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Thatboyofmine

Help me figure this out... mental health

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PLEASE DO NOT QUOTE. I will be deleting... tia!

If someone is obsessed with past mistakes, what they perceive as 'sins', failures, etc, is this a form of severe anxiety? Is this a sign of bipolar? The memory just gets triggered by something or nothing and all of a sudden it's a severe full-on breakdown. A 'confession' seemed to help and the knowledge that they are not abnormal, doomed to hell, destined for a life of depravity, whatever. This person, while a Christian, has never been in a family of hell and brimstone teachings, if that helps. Pretty middle of the road, non judging family.

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I don't see that this in any way indicates bipolar disorder. Sounds more like a form of OCD. Which can be related to anxiety disorders.

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I went through something similar as a teenager as part of my OCD, though at the time I had no idea it was OCD because I hadn't been diagnosed yet. It could fall under either OCD or GAD, but yes, from what you've described it sounds like it's definitely anxiety-related.

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~As someone who has attended seminary, and husband is a pastor~

 

No, this is not OCD or anxiety disorders.

 

This is a person with a strong higher conscious. It also sounds to me like the person is not focusing on the idea of repenting and forgiveness being granted of the new testament for believers who accept the Messiah.

 

No this is NOT a mental health issue, it is a poor teaching of religion it sounds to me. I recommend going to see a CHRISTIAN counselor to talk about these things - they will address sin likely equally to the person who is struggling's beliefs and be able to reconcile it with Biblical teachings.

 

That is my opinion at least.

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Is that possible?

 

No it is not - please see my post above. This is common for people who have not been able to reconcile in their hearts the idea of repentance for salvation and the ways we are always sinners and it is part of being human in the flesh. PLEASE get them some Christian Counseling! :) Likely this is a simply matter that just talking with someone who knows these things from angles perhaps this individual has not considered would benefit in understanding and finding peace. :)

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Sounds like OCD to me. Feeling the need to confess can be a compulsion. Some people also have only the obsessive part of OCD without having compulsions.

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I'm not a mental health professional, and my response is very much anecdotal, for a limited experience.

 

One thing to consider is depression. In my experience with depression, an individual tries to figure out WHY they're feeling so sad/angry/frustrated. It can because of family situation, work situation, past mistakes, anything to make sense out of why they feel the way they do. Depression isn't logical though, and any number of circumstances and decisions CAN make a person sad, but depression brings a deeper level of these feelings. 

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Scrupulosity is a common form of OCD. OCD without the compulsions is sometimes called pure-O, but some compulsions--compulsive praying, for example, are not visible to onlookers.

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~As someone who has attended seminary, and husband is a pastor~

 

No, this is not OCD or anxiety disorders.

 

This is a person with a strong higher conscious. It also sounds to me like the person is not focusing on the idea of repenting and forgiveness being granted of the new testament for believers who accept the Messiah.

 

No this is NOT a mental health issue, it is a poor teaching of religion it sounds to me. I recommend going to see a CHRISTIAN counselor to talk about these things - they will address sin likely equally to the person who is struggling's beliefs and be able to reconcile it with Biblical teachings.

 

That is my opinion at least.

 

Poor teaching of religion can be a real issue. As can mental health. There are real mental health issues that one cannot just "believe" their way out of. 

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I'll agree with OCD/Anxiety.  It sounds like the person perseverates on past mistakes.  Perseveration is generally a symptom of OCD and/or anxiety.

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~As someone who has attended seminary, and husband is a pastor~

 

No, this is not OCD or anxiety disorders.

 

This is a person with a strong higher conscious. It also sounds to me like the person is not focusing on the idea of repenting and forgiveness being granted of the new testament for believers who accept the Messiah.

 

No this is NOT a mental health issue, it is a poor teaching of religion it sounds to me. I recommend going to see a CHRISTIAN counselor to talk about these things - they will address sin likely equally to the person who is struggling's beliefs and be able to reconcile it with Biblical teachings.

 

That is my opinion at least.

No it is not - please see my post above. This is common for people who have not been able to reconcile in their hearts the idea of repentance for salvation and the ways we are always sinners and it is part of being human in the flesh. PLEASE get them some Christian Counseling! :) Likely this is a simply matter that just talking with someone who knows these things from angles perhaps this individual has not considered would benefit in understanding and finding peace. :)

Are you serious? :svengo:

 

How could you possibly have even the slightest clue that "poor teaching of religion" could cause something like this? :glare:

 

I'm sorry to sound disrespectful, but you're making an awful lot of assumptions and strong recommendations for someone who doesn't know the first thing about the OP.

 

I noticed that you are new to the forum, so I would like to welcome you, but I would also suggest that perhaps you should consider asking for more information before you reach such sweeping conclusions.

 

 

 

Edited for typo

Edited by Catwoman
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~As someone who has attended seminary, and husband is a pastor~

 

No, this is not OCD or anxiety disorders.

 

This is a person with a strong higher conscious. It also sounds to me like the person is not focusing on the idea of repenting and forgiveness being granted of the new testament for believers who accept the Messiah.

