Posted by g_g_g_unit on January 10, 2010, at 0:47:15
i've been doing my best to commit to therapy lately, and have been astounded to discover how much of a deblitating effect perfectionism has had on my life - to the point that's it's pretty much made me rethink my entire approach to medication. up until now, it seems like i have been trying to use medication as agents to meet perfectionistic requirements, grown despondent when i 'sense' that they've interfered with my functioning somehow, and then quickly abanonded them. so me and my therapist have agreed that until i can let go of that (self-destructive) intuition, i will never really make any progress. sometimes bullying yourself can help to an extent - i know it helped me push myself creatively, socially, academically etc., but the problem is you can destroy yourself trying to maintain those standards permanently. i can cry thinking about how much time, money and components of my sanity i've wasted unnecessarily.
what's most difficult is trying to ascertain why the perfectionism was aroused in the first place; in my case, the perfectionism has graduated to full-borne OCD - no doubt about that - but the underlying condition feels more vague.
i was wondering if anyone can maybe quantify whether any of this sounds familiar, and might be more an outgrowth of OCD or ADD. prior to the OCD fully taking root at around 18, in high school i demonstrated the following problems:
- great ease in 'hands on' subjects like mathematics, where my attention was constantly occupied. i was excellent with detail, but often unable to see the 'bigger picture' - for example, i could memorize large passages of information with ease, but often failed to intuit the core ideas behind them.
- feeling extremely lost when instructions on how to perform a task weren't clearly delineated. if i didn't know what was 'wanted from me', i found it hard to take initiative and act. this also exists in concert with a certain cognitive inflexbility, where i felt like once i had learned how to do something, it was frustrating to find it could be done other ways. it's really hard to tell if that lack of initiative/free thinking is just a confidence issue, or the result of something else.
unfortunately, i've become so reliant on that perfectionistic 'inner voice', that i often feel lost acting without it.
my therapist and i have tried to work out more logical goals for me to attempt to undertake. my family is moving to a new country soon, which means that i need to prioritize. at this point, my former line of work as a freelance writer is causing too much grief (due to too much freedom afforded) for me to really pursue it as a realistic career. so in that sense, i think it might be better to return to university in order to undertake an honor's/masters in an area that might allow me to get a normal job. i also suffer from pretty crippling social anxiety, so feel like that side of things needs to be taken care of.
SSRI's i guess helped by suppressing the need to perform things perfectly, but they don't indirectly improve concentration as a result, and also make socializing even more difficult. the exception might be prozac, which helped brain fog at first, but which i was taken off due to initial insomnia.
Nardil i liked a lot. unfortunately, i kept upping the dose in order to pursue the euphoria. at 75mg+, i couldn't deal with the cognitive and neurological side-effects (RLS, leg-twitching, etc.) which i get on all SSRI's. my anxiety also got a lot worse. i've been thinking maybe a lower dose (60mg) of Nardil might be suitable. i know it can effect short-term memory though. is this more of a temporary or last side-effect? and as for the neurological (and memory) problems, could something like memantine, which might increase dopamine concentrations? improve the problem?
finally, my doctor has arranged for a Dexedrine script, which i get in two weeks. i can see how in the hands of a perfectionist, it might be a disaster, but i guess if there is an ADD component at work, i'll know because hopefully it might correct an underlying imbalance.
so, Nardil seems to cover most of my bases, and thereotically memantine seems like it might be a good augmentation for brain fog issues etc.?
otherwise, i wonder about a more targeted approach like Prozac +dex or an NRI, though am a little concerned about long-term SRI use. all i know is that this time if i find something that works, i really need to try sticking with it, so i'm doing my best to think this through semi-logically.
thanks for anyone who had the patience to read this.
poster:g_g_g_unit
thread:933106
URL: http://www.dr-bob.org/babble/20100103/msgs/933106.html