Posted by fca on September 29, 2006, at 17:26:09
In reply to My Brain is on Speed, posted by MCush on September 29, 2006, at 12:54:28
I have an anxiety disorder with some OCD features--you can find some posts of mine(fca) on SIAD where I just saw a post of yours. I am glad you are getting as much information as possible. It does sound as if there is some OCD in your thoughts and behavior. The only real test is if your obsessive thoughts and or compulsive behaviors interfer with your daily life. It certainly does sound as if you are experiencing a great deal of anxiety. The good news is that medication for both anxiety disorders and OCD is often quite similar: I see you are taking Epival--have you been diagnosed bi polar (with mania) or are you using it off label. It is a pretty potent drug with potentially difficult side effects. If you are Bipolar this is out of my league so ignore what I am saying except for cbt/erp and healthy living.
Common protocol includes:
1)SSRIs (higher dosage for OCD than depression or anxiety) alone or SSRI and possible benzo as needed during initial titration or until side effects are minimal--with a history of substance abuse your are less likely to receive a benzo--historically preferred SSRIs for OCD are paxil, prozac, luxox--I am not sure it really makes any difference--BTW--you can easily move from one to another wwith little problem as long as you have not discontinued one before starting the other2)SSRI plus benzo or other anxiolytic on a regular basis or until anxiety is dampened and symptoms are under control
3)A TCAs or other drugs--
4) Who knows--but plenty of options
The important thing to remember from my perspective (as a 35 year sufferer with mostly successful experiences and 40 years in the MH profession)
1) Good CBT and ERP are extremely important
2) Give the meds a chance--6-12 weeks at least before switching--response for OCD tends to be longer--higher dose can be quite important
3) If they are not working do not be afraid to switch
4) No matter how good the meds are you need to do the things you need to do as much as is humanly possible for you--work, school, some social life, exercise, blah,blah,blah
4) Stay in CBT and/or ERP as long as necessary and refreshers are usually necessary and important
5) Alcohol and drugs a no no--any temporary relief displaced by almost inevitable rebound anxiety etc--if you really are completely clean and sober benzos can be helpful--they are discouraged as a first line response but.....you are already taking them.
Probably more than you wanted and I apologize if so--perhaps to simple minded
However--my best wishes and good luck fca
poster:fca
thread:690211
URL: http://www.dr-bob.org/babble/20060927/msgs/690268.html