 

No this is NOT a mental health issue, it is a poor teaching of religion it sounds to me. I recommend going to see a CHRISTIAN counselor to talk about these things - they will address sin likely equally to the person who is struggling's beliefs and be able to reconcile it with Biblical teachings.

 

That is my opinion at least.

No. Saying this as a Christian, just no.

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With PANDAS, its from strep, right? I don't think he's had that in a while, but he has had throat ulcers (strep test neg). How long can you have PANDAS? He's had many cases of strep, just not within the last six months, I don't think.

Is there a test for PANDAS?

 

 

Scrupulosity sounds dead on. That's treatable, right? He sees a psych next week and the office has several therapists so he'll see one of those, too.

His GP raised his celexa to 40mg and put him on Ativan which we're about to pick up. Please give me some hope that the Ativan will help until next week. It will calm him, right? He does seem to feel better since his "confession" but I have zero hopes for calmness in our lives right now.

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With PANDAS, its from strep, right? I don't think he's had that in a while, but he has had throat ulcers (strep test neg). How long can you have PANDAS? He's had many cases of strep, just not within the last six months, I don't think.

Is there a test for PANDAS?

 

 

Scrupulosity sounds dead on. That's treatable, right? He sees a psych next week and the office has several therapists so he'll see one of those, too.

His GP raised his celexa to 40mg and put him on Ativan which we're about to pick up. Please give me some hope that the Ativan will help until next week. It will calm him, right? He does seem to feel better since his "confession" but I have zero hopes for calmness in our lives right now.

I don't know how long the PANDAS can lie in wait. I don't know about a test.

 

:grouphug:

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:grouphug:  :grouphug:  :grouphug:

 

It might help calm him down just to find out that there are millions of people who have OCD and have had similar thoughts and compulsions. As a kid with OCD, that would have helped me enormously - but I never even heard of OCD until I was in my early twenties. It was a huge relief to find out that I wasn't the only one and I wasn't crazy, as I had thought for so many years.

 

 

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~As someone who has attended seminary, and husband is a pastor~

 

No, this is not OCD or anxiety disorders.

 

This is a person with a strong higher conscious. It also sounds to me like the person is not focusing on the idea of repenting and forgiveness being granted of the new testament for believers who accept the Messiah.

 

No this is NOT a mental health issue, it is a poor teaching of religion it sounds to me. I recommend going to see a CHRISTIAN counselor to talk about these things - they will address sin likely equally to the person who is struggling's beliefs and be able to reconcile it with Biblical teachings.

 

That is my opinion at least.

 

 

No it is not - please see my post above. This is common for people who have not been able to reconcile in their hearts the idea of repentance for salvation and the ways we are always sinners and it is part of being human in the flesh. PLEASE get them some Christian Counseling! :) Likely this is a simply matter that just talking with someone who knows these things from angles perhaps this individual has not considered would benefit in understanding and finding peace. :)

 

 

NO. You can NOT pray away mental illness. NOR does being repentant make mental illness go away. A Christian counselor who thinks that mental illness is a sin or repentance will make it go away is someone who should be locked up for malpractice.

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I just called his GP to see if they can do some strep testing for PANDAS. I have no idea if it's even a possibility, but it'd be nice to mark it off my list, ykwim? I'll probably hear back this afternoon or tomorrow.

I told ds and dh about scrupulosity and they both said, "that's it". Maybe I already said that. I can't remember. My mind is shot.

 

 

Oh, and he hasn't had a poor teaching of religion. I understand you are trying to help, I really do (and I'm thankful for that), but what he's going through is absolutely not his fault, nor is it mine.

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re: PANDAS, when my middle son first started showing tics (eventually dx'ed with Tourette's), they *did* run a blood test among other things to check for indications of past strep. I don't think you can specifically test for PANDAS, but the test for strep can, I think, tell them if he's had it recently enough to be worth looking at. 

 

((hugs)) to you. I also agree you are not dealing with poor religious teaching, at all, and I'm sorry someone brought that up. I will pray you guys find some answers; mental health issues are scary and exhausting. (((Hugs)))

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There is a PANDAS specialist that feels that they ar just at the beginning of understanding and it is an autoimmune response to several viruses and not always strep. Plus, in some kids they might never show signs of strep and yet they have it.

 

I am close to someone whose kid never had strep that they knew as he had several sinus infections and was diagnosed with PANDAS.

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Oops, I posted too early and did it double. I guess that's oops, oops. 

 

I am not an expert in PANDAS but I just had a patient a few weeks ago in my practice who presented in much this way. I don't like to give details about patients online but I'll just say his obsessions seemed to be needing to confess all the time, and to very minor things. He was strep positive at the time. I treated him and sent him to a specialist. 

 

I think the confessing can definitely be OCD or anxiety. I would be more concerned about PANDAS if it was fairly sudden in onset. But again, I'm not an expert. 

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OP I'd like to share, but not in public. If you're interested, you can PM me. I have somewhat of a faith-based perspective to share, but it's personal. If you're not opposed to a faith perspective, I welcome you to reach out. If not, I wish you best of luck with all this. It's tough, for sure.

