Help me understand OCD/Anxiety Disorders...

[ma23peas]

A family member of mine just received this diagnosis....I'm trying to look back and see a trend....she is in college and just dropped out this week. The college doctor (her parents' insurance won't kick in until mid-April..job change) she went to gave her this diagnosis and prescribed prozac. I am not a fan of that drug, especially in younger adults.

 

Background facts: Through her teens she went through a few anomalies (but many teens do, so not many of us thought much of it) but she went through a handwashing phase, literally chapping her hands, she could not stop it. That ended after about 7 months. Then she went through a vegetarian phase (not saying anything negative about it, but the way she went about it was more OCD I guess than you'd think)....that lasted 3 years, she has for about a year now added meats back in. She had some episodes of freaking out about germs...one time another cousin was brushing her hair with this girl's brush and put it in between her legs while she was bending over to pull her hair into a ponytail, the other niece really overreacted about the whole thing. Those are really the only things I can think of over a span of 7 years where anything 'different' was going on..she's a pretty happy go lucky girl. This was her second semester in college...I'm wondering if the stress of college could make it worse?

 

My concern is of course for her welfare and part of that is her sleep patterns, I do not think she has gone to bed before 2am for 6 years. Her parents just said that's how she is. They never tried to help her in this area. She came to visit me for a week and the first night stayed up until 2am..but I woke her up at 7am and made her go with us for our daily schedule..she helped out on the farm and was zonked at 10pm...she went to bed at 10pm each night after that and woke up normally..it was almost as if she was a different person. Can sleep rhythms have a significant affect on those with issues like these?

 

I guess I'm just trying to find ways that we can help her....any modifications that may mean a lesser prescription or help her symptoms? Right now, I think her main symptom is performance anxiety, she is in school for voice and she could just not perform. She's never had that problem...please say a prayer for her if you can and any insight from those who have experience with this please share...

[Night Elf]

Wow, she changed her entire sleep pattern in one 24-hr cycle? I'm impressed. I don't go to bed before 2 am and I sleep at least 8 hours each night (and that is a good thing). But even when I wake up really early like 7am, I still can't fall asleep before 2am the next night. Of course, I've never worked on a farm or done anything so labor intensive. The most active I've been is an hour of exercise but it didn't help me go to sleep any better.

 

One of my diagnoses is OCD, thought related not physical repetitive actions. It's a nightmare without my meds. Life was not good before meds. Sometimes they really are necessary and I'm not ashamed to say I need them.

 

She could certainly seek a second opinion and should also discuss any possible meds with her doctor. It's also important to realize that not everyone responds to the same medicines. For example, prozac does nothing for me.

[GingerPoppy]

I have a family member with (undiagnosed) OCD. She went through the bright red, raw hands from over-washing phase. She is obsessive about germs in some ways--won't eat something that's been expired even a day, forces hand sanitizer on her kids a lot, won't simply wash and use dishes that were in the garage in case they were contaminated by mice, will only wash all loads of clothing on super hot, extra long wash, etc. On the other hand, she is a hoarder and hardly cleans, so her family was living in filth, and I mean truly dirty, stinky, gross filth. She doesn't see the discrepancy.

 

She's completely obsessed with safety, to the point that she was forcing her kids to bring along a carbon monoxide detector when they went to other people's houses (including mine). She wouldn't walk into my parents' house without barring and locking the back door and going around and "safety-izing" a bunch of stuff (and her youngest was not a toddler, but more like five). She won't drive away until she's checked and checked the seatbelts on her kids--this takes around 15 - 20 minutes each and every time.

 

There have been weird behaviours around food. Kind of like what you said about the vegetarianism, my family member was doing a bunch of fasting that we think was tied in with religion, but done in a very OCD way for what I believe were OCD reasons. So I understand. She also is extreme with religious beliefs, praying before drinking even a glass of water and encouraging her kids to do the same, and other similar rigid thoughts and actions.

 

And there's much more. But suffice it to say, it's a lot.

 

She was a pretty happy go lucky kid, too, other than a wild temper in a few situations. She was a very easy teen for my parents--no bad behaviours. The only sign in her childhood was that she went through a stage of trichotillomania (pulling out hair), but that resolved.

 

The turning point was when she met the loser father of her children. He took over her life and treated her badly. The stress must have been incredible... and yes, stress is a trigger. She also was living in a kind of bubble that he had created for her, as she wasn't allowed much outside contact, especially at first. She lost all of her friends. She caused endless anguish for her family.

 

She is finally not with the loser anymore, but the remnants are all still there. In many ways he still controls her and the raising of the kids, plus he simply changed her into a different person and it will be a long, hard climb out if she ever decides to get help. At this point, she doesn't think she has a serious problem at all.

 

Ok, well that was depressing but somewhat cathartic. I don't know if it will help in any way, but there's my story anyway. She sleeps decent hours, since you wanted to know that. She absolutely does better with less stress. I'm sure really wholesome food and certain supplements would help. I guess if I had any bottom line message, it would be... find a way to get her to seek as much help as possible before it gets bad and sucks her life into a black hole, like it did with my family member.

[Slartibartfast]

I like Wellbutrin for my OCD but mine doesn't manifest the same. I do have a lot of issues sleeping, I take a prescription antihistamine that helps.

[sbgrace]

I'm sorry she's suffering. :grouphug: You are certainly mentioning OCD signs in her. I believe that time of life (college age) would be a typical time for things to worsen. Stress in general might worsen the symptoms and girls typically present later than boys. Further, OCD can wax and wane so be manageable and then suddenly worsen. The type of OCD can vary over time and, therefore, so would the symptoms you see. OCD can be all internal/thought based without outside observable actions. In that case you might not see anything.

 

Meds can be life savers literally. She likely needs that medication right now. It takes a while to "kick in" and help. I hope the doctor made her aware that the effect won't be anything like immediate. I wanted to add that taking meds and feeling like you'll be on them "for life" can be hard even without family support. And when I said they can be life savers they really can and often will be at least quality of life savers for those with OCD. She sounds like she really needs help to function. So I'd encourage you to be supportive of her medication if you can.

