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Re: What is OCD? For those that don't know.... » Bill82

Posted by ed_uk2010 on February 12, 2015, at 12:36:52

In reply to Re: What is OCD? For those that don't know...., posted by Bill82 on February 11, 2015, at 21:21:36

Hi there,

We are often guilty on this board of using a lot of medical/psych terminology such as OCD, dysphoria, bipolar, anxiety disorder etc without qualifying what it really means to us or how horrible it feels. I think you've done really well to describe the distress you're in. It's a lot easier to just say OCD without explaining anything, but if no one knows what you mean, it's difficult to advise or help. Through an improved understanding of your illness, you can gain insight into the workings of your own mind, and begin the journey toward health.

>Yea I havn't mentioned my main obsession resolving sex but it is one of the classic ones and you mentioned it on the page. I masturbate to check that I am not aroused to the thoughts, which can last for hours.

I understand. Classic sexual/violent OCD is always based on the worst thoughts the sufferer can think of. That is the very nature of OCD. The obsession either terrifies or appalls the sufferer (ego-dystonic). You don't need to name your specific symptoms on here. That could cause you more anxiety and isn't necessary. The diagnosis is not in doubt.

>I was in college and was really drunk and couldn't get it up. Was worried what this meant.

People with OCD can often trace back the origin of a particular obsession. The symptoms can begin with a sort of 'horrible realisation' that a certain scenario is possible. The feature of OCD is the person can't brush the unwanted, and often frankly ridiculous thoughts away. It's almost like a form of self-punishment. There is a constant doubt.... what if, what if, what if it's real? What if this happens, that happens etc

>SSRIs would only worsen the problem....

SSRIs rarely affect testosterone levels, but they do produce sexual side effects quite often because serotonin is involved in controlling orgasm/ejaculation and (to some extent) libido.

Am I right in assuming that you fear SSRIs may invalidate the 'usefulness' of your compulsion because they may interfere with your ability to use it to 'disprove' your obsession? (Does that even make sense!?)

>I ponder if I want to be celibate after all this sh*t,
>In accepting my obsession I feel it would ruin the ability for me to ever love again

There's different forms of 'acceptance'.

Here is a invented scenario with typical symptoms...

A young woman has sexual-theme OCD involving recurrent intrusive images and thoughts about having sex with her family members. Her compulsion involves constantly going to the bathroom to check her pulse rate. She believes that if it's fast she must be 'aroused' and that thought is terrible for her. She will then need to measure it again. If it's normal, she has to check it again, 10 times, to 'prove' to herself than the thoughts are 'false'. Sometimes, she checks it 100 times to be sure. She does this for about 4-5 hours a day. She feels she can never do anything which raises her pulse rate, so she rarely leaves her home. She wants a boyfriend but the horrible unwanted thoughts make this seem impossible. She starts to hate her life.

How can she help herself to get well again? On SSRIs, she notices that her pulse doesn't rise as much. She fears that she can't use her pulse rate as a 'measure' anymore, and stops the meds.

Her doctor advises her to try to resist the compulsive checking because it doesn't actually make her feel better for more than a second, she simply has to do it again to be sure. She understand his advice and tries to follow it but can't. She is compelled to check. She feels that if she is a 'bad' person, her life is not worth living, so she has to check and check and check.

So, she tries to change her thoughts. What can she possibly accept or change?

Are the thoughts bad? No. And she is not bad either! The thoughts are unwanted and horrify her. She needs to accept that she is not a 'bad' person. If she was, she wouldn't have spent years hating the thoughts.

How can she come to terms with the thoughts? She needs to accept that the thoughts are OCD. Other people with OCD have bizarre unwanted thoughts too, she is not alone. She needs to accept that since none of her thoughts will ever 'come true', the content of her obsessions don't really matter. NO ONE is being harmed by the OCD except herself. Her family certainly aren't being harmed. They just want to see her well again.

How can she stop the compulsive behavior? Like the masturbation, it isn't helping her. She will not be able to resist the compulsions until she accepts that they are futile. This will be hard to accept because she currently uses them to suppress her anxiety briefly. She needs to let her pulse rate rise in many different circumstances and see that it's not really anything to do with arousal in most circumstances, and even when it is - nothing happens and no one is hurt.... certainly not her family. The thoughts are hurting no one except herself. If the thoughts are not hurting her family, do they really matter? No. They are horrible but they are just thoughts created by the illness. And they won't go away until she lets them lose their power over her.

>Celibacy

Depending on your type of OCD, what would happen if you think.... well, what if I did become celibate? Maybe think to yourself 'I will become celibate until I'm well', and that will be OK. Would that reduce your anxiety?

>doubt it and still wonder what if ect. On top of all this I am also unfortunate to be particularly med sensitive.

True, and you've not had much luck with psychological therapies so far either. The success (or otherwise) of psychological treatment depends a great deal on the type of therapy and the therapist themselves. Is there a different psychologist you can see?

>Although part of me thinks I am making it up and lying.....

Obsessions of doubt?

>So I have been having trouble finding something that is tolerable atm.

Does your doctor have any suggestions? I wondered whether you discussed the possibility of trying an SSRI such as sertraline (Zoloft) at below the normal dose range, since you seem hypersensitive for whatever reason....

Psychological treatments can be of great benefit if you have the right therapist. A bad experience with one tells you little or nothing about how you'll do with another. You can also do self-help psych therapies using information in books or online. There is an increasing amount available.

Take care and write back.

 

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