really not managing. He is covertly drinking, becoming overwhelmed, disappearing in the car for hours, disappearing on foot whilst drinkung/drunk, has stopped going to the gym or eating properly but the biggest issue is the fatigue.

I guess the OCD alone would be enough to make him exhausted but everything else is adding to it. I often find him asleep when I get back from work and if he is awake he is so tired he is asleep by 7 if he can make it that long. 

This is having an effect on our relationship, family time and generally being able to do anything together. 

I am struggling to manage everything and feel very sad he is in this place again (not the first time he has been like this), sad I cannot help him more and actually very lonely despite lovely friends and gorgeous kids.

Sounds selfish I know, but I miss my wonderful husband and worry for him. 

He is reluctant to seek further help as has had so many meds over the years and tried therapy etc but can't seem to try and so the little things that might help - go for walk, come out for lunch, sit in the garden and read. I can't make him do things but want him to want to help himself. 

Any ideas gratefully received...  or maybe just knowing I'm not alone in feeling like this might give me a bit more strength 

Thanks all 

 

[snowbear]

Hi Caffledup and welcome to the forums.

It isn't unusual for OCD to worsen when life gets stressful and with your NHS jobs  and his mum there's plenty of scope for stress! I think he's doing well to hold it together enough to continue working. However family life and your relationship time is suffering by the sound of things so it would be good to get him to agree to some help.

CBT is the way forward for treating his OCD, but it can be challenging. The pattern of drinking you describe suggests he has got used to using drink as a crutch when he feels stressed. In my opinion it's likely an attempt at CBT at present would only result in your husband drinking more and CBT would 'fail' again. Therefore my suggestion would be to see he gets help for his drinking first. Alcohol makes everything worse. Once that's under control and he's able to face challenges without needing to drink to escape them then he stands a much better chance of succeeding at overcoming his OCD.

Also, when he does have CBT, it would be a good idea to ensure the therapist understands the importance of starting with the cognitive part of therapy rather than with exposures (the behavioural part.) Developing an understanding of what he's being asked to do and why makes doing the behavioural exercises much less stressful, plus he'll have more confidence that he has the inner strength to face up to his OCD and doesn't need a crutch to help him do it.

In practice it may be possible, even necessary, to tackle both problems together. CBT is about learning to recognise how your thoughts and feelings influence your behaviour and that changing your behaviour can also improve how you feel. So it's relevant for drinking problems and for OCD.

However, nothing can be done unless he agrees to it, so your first challenge is to have a conversation with him about where you're at, where he's at, and where your life is as a couple. Encourage him to get referred for CBT either via his GP or your local IAPT service. Good luck!

[Caffledup]

Hello and thank you so much for the advice. 

I think we both know this is the way to go, but as you say, he has to be ready to take those steps.  

More time, patience and gentle reaurrance and encouragement may be needed on my part. 

Useful to know that it's as important to look at the cognitive elements first. My remembrance of previous CBT for him, seemed to be more behavioural and maybe a different approach might work better for him. 

Thanks very much - I appreciate your time and advice very much. 

[Caffledup]

Early October, my husband was so desperate he took an OD.  He survived, but not without sustaining longlasting damage. 

Sadly MH services are so poor, his GP has still not received his report from the Crisis team who discharged him from hospital, nor has he been offered any support or input since. 

No longer fit for work due to the damage he has sustained and no support for how he is going to have to move forward. 

Just as isolated and unsupported  as before. 

 

[snowbear]

Hi Caffledup,

I'm so sorry to hear how bad things have been for you both these past months. How are you holding up with everything that's been going on?

What would you say your husband's mental state is like now? Do you think he's depressed, or mainly tormented by obsessive thoughts still? Is he still trying to cope by drinking more than he should?

It's often hard to know where to start when life just seems to get ever more complicated. What kind of support would be most use to each of you just now?

Have his siblings been supportive? Have they at least taken over caring for his mum, or got her social services input if she's unsafe at home alone?