 

I agree with the pp that I'm shocked a person who regularly stays up to 2 am was able to suddenly adjust her sleep patterns! Good for her though. At any rate her sleep phase issues and/or late owl issues (which are likely inborn for her) would not be contributing to the OCD. Lack of sleep might...back to the stress thing...but then OCD can interfere with sleep so you have a chicken/egg question. Either way going to bed at 10 won't change her OCD.

 

Inositol is a b vitamin that in very high doses can act in the brain like the prozac and similar drugs. The doses for OCD are extremely high and it's dosed three times a day by mixing powdered inositol in a drink. It's much easier for her to just do a regular antidepressant effective with OCD. I might not have picked Prozac as the first try (maybe Zoloft or Celexa) but I guess I'm not surprised they did at her age. Adding N-acytl Cysteine (a readily available supplement that's very safe) might help the OCD in concert with the medication. If it does it might be a clue glutamates (in lots of foods) are a component.

 

The best thing she could do is get Cognitive Behavioral Therapy (CBT) with a therapist who specializes in OCD treatment. Just any therapist, even a CBT therapist, isn't a good choice for OCD. It needs to be someone trained to treat that disorder as the treatment is quite specific. The OCD foundation (online) has lists of providers. The website also has lots of information that might help you learn more about it. Some is geared toward loved ones. If she can see someone good it would be most helpful. She may even be able to eventually get off meds with the techniques she learns or, if not, at least it will very likely give her better control than otherwise.

 

:grouphug:

Edited March 31, 2012 by sbgrace

[A.Balaban]

I am OCD as well.

 

My big concern with your post is your attitude. She's a young adult now, and she needs to learn to take care of herself. Yes, overmedication is bad but she needs to find a stable place again. One medicine won't work for everyone, and it takes weeks and weeks to figure out if a medicine is working. You have to give it time to work. If you start putting negative thoughts and emotions into this, she will start to feel bad and be non-compliant with her meds. She might end up on a different drug in a couple months anyway.

 

Yes, her sleep habits are bad, but that's her choice. Unless she is suffering from anxiety that is not letting her sleep, I don't see how this relates to her OCD/Anxiety. Sleep habits affect daytime activity. Energy levels, hormone levels, etc. So yes, sleep is important, but I think she needs to want to regulate her sleep better. (Of course, if she is now a college school drop out, why does she need to?)

 

For an extreme example, when my sister went into rehab, she started smoking a lot more. The heroin addiction was "replaced" by the nicotine addiction.... and there was the help of some pretty strong medications. My mother, in her panic to "do what's best" urged my sister to quit her medications (because it's addictive and can control her life). She would also constantly urge her to cut back on the cigarettes. I would tell my mother that this process had to be done slowly, and carefully. She needed to be stable before she could really figure things out. At less than six months sober, my sister relapsed.

 

Your family member is obviously going through a tough time, and the best thing you can do for them is be supportive and give them a shoulder to lean on. If she asks for your help... that is when you can give your opinion. However, your opinion should always start with: "I am not a medical professional, so please discuss this with your Dr/therapist... but it is my feeling that..."

 

I, for one, need to get back on my medication... but that's JMO.

[MamaSheep]

Prozac has been a life=saver for my son, who takes it for OCD and GAD. One side effect it can have is to affect sleep patterns, though not necessarily in the same way for everyone. For my son, it has really helped regularize his sleep patterns so that he now usually goes to sleep at a reasonable time, sleeps all night, and is ready to wake up and get on with the day in the morning. Although the other night I did hear him up doing laundry in the middle of the night so he does still have some bouts of insomnia, but it's SOOOO much better than it used to be.

 

I also like that Prozac has been around long enough to have established a track record so I don't feel like it's likely that some unexpected health risk is as likely to crop up down the road. But like someone else said these meds affect different people in different ways, and sometimes it takes a while to figure out which is best for any particular individual.

 

Something else to consider before you get too negative about medication is that being unmedicated also has negative "side effects". Sometimes you have to look at both sides and just decide which set of side effects you would rather live with. And by "you" I mean the family member in question, not "you" as an outside party. She's the only one who knows what it feels like to be in her head, and she is old enough to make her own decision.

[lewelma]

My OCD is aggravated 10x over by stress, and school stress was the worst. I am a checker and an intrusive thoughts type. Once I left university, my symptoms reduced year after year.

[ma23peas]

Thank you all!!! Such wonderful insights and some very hard situations expressed!

 

I have offered for her to come and stay with me for 2 weeks, I just wanted to be as informed as I could with how to help her, encourage her and support her through this. I was in the pharmaceutical industry for 10 years so I know more than I need to know about many medications...my biggest issue with Prozac is that it really needs to be taken daily and at the exact hour to maintain a steady state therapeutic level...my biggest fear is that she is not capable of doing this...she is likely to skip doses or double up on missed ones, then I have serious reservations about the efficacy the drug can provide for her. I kind of wanted her to come here so that I could impress upon her the need to take it as prescribed...her parents are just not the kind to be diligent with stuff like this.

 

Interestingly, I think her mother might have some root issues? One of you mentioned hoarding...I do not think she hoards but early in their marriage, I went to visit them when I was in town and the house was in horrible condition...honestly, it would have been condemned on many levels...feces on the wall in their bathrooms b/c they ran out of tissue and their son used his hand? microwave that was coated in black, could not see a single white plastic wall! I spent 12 hours just trying to clean what I could....I won't even say what the oven and fridge looked like...but I just could not see how a home could be like that....her mom really had no opinion...just acted surprised when I showed her how to clean stuff....it made me so sick that her daughter was living in this and her son. Her entire wall in her kitchen was covered in fly mess...it was bizarre. I just assumed it was b/c her mother was lazy, she is known to just sit around all day reading romance novels (she does hoard those). I just have not dealt with issues like these and know the family has no structure, I just don't know if they are going to make things worse for their daughter by not being able to help her... :(

[Mergath]

I was diagnosed with OCD about a year ago. I have the obsessional kind, where I'll sit and worry about something completely illogical for days, to the point that I can no longer sleep or function. Celexa works well for me, and if I go off of it, my life is a nightmare.

 

The best thing you can do is to support this girl. If you start telling her she shouldn't be on prozac because it's bad for her, you could send her into a downward spiral that ends with her refusing to take any meds at all, and she'll probably need to be on at least one med to lead a normal life. So just be supportive, without trying to rediagnose her or fiddle with her medication.

[Night Elf]

I have offered for her to come and stay with me for 2 weeks, I just wanted to be as informed as I could with how to help her, encourage her and support her through this.

 

It's wonderful that you want to help her but in the end, she will be the one to make her decisions. You can let her stay for a couple of weeks and help her remember her meds but that doesn't guarantee she will remember them after she leaves. And I hear your concern about Prozac, but do you have the details for all meds that can be used for OCD to help her make an informed decision about which one to take? That might be very helpful information for her.

 

FWIW, my ds15 was on Zoloft for OCD but it's lost its effectiveness and he is being put on Anafranil. His doctor told me that was one of the most effective meds for OCD. I hate beginning new meds. It's very nerve wracking.

 

I also hear your concern about helping her do things to combat the OCD. I would think she could get some type of help if she sees a counselor. My coping technique that I have worked on with my therapist is redirection. When I begin obsessive thinking, I talk aloud to myself and tell myself to stop and then I purposefully find something active to do that will engage my mind. My combination of meds help tremendously but they do not cure all of my issues. I'm very thankful for the support of my family and children. They all recognize when I'm having a bad time and will also actively help me through it. I can't imagine being without that support. If you can let your niece know you are there for her anytime, she might really respond to that. I'd like to say, however, to be careful about what you say or do because it's very easy to misunderstand someone when I'm in the lows of issues such as obsessive thinking. I had to learn to let my DH help and remember that he is never putting me down, which I did misinterpret many times. I tell you, it's not an easy road. It's really bad when I sit and think about how this is a lifelong condition. It's just helpful that my family understands that. Well, not my mom. She's not supportive at all. She hates any type of medication for mental issues. She has mental issues herself, but denies them and believes that that all psych doctors are out only to make money off the gullible. I cannot talk to her about anything related to this. I'd rather have a neutral relative than one who actively seeks to destroy any faith I have in my team of doctors.

[AngieW in Texas]

We had to search to find an OCD specialist for our dd. There are only 2 in my major city and they aren't on my insurance. The improvement my dd has made in a very short time is very encouraging, but it is a long and slow road. This will always be a challenge for my dd.

[Joanne]

I'm concerned about your perspective on mental health - at least in this case. OCD and anxiety are often brain function anomalies. They are often related to something wrong with their bodies. This is why prescription meds can help - because they treat the problem.

 

Exacerbating issues (nurture and environment) can be helped by loving, informed people, professionals, etc.

 

You seem, judging by your posts, to be wanting her NOT to have anxiety or OCD based on some reaction to them in general. I would respectfully suggest working on your perspective on mental health before trying to "help" her.

 

What *I* read when I read your post on the topic is a desire to change her into a behavioral pattern that more closely fits your standard. I'm not sure that is therapeutic for her - or anyone!

 

Some people have anxiety and OCD. *shrug* While I don't encourage people *seeking* to have mental illness, I also don't imbue having one with a stigma.

[ma23peas]

I'm concerned about your perspective on mental health - at least in this case. OCD and anxiety are often brain function anomalies. They are often related to something wrong with their bodies. This is why prescription meds can help - because they treat the problem.

 

Exacerbating issues (nurture and environment) can be helped by loving, informed people, professionals, etc.

 

You seem, judging by your posts, to be wanting her NOT to have anxiety or OCD based on some reaction to them in general. I would respectfully suggest working on your perspective on mental health before trying to "help" her.

 

What *I* read when I read your post on the topic is a desire to change her into a behavioral pattern that more closely fits your standard. I'm not sure that is therapeutic for her - or anyone!

 

Some people have anxiety and OCD. *shrug* While I don't encourage people *seeking* to have mental illness, I also don't imbue having one with a stigma.

 

 

Not at all, my concern lays in knowing how to help her. I have had no experience with any of these disorders, I sold medicines for schizophrenia which is a completely different beast but similarly related to hormones to some extent. I am sorry if my post came across that way, as I mentioned I am not a fan of Prozac because I have seen the bad results associated, many patients on the antipsychotic drug I represented had experience with Prozac as well, so my experiences with it have by far been negative. It is reassuring to hear others have had success with this drug and even with dosage increases.

I am going to help her family find the quality care she needs, they just are not aggressive when it comes to the medical issues...there are many ways you can find the better mental health care providers...I just want the best or her so she can regain some confidence in her future.

[Joanne]

Not at all, my concern lays in knowing how to help her. I have had no experience with any of these disorders, I sold medicines for schizophrenia which is a completely different beast but similarly related to hormones to some extent. I am sorry if my post came across that way, as I mentioned I am not a fan of Prozac because I have seen the bad results associated, many patients on the antipsychotic drug I represented had experience with Prozac as well, so my experiences with it have by far been negative. It is reassuring to hear others have had success with this drug and even with dosage increases.

I am going to help her family find the quality care she needs, they just are not aggressive when it comes to the medical issues...there are many ways you can find the better mental health care providers...I just want the best or her so she can regain some confidence in her future.

 

Your desire to change her sleep/wake cycle, the phrase you used to "lesser prescription", the looking for a reason (performance anxiety, stress of college).....it all speaks to an orientation about her diagnosis that right now at this time I am not sure you are in a position or mind frame to help her.