 

[Caffledup]

Thank you for the support. 

He seems more settled not being in work but it is still the intrusive thoughts that are the issue. He is not drinking, despite still wanting to. He now says this out loud rather than acting on it like before and seems to be aware that he needs better coping strategies. This is positive in itself. 

He is coming to terms with not being able to go back to work, despite it being a huge part of the pressures he was under. So much of his personal identity was wrapped up in the job. So I am hoping he can adjust. 

He has asked the GP a few times for an onward referral for support so I guess it's a matter of waiting or paying for it if he wants to go down that route. 

His siblings have withdrawn completely from him, but they are dealing with their mum who has sadly been in hospital since October herself. His sister chats with me but they don't seem to know what to say to him. 

Small steps, small successes I guess is how we are going forward. He was very pleased that he seemed to be able to employ some CBT to help him manage when he was struggling to put some clothes away. 

Complicated is a good description, but patience and perseverance on all sides needed. 

I have been supported through work to a degree, but understandably there are pressures to do my job as normal despite things at home. I have considered giving up and looking for something closer to home and with less responsibilty to help me manage how I feel. However not sure how we would manage financially so basically hanging on until his decision is finalised through work so I can make a decision. 

As you say, complicated. 

 

Thanks again 

[snowbear]

I'm glad there have been some small successes for you both to hang onto through this difficult time. You know where we are if either of you want to chat more.

[Deestress]

 

My husband has been diagnosed with OCD Intrusive Thoughts and depression.   The last 6 months have been torture for the whole family.  My children are in their teens so understand about depression, they also see the pressure that I am under.  He thinks nothing of keeping me awake for days to discuss his thoughts.  Sometimes I have to work from home to accommodate his obsessive behaviour.  Today was another bad day.  When I explained that everyday I awake with a sinking feeling.  I put on a happy face to see our children off to school and then whilst trying to work I am having to deal with his thoughts.  Every conversation we have is about him and his thoughts, I cannot remember a day when its been about anything else.  

I do not think I have much more to give.   He looks at me like I can sort everything out for him.  He is going to therapy and on antidepressants but I cannot see any improvement.  He is self employed and is taking a break.  And I know he thinks I should take a break from work to look after him but work is my outlet.  My family are worried about my own mental health because my husband is very emotionally draining and has always been.

I am scared things will not get better and I do not feel that I can live like this for much longer.

[Hal]

Hi Deestress,

I'm very sorry you're going through so much as a family because of the disorder...but please, however much your husband wants you to take a break from work to look after him, remain resolute that you can't and won't, unless it's to have a proper break youtself. Taking that route really is a very slippery slope because the more anyone gives to OCD the more it will take. 

Ultimately there's only so much you can do, it really is up to your husband to work harder at not carrying out his compulsions and involving you in them. I wonder though if he's receiving the right level of help he needs to do that...do you know if his therapist specialises in treating OCD? So many claim to be qualified but only provide regular counselling rather than CBT...something that really won't get to the crux of the problem.

This is going to be hard to do but you do have every right to say enough is enough and you're not prepared to always continue colluding in his compulsions. You'll be there to support him and his recovery but won't support a disorder that's affecting the whole family to this degree. I'm not suggesting you refuse point blank to go along with them...I would though explain to him that to get well again he really does need to dig deep and start to gradually reduce them. That might mean he involves you when you're back from work but certainly not at night when you need to sleep.

To be very honest with you I don't know how you're managing to work, look after your children and your husband's demands on so little sleep. You really need to start putting yourself first or you're going to break under this level of pressure. Could you persuade your husband to possibly take a look at the forum? I really think it might be helpful to him. But as I say, it's very important you do look after yourself through this.

[Tikiti35]

I’m so sorry but I can’t offer you any advice but just wanted you to know you’re not alone. I don’t know how you can come to terms with everything that’s happened over the past few year all the while dealing with your husbands OCD - you’re amazing, keep going!