 

She has meds, and I presume, support in terms of therapy. I feel like you are trying to out-guess the professionals and undermine what she (an adult) is doing with the help of her close family members.

[ShelliR]

I want to second the post up above that recommended Cognitive Behavior Therapy specific to OCD. My sister has had SEVERE OCD for over 10 year and has had 2 inpatient hospitalizations for it. The only things that helps, IMHO is medication in combination with Cognitive Behavior Therapy. My sister improved greatly after each hospitalization but then couldn't maintain because she couldn't find a follow-up therapist who could be helpful at all! The problem is, that they are hard to find. Once one is located (maybe with the help of the OCD foundation), I would recommend just moving to whatever that town is. I know that may sound extreme, but my sister is stuck in her home, with no help near her and I don't know if she'll ever get the help she needs again. I realize that she is an extreme case, but she was leading a normal life 15 years ago.

[Jean in Newcastle]

I would be pretty upset as a parent if a family member decided that I wasn't pushy enough with my own child's medical needs and decided to figure out the best medical plan for her. Not to mention that as an adult college student, I would be also upset if someone who was not my parent tried to take that role.

[ma23peas]

I would be pretty upset as a parent if a family member decided that I wasn't pushy enough with my own child's medical needs and decided to figure out the best medical plan for her. Not to mention that as an adult college student, I would be also upset if someone who was not my parent tried to take that role.

 

The key is these parents have called me in the past on their medical questions because I was premed, worked in the industry for 10 years and unfortunately have had to seek out specialists at St. Jude, Vanderbilt, Children's hospital, and the Mayo clinic because of acute and chronic illnesses my own daughter has suffered from in the past. Before they make that call, I want to make sure I am informed nd not relying on my own experiences. That is why I shared my observations and why I have sought out help here.

You both may not have read my concerns put later in the thread..there is a history of her parents neglecting their living condition to extremes...this translates into concerns. I am only helping if asked to, but I want to be as educated on the issue as I can. In no means am I calling them up and dictating care, but if they ask, it is because they are not confident in knowing how to help her...the more information anyone can gain will only help.

[ma23peas]

I want to second the post up above that recommended Cognitive Behavior Therapy specific to OCD. My sister has had SEVERE OCD for over 10 year and has had 2 inpatient hospitalizations for it. The only things that helps, IMHO is medication in combination with Cognitive Behavior Therapy. My sister improved greatly after each hospitalization but then couldn't maintain because she couldn't find a follow-up therapist who could be helpful at all! The problem is, that they are hard to find. Once one is located (maybe with the help of the OCD foundation), I would recommend just moving to whatever that town is. I know that may sound extreme, but my sister is stuck in her home, with no help near her and I don't know if she'll ever get the help she needs again. I realize that she is an extreme case, but she was leading a normal life 15 years ago.

 

I think she would greatly benefit from these therapies! She is a bright girl and I think if she knows it works for some, she would be encouraged....thank you! She lives close to a metro area and I know they must have that available!

[ma23peas]

Your desire to change her sleep/wake cycle, the phrase you used to "lesser prescription", the looking for a reason (performance anxiety, stress of college).....it all speaks to an orientation about her diagnosis that right now at this time I am not sure you are in a position or mind frame to help her.

 

She has meds, and I presume, support in terms of therapy. I feel like you are trying to out-guess the professionals and undermine what she (an adult) is doing with the help of her close family members.

 

You presume too much, there is no therapy at all, just sent home with a prescription. My frame of mind is seeking out experiences from others and I shared my own...if you can not help in this regard...how is that going to help her? No one in our family has experience with these issues...we are all trying to become more informed and I greatly appreciate the help.

[Joanne]

The key is these parents have called me in the past on their medical questions because I was premed, worked in the industry for 10 years and unfortunately have had to seek out specialists at St. Jude, Vanderbilt, Children's hospital, and the Mayo clinic because of acute and chronic illnesses my own daughter has suffered from in the past. Before they make that call, I want to make sure I am informed nd not relying on my own experiences. That is why I shared my observations and why I have sought out help here.

You both may not have read my concerns put later in the thread..there is a history of her parents neglecting their living condition to extremes...this translates into concerns. I am only helping if asked to, but I want to be as educated on the issue as I can. In no means am I calling them up and dictating care, but if they ask, it is because they are not confident in knowing how to help her...the more information anyone can gain will only help.

 

 

 

 

You presume too much, there is no therapy at all, just sent home with a prescription. My frame of mind is seeking out experiences from others and I shared my own...if you can not help in this regard...how is that going to help her? No one in our family has experience with these issues...we are all trying to become more informed and I greatly appreciate the help.

 

I hope your family member gets help. Most importantly, I hope SHE seeks it. If nothing else, I hope the Rx helps her.

 

I'm sorry, but one of us is not seeing this clearly. Your answers back in this thread to stated concerns (I am not the only one) just reinforce the concerns for me. It leaves me confused.

 

Since my perspective is not helpful to you, I will back out of the conversation.

[ma23peas]

"Both addictions and OCD can be overcome by participating in the appropriate treatment for each. The appropriate treatment for OCD is cognitive behavior therapy with an emphasis on exposure and ritual prevention. And people who smoke or drink or do drugs can choose to stop. It is hard, but they can make that choice. People with OCD can choose to stop their compulsions too. It is hard, but we can make that choice and we can stop. No, we don't overcome it completely, but neither does the addicted person overcome completely his addiction. The desire to use is always there. And with OCD, the obsessions will always lurk in the back or our minds. But they will fade.*

 

OCD is a disease, but like diabetes and addictions, it can be treated. And much of the treatment comes from choosing to participate in lifestyle changes."

 

Experiences like these from OCD patients are helpful...I believe firmly that the best therapies are a combo like mentioned above, just trying to see all avenues.

[GingerPoppy]

The key is these parents have called me in the past on their medical questions because I was premed, worked in the industry for 10 years and unfortunately have had to seek out specialists at St. Jude, Vanderbilt, Children's hospital, and the Mayo clinic because of acute and chronic illnesses my own daughter has suffered from in the past. Before they make that call, I want to make sure I am informed nd not relying on my own experiences. That is why I shared my observations and why I have sought out help here.

You both may not have read my concerns put later in the thread..there is a history of her parents neglecting their living condition to extremes...this translates into concerns. I am only helping if asked to, but I want to be as educated on the issue as I can. In no means am I calling them up and dictating care, but if they ask, it is because they are not confident in knowing how to help her...the more information anyone can gain will only help.

I think it's good of you to try to help the best you can, especially in these particular circumstances. Speaking from experience, it's not easy at all to help and can take an enormous amount of patience and understanding. In my own case, she refuses all help, so we simply watch her struggle, hurt her kids (as a side effect, not deliberately), and sink deeper. If you can help, I think it's great. (I would suggest, though, that the sleeping patterns have nothing or little to do with it, so that's an issue I probably wouldn't press.)

[sbgrace]

I think she would greatly benefit from these therapies! She is a bright girl and I think if she knows it works for some, she would be encouraged....thank you! She lives close to a metro area and I know they must have that available!

 

Good. Please do check the OCD foundation website so you can provide names of people who specialize in OCD treatment. Seeing someone who doesn't do CBT specifically with OCD can be actually harmful. Also, this treatment is extremely difficult. The medication will make it easier for her to accomplish. For many people it's really not going to be an either...they will need both therapy and medication to manage OCD. Depression often comes with untreated OCD. I could see lifestyle issues feeding that. Hopefully her parents are emotionally supportive.

[ma23peas]

Good. Please do check the OCD foundation website so you can provide names of people who specialize in OCD treatment. Seeing someone who doesn't do CBT specifically with OCD can be actually harmful. Also, this treatment is extremely difficult. The medication will make it easier for her to accomplish. For many people it's really not going to be an either...they will need both therapy and medication to manage OCD. Depression often comes with untreated OCD. I could see lifestyle issues feeding that. Hopefully her parents are emotionally supportive.

 

Yes! Very emotionally supportive! I know they love her dearly, they just have not been able to give her much constructive support. I see OCD issues with her mother and my brother has always had issues with germs and that kind of stuff...so I think they both could benefit from any therapy they find for their daughter. Their insurance will not kick in until next month so I know they will need to wait to follow up with local physicians. Looking back, and the condition of the house they just moved out of I am guessing her mother does have hoarding issues...my parents have had to throw out truckload after truckload in able to get it ready to sell. They just did not know what to do with items...so they just kept them I guess. I greatly appreciate all the help! It helps to know what has worked for others!

[JennyD]

My brother has had OCD (all obsessions, no compulsions -- meaning an endless loop of obsessive thoughts rather than handwashing) his entire life, probably since early childhood. After spending most of his late teens and early twenties unable to leave the house, the problem was finally properly diagnosed and treated, and he now leads a more or less normal life (wife, kids, job) although he will be on medication his whole life.

 

I wholeheartedly agree with the recommendation to find a psychiatrist AND a therapist specializing in CBT for people with OCD. It took quite a while to find the right medication for my brother (I think he's on Luxor now?) and the process was pretty ugly. He has also gone off his medications twice over the years which resulted in complete breakdowns and new meds issues. (Apparently once you come off a medication for OCD, it doesn't always work for you again.)

 

It is a scourge of a disease, but treatment is getting better all the time. I wish her all the best. Oh, and one book my mom always recommends is Brainlock, by Jeffrey Schwartz, but I haven't read it.

[MomatHWTK]

I don't sleep w/o taking an adhd and anxiety medication. I might fall asleep one night if someone ripped me out of bed early, but it's not going to last. I'm just going to suffer from less sleep. The other issues cause insomnia. So that is my experience. If someone has problems that are physical due to bad habits, those can be amended by fixing the habits. If someone's brain is wired differently, they can learn coping skills to work with the wiring or they can medicate or often both.

 

FWIW, Prozac usually goes first because it is best known and generic (thus cheap). My medicine advice would be Lexapro. It just went generic this month, similar to Prozac but with less of a fall off over time (according to my doc and my experience.) This treats anxiety, which is a start. But I didn't see true progress until I was able to treat the ADHD as well.

Edited April 1, 2012 by MomatHWTK

[Mergath]

"Both addictions and OCD can be overcome by participating in the appropriate treatment for each. The appropriate treatment for OCD is cognitive behavior therapy with an emphasis on exposure and ritual prevention. And people who smoke or drink or do drugs can choose to stop. It is hard, but they can make that choice. People with OCD can choose to stop their compulsions too. It is hard, but we can make that choice and we can stop. No, we don't overcome it completely, but neither does the addicted person overcome completely his addiction. The desire to use is always there. And with OCD, the obsessions will always lurk in the back or our minds. But they will fade.*

 

OCD is a disease, but like diabetes and addictions, it can be treated. And much of the treatment comes from choosing to participate in lifestyle changes."

 

Experiences like these from OCD patients are helpful...I believe firmly that the best therapies are a combo like mentioned above, just trying to see all avenues.

 

If one's OCD is the purely obsessional kind, exposure and ritual prevention aren't going to do a darn thing. Lifestyle changes aren't going to do anything. Just so you know.

 

You might want to consider researching the different kinds of OCD, because they can vary quite a bit and require different kinds of treatment.

[sbgrace]

If one's OCD is the purely obsessional kind, exposure and ritual prevention aren't going to do a darn thing. Lifestyle changes aren't going to do anything. Just so you know.

 

You might want to consider researching the different kinds of OCD, because they can vary quite a bit and require different kinds of treatment.

 

Is yours just obsessional form? Because I want to tell you and anyone reading that this form certainly can be treated with CBT. You can treat this just as effectively as other forms. Perhaps some therapists don't "get" pure-obsession OCD and so don't know how to approach treatment though I hope this would be less of a problem now than in the past. The facts are there are mental rituals involved. Instead of outward stuff like washing hands the obsessions are handled with thinking/internal rituals. These can be trying to solve the question (thinking it out for example or going through reassurances) or trying to avoid the thoughts or any number of things. Just as in other forms you expose to the thoughts or allow the thoughts, and refrain from performing the mental rituals essentially. I'll post some links. The exposure response prevention still works with obsession OCD if the clinician treats it appropriately.

http://www.ocdonline.com/articlephillipson1.php and http://www.theotherocd.com/

 

Someone with pure-o can switch forms to outward rituals or the other direction (say a germ phobic becoming a pure o on another topic). The brain differences are the same and treatment is as well.

Edited April 1, 2012 by sbgrace

[ma23peas]

If one's OCD is the purely obsessional kind, exposure and ritual prevention aren't going to do a darn thing. Lifestyle changes aren't going to do anything. Just so you know.

 

You might want to consider researching the different kinds of OCD, because they can vary quite a bit and require different kinds of treatment.

 

Very helpful! Thank you! I am hopeful she can receive therapy where the degree of her condition can be adequately assessed. The experiences you all have shared are so valuable....with many diagnoses you want to learn from other experiences...

[NASDAQ]

What you have described sounds like textbook OCD. Hand-washing is the most classic manifestation of course. OCD tends to show up in late teenage-hood or young adulthood, although there are signs earlier on (usually the type you can see in retrospect). People suffering from OCD and anxiety are often poor sleepers, because they have intruding, obsessional thoughts.

 

OCD is not responsive to most therapy. It _can_ be responsive to cognitive behavioural therapy. It is almost always treated with medication first, because a person with OCD needs the experience of normal to have even a reference point. CBT is not available in all places at all times. It requires a great deal of time and energy to complete, which someone often doesn't have when he seeks treatment, because people with OCD have been trying to control their own difficulties for many years. They are exhausted.

 

People with OCD can "decide" not to wash their hands, but there's a limit to the amount of mental energy people have or want to spend on not washing their hands. Generally people have tried avoiding triggers and so on before they seek psychiatric help. If Prozac is effective for her, that may very well be the best long-term solution.

 

I think the best thing you can do to support her is to be pleasant and to not make a big deal out of any particular quirks she might have. Don't draw attention to it if she chooses not to eat something, for example.

 

I would definitely not engage with her about treatment unless she broaches this topic with you.

 

Most sick people do not relish the intervention or the advice of well-meaning relatives who have been reading about the sick person's condition.

[Mergath]

Is yours just obsessional form? Because I want to tell you and anyone reading that this form certainly can be treated with CBT. You can treat this just as effectively as other forms. Perhaps some therapists don't "get" pure-obsession OCD and so don't know how to approach treatment though I hope this would be less of a problem now than in the past. The facts are there are mental rituals involved. Instead of outward stuff like washing hands the obsessions are handled with thinking/internal rituals. These can be trying to solve the question (thinking it out for example or going through reassurances) or trying to avoid the thoughts or any number of things. Just as in other forms you expose to the thoughts or allow the thoughts, and refrain from performing the mental rituals essentially. I'll post some links. The exposure response prevention still works with obsession OCD if the clinician treats it appropriately.

http://www.ocdonline.com/articlephillipson1.php and http://www.theotherocd.com/

 

Someone with pure-o can switch forms to outward rituals or the other direction (say a germ phobic becoming a pure o on another topic). The brain differences are the same and treatment is as well.

 

But part of the problem with the pure-o kind is that you spend so much time trying to think your way out of these intrusive thoughts, trying to convince yourself why these bad things won't happen, or whatever. Spending more time trying to think your way out only exacerbates the issue, and exposure to an intrusive thought doesn't do much when you're already thinking about it 24/7. Maybe that works for some people, but the only thing that helped me was medicine. Once I went back on Celexa, the thoughts were gone within a month. When I'm at the point where I can't eat or sleep because it's so bad, I'd rather go that route than spend months or years on CBT that may or may not work.

[Lady Florida.]

 

I would definitely not engage with her about treatment unless she broaches this topic with you.

 

Most sick people do not relish the intervention or the advice of well-meaning relatives who have been reading about the sick person's condition.

 

:iagree:The best thing you can do for her is be available *if* she asks for help/suggestions. I know you said her family asked, but she's an adult, and she hasn't asked (or has she?). She did seek treatment, as evidenced by her meds, so it's not as though you have to do something to get her to acknowledge she has a problem.

 

:grouphug: It can be hard to watch a loved one go through any kind of illness. Just be there if she needs you.

[Mergath]

People suffering from OCD and anxiety are often poor sleepers, because they have intruding, obsessional thoughts.

 

:iagree: I went through a period of time last year where I was convinced something was in my attic. What, I couldn't tell you, but I had this irrational fear that something was up there, and I worried about it constantly. I couldn't sleep, because I laid there awake at night trying to convince myself that there was nothing up there. It's strange, because unlike a person with actual delusions, I knew I was acting irrationally and that there really wasn't anything up there, but the fear was still paralyzing. I went for two weeks with maybe an hour of sleep each night, because I thought that if I feel asleep, the something was going to take my dd. I checked the attic hundreds of times a day. I called a friend and made her come over to make sure the attic door was in the same position it had been in the day before. If I hadn't had a mental health pro figure out that what I had was OCD (and probably not BPD, like I'd been diagnosed with before) I probably would have ended up attempting suicide. It was that bad.

 

Op, I understand the desire for a more natural treatment, for therapy over meds. Truly, I do. But there also comes a point when you have to look at the person's quality of life and decide, "Okay, this medication does have some risks, but looking at the way my loved one is living now, it's worth the risk."

[lewelma]

But part of the problem with the pure-o kind is that you spend so much time trying to think your way out of these intrusive thoughts, trying to convince yourself why these bad things won't happen, or whatever. Spending more time trying to think your way out only exacerbates the issue, and exposure to an intrusive thought doesn't do much when you're already thinking about it 24/7.

 

CBT did not work for me either, for the same reasons. It definitely exacerbated the pure-o. I was just thinking about the thoughts even more. I knew the thoughts were irrational, but that did not stop them going through my head over and over and over.....

 

Instead, redirecting thoughts was very effective for me. I especially found the senses worked in my favor, specifically focusing all thought on the feel of the fabric of my clothing.

 

If one method does not work, look for another.

 

I will also say that I overcame my OCD without medication. Perhaps mine was less severe than others posting here, hard to say. When I was checking, I spent about 3 hours per day checking. This lasted about 5 years and then at a reduced level (perhaps 1.5 hours) for 10 more years. When I had pure-o, it was about 10 hours per day (basically all day, I seriously thought I was going insane). This lasted only 6 months because it was so awful that I found help very rapidly. The 2 types did not overlap in time. Today, I have no pure-o, and check perhaps only 15 minutes per day, which is acceptable to me.

 

Good luck,

 

Ruth

Edited April 1, 2012 by lewelma

[NASDAQ]

I will also say that I overcame my OCD without medication. Perhaps mine was less severe than others posting here, hard to say. When I was checking, I spent about 3 hours per day checking. This lasted about 5 years and then at a reduced level (perhaps 1.5 hours) for 10 more years. When I had pure-o, it was about 10 hours per day (basically all day, I seriously thought I was going insane). This lasted only 6 months because it was so awful that I found help very rapidly. The 2 types did not overlap in time. Today, I have no pure-o, and check perhaps only 15 minutes per day, which is acceptable to me.

Ruth

 

Difference in severity, and difference in what people are willing to commit to in order to avoid medication. By your estimate you have spent thousands of hours, years of your life, engaging in OCD ritual. I think for some people, they would rather accept the risk of side effects from an effective medication than lose that kind of time out of their lives. Maybe not the choice you'd make, but not at first glance an irrational one.

[lewelma]

Difference in severity, and difference in what people are willing to commit to in order to avoid medication. By your estimate you have spent thousands of hours, years of your life, engaging in OCD ritual. I think for some people, they would rather accept the risk of side effects from an effective medication than lose that kind of time out of their lives. Maybe not the choice you'd make, but not at first glance an irrational one.

 

Oh heavens, don't be harsh. I did not even know I had OCD, or I am sure I would have happily done anything to help myself. It just seemed normal to me, so I did not seek help. It was not until my younger sister took abnormal psychology in college, that I even knew there was a name for "that funny thing I do." By the time I had a name for it, I had reduced it to 1/2 intensity through my own efforts, and often much less if I was not stressed. So I was not driven to therapy or meds. And when I got the pure-o, I did not know that was OCD either. I just thought I was going crazy.

 

I would never suggest that medicine would not help someone, but given that the OP was looking for understanding, I thought I would tell her that there are people out there who have been symptom free for 10 years without meds.

 

I am absolutely not against meds. side effects or not. Do what works.

Edited April 1, 2012 by lewelma

[sbgrace]

But part of the problem with the pure-o kind is that you spend so much time trying to think your way out of these intrusive thoughts, trying to convince yourself why these bad things won't happen, or whatever. Spending more time trying to think your way out only exacerbates the issue, and exposure to an intrusive thought doesn't do much when you're already thinking about it 24/7. Maybe that works for some people, but the only thing that helped me was medicine. Once I went back on Celexa, the thoughts were gone within a month. When I'm at the point where I can't eat or sleep because it's so bad, I'd rather go that route than spend months or years on CBT that may or may not work.

 

Did you look at the links I posted? Most of my life pure-o was my kind of OCD. The ritual in your case (and was in mine too) is thinking your way out of it. The CBT would be, perhaps, accepting that the "it" might be true. So the handwasher thinks "there might be x on my hands...I must wash it off or I might get sick" and the treatment is yep, x might be there and I might get sick and die (or whatever) but I'm not going to wash. The pure-o person thinks "there might be something in my attic" in your example and the CBT for that is "yep, something could be there and whatever bad outcome might happen" I'm not going to go over x and y and z in my mind to think my way out of this because it will just feed the obsessions and make them stronger. Instead, you sit with the anxiety the obsessional fear brings. Not easy to do at all. Sometimes impossible for some people...but that's true for regular/non-pure O OCD as well.

 

I've dealt with both. In my experience neither are more or less difficult to either live with or treat. I used to think the "outward" OCD CBT would be so much easier than the pure-o stuff. Well, it's not at all easier. More straightforward for the therapist to direct possibly but not easier to do for the person involved. Anyway, I'm glad Celexa works that well for you. I hope the meds take it all away for the OP's loved one too. Most of the time people need both meds and therapy approaches to get that sort of relief.

 

To be clear I'm not trying to contradict your experience. CBT might not have been successful in your case. That can happen with all types of OCD for particular people or particular obsessions. For some people neither CBT nor medication help or help enough. I think they are finding new treatments to help even those. OCD is not hopeless. I just don't want anyone reading to think pure-o OCD isn't treatable with CBT because it is treatable as are the forms of OCD. Well, outside of hoarding. That's the form that, to my knowledge, has no generally effective treatments at this time.

Edited April 1, 2012 by sbgrace

[lewelma]

Most of my life pure-o was my kind of OCD. The ritual in your case (and was in mine too) is thinking your way out of it.

 

My pure-o had no ritual component. The bad thoughts came and there was nothing to do to stop them - that was why they were there all the time. I could not think my way out of them and never tried. In contrast with the checking, the fear that the stove was still on or the door was unlocked was reduced with the ritual of checking. Perhaps this is why I lived with the checking type for so long, I could reduce the stress with the ritual so I never felt out of control, whereas I could not reduce the stress with the pure-o. The difference is like night and day between the 2 for me.

Edited April 1, 2012 by lewelma

[sbgrace]

:grouphug:

 

My pure-o had no ritual component. The bad thoughts came and there was nothing to do to stop them - that was why they were there all the time. I could not think my way out of them and never tried. In contrast with the checking, the fear that the stove was still on or the door was unlocked was reduced with the ritual of checking. Perhaps this is why I lived with the checking type for so long, I could reduce the stress with the ritual so I never felt out of control, whereas I could not reduce the stress with the pure-o. The difference is like night and day between the 2 for me.

 

The example I gave was for someone who thinks their way out as their ritual. But the rituals for pure-o are as varied as they are for regular OCD forms. I do think the ritual component can be hard to figure out in pure-OCD.

 

In your case the ritual your therapist identified was probably being with the thought rather than trying to redirect (via noting sensory or whatever) your thoughts, right? Or maybe it was to tolerate the thought. Sort of this? http://www.ocdonline.com/articlephillipson1.php

 

Rather than attempting to escape the spikes, the "Pure-O" is encouraged to purposely create the thought repeatedly following its occurrence. This has the effect of desensitizing the brain to these spikes by sending the message that not only am I not going to attempt to escape these thoughts, but I am at such peace with them I can create a multitude of them. .... At this point, my skills as a therapist are not nearly as valuable as the client's willingness to utilize the procedures. Unless you are thoroughly fed up with the disorder, behavior therapy will be of limited help. Often I have been informed that the treatment is as painful as the disorder. My only response is that with this treatment there is a light at the end of the tunnel. The disorder offers only endless suffering.

And from the other site http://www.theotherocd.com/#!__therapeutic-techniques:

The following scenario is an example of extinction and habituation. While changing her daughter's

diaper, the mother has an automatic thought (spike) that she "should" suffocate her child with a pillow. A therapeutic response would entail having the mother say, "OK, maybe I'll kill my daughter, so let's do it now." This response is based on the premise that through acceptance, the mind will reduce its

sensitivity to these ideas (e.g. extinction). Escape or intolerance regarding the feared stimulus (spike) tends to perpetuate its strength. Having this mother purposefully create the thought (approximately 15 times) while changing a diaper would act as a purposeful exposure (e.g. habituation) and also further reduce the mind's sensitivity to these topics".

Note the ritual might be escape or maybe intolerance to the thought for one person. For another pure-O the ritual might be seeking reassurance from others (which, I guess is an outward action) or avoiding things that might trigger the thoughts. I already mentioned thinking it through. There are so many ways it can present. The ritual is whatever the person is doing or not doing to try to relieve the anxiety about the thought.

 

As I said to the pp, I'm not at all trying to say that CBT should have worked for you. I think it terribly hard and sometimes simply too hard. He's so right in saying the treatment is as painful as the disorder. I'd say more so sometimes and probably always more so at first. I'm just saying one person's experience can't be generalized to the entire class of sufferers though I know you aren't trying to do that.

 

I'm glad you've gotten relief.

Edited April 1, 2012 by sbgrace

[lewelma]

For me, the redirection through sensory input was the therapy. Over time, the thoughts faded to the point that they were gone and never came back. This process took 2 months. And now when I feel new thoughts bubbling at the surface, I use the technique right away and they never grow.

 

:grouphug: I'm just saying one person's experience can't be generalized to the entire class of sufferers though I know you aren't trying to do that.

 

Absolutely. I have only discussed this very difficult time in my life on a public forum in hopes that it might help someone either have compassion and understanding for a loved one suffering from it or be able to recognize the different forms this terrible illness can take.

 

I'm glad you've gotten relief.

Thank you. So am I. Edited April 1, 2012 by lewelma

[HappyGrace]

Thank you for the info in this thread-very helpful!

[ma23peas]

:iagree:The best thing you can do for her is be available *if* she asks for help/suggestions. I know you said her family asked, but she's an adult, and she hasn't asked (or has she?). She did seek treatment, as evidenced by her meds, so it's not as though you have to do something to get her to acknowledge she has a problem.

 

:grouphug: It can be hard to watch a loved one go through any kind of illness. Just be there if she needs you.

 

To clarify, she is only 18...and honestly, she has the maturity of a 15 year old, so while many of you point out she is an adult and should take control of this on her own, she has never worked a day in her life, had any responsibility (her parents have not encouraged this) and never driven...she has struggled with being away at college...the only way to quit at this point was to get a medical excuse, that was a big motivation, she did not want to get failing grades this semester. I am hopeful that some of her peers at school helped guide her to get checked out, because she would not do this on her own. I do know one of her best friend's mother's has been institutionalized several times, she would be one to help her realize these are medical conditions not just minor issues. Thank so much for your kind thoughts, we love her deeply and each of us want to be a network of support, if we are not informed, it makes it harder to know how! Thanks!

[ma23peas]

Thank you for the info in this thread-very helpful!

 

It truly is an encouragment to hear the testimonies of those who have tried various methods to reach peace and healing with these disorders...sometimes just the knowledge that others have been there done that (kind of like reading trip reports before you travel to a foreign country) makes the ability to encourage that much stronger...thank you all and :grouphug: to the difficult journey many of you have faced and managed!

[mommymilkies]

Wow, she changed her entire sleep pattern in one 24-hr cycle? I'm impressed. I don't go to bed before 2 am and I sleep at least 8 hours each night (and that is a good thing). But even when I wake up really early like 7am, I still can't fall asleep before 2am the next night. Of course, I've never worked on a farm or done anything so labor intensive. The most active I've been is an hour of exercise but it didn't help me go to sleep any better.

 

One of my diagnoses is OCD, thought related not physical repetitive actions. It's a nightmare without my meds. Life was not good before meds. Sometimes they really are necessary and I'm not ashamed to say I need them.

 

She could certainly seek a second opinion and should also discuss any possible meds with her doctor. It's also important to realize that not everyone responds to the same medicines. For example, prozac does nothing for me.

:iagree: Wellbutrin is not good for treating anxiety or OCD. Zoloft helps me a lot.