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Yeah, that's not abnormal or balanced response even within a strict interpretation and practice. It does sound like some anxiety or related condition at play, especially with the semi-random triggering and ritual forgiveness seeking. I hope they find some help - there are certainly Christian counselors who could aid, but honestly this sounds like it might be better addressed with a team that included a psychiatrist, in case medication would help in tandem with counseling.

Edited by Arctic Mama
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A Christian counselor who thinks that mental illness is a sin or repentance will make it go away is someone who should be locked up for malpractice.

 

Frequently, but not always, a "Christian Counselor" is not simply a counselor or therapist who is Christian and specializes in helping other people of that religion but somebody whose only qualification is their religion. They aren't medical professionals and don't claim to be... but they can do just as much harm or more by claiming they're better than the professionals!

 

Obsession with past mistakes can be a sign of any number of conditions. If it's impairing this person's ability to live their life - and it sounds like it is - they should see an actual doctor.

 

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I would just remind some posters that the OP requested us NOT to quote her.  Thanks!

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PANDAS is now a subset of PANS, in which a number of possible immune system triggers can cause the neuropsychiatric symptoms, although the mechanisms aren't well-understood beyond strep. These can include viruses (HSV, EBV, CMV, flu, etc) and other bacteria (mycoplasma, bartonella, etc etc).  The science is definitely still developing; it seems to me that an understanding of the strep mechanism has come a long, long way just in the past couple of years, with the basic idea involving strep-specific Th17 cells crossing into the brain via the olfactory bulb; see, e.g. â€‹http://journal.frontiersin.org/article/10.3389/fimmu.2017.00442/full.  New PANS guidelines came out just recently, though even those were more of a compromise, in order to help guide primary care providers, than anything really definitive or set in stone. (Guidelines overview, Part 1, Part 2, Part 3)

 

For testing, strep titers (ASO and Anti-DNase B) are a start but are really the tip of an iceberg, as negative titers don't rule out much (some people don't have a titer rise after strep infection or may have been triggered by some other pathogen).  So for example, our immunologist would order a round of tests that involved more than 20 tubes of blood over multiple draws.  One article that sets out some basic testing:  http://ndnr.com/autoimmuneallergy-medicine/elucidating-pandas/

 

A new, interesting direction:  Improvement of psychiatric symptoms in youth following resolution of sinusitis.

 

Like the others said, scrupulosity is a well-known form of OCD.

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Obsessive thoughts about past mistakes (or potential future mistakes) can definitely be a part of OCD, and anxiety can play a role too.

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Absolutely yes. I have had severe OCD most of my life and scrupulosity has been a definite manifestation at times. For kids, I highly recommend the book What to Do When Your Brain Gets Stuck.

 

Medication has been most helpful for me.

 

:grouphug:  :grouphug:  :grouphug:

I will second that recommendation!  We have multiple copies of that book, and when we showed it to our psychologist, he bought himself a copy.

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As someone with anxiety issues, which used to be much worse, I can say that I've had some problems with perservating on mistakes/bad choices.  Not to the extent described, but I could kind of identify with the "stuck" aspect.  Since getting my anxiety under better control, I'm able to let things go more easily.

 

My full profile is ADHD with anxiety and depression.  While those things certainly suck and exist on a spectrum of manageable to devastating for each individual on different days, no professional has ever hinted toward any more complex mental health issues for me.  I would assume the given example falls somewhere in that general family of diagnosis, though on a more extreme end.  Assuming that's the ONLY example of atypical behavior.

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OCD even without the compulsions? Unless feeling the intense need to 'confess' is a compulsion. Is that possible?

Yes, the need to confess is a compulsion. You have described a fairly common OCD trait, religious or moral scrupulosity.

 

https://iocdf.org/wp-content/uploads/2014/10/IOCDF-Scrupulosity-Fact-Sheet.pdf

 

I have a family member whose OCD sometimes manifests this way.

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The answer is, "It depends."

 

It can be a sign of scrupulousity, which is a form of OCD.

 

It can be part of anxiety or depression.

 

It can be a sign of poor religious teaching.

 

It can be a sign of a tender conscience and awareness of even minor sins or hurts.

 

It just depends.

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Still trying to keep it together. Psych appt next week. Ds got the Ativan today and the dr should be calling tomorrow regarding the PANS possibility. Dh will be out of town on business next week so I may have to get my mom to come stay. I scheduled an appt with the psych, too. My appt is in two wks. Ds took the Ativan and feels more relaxed right now. I'm on edge something fierce. I wish we could just be hospitalized and force them to deal with him now and just flat out sedate me. I just want to move past this.

What are some typical OCD meds? Do they start working quickly? I was put on Effexor 16 yrs ago when I had a problem with OCD and didnt like it. Actually it worked but the dr didn't warn me about coming off of it. That part was brutal, but at least now we know what to expect.

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As a Catholic, we don’t see that as a mental illness but call it scrupulosity. Often the guidance needed is spiritual and continuing reassurance of His forgiveness and love for us.

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I don't have any answers, but I'll be praying for your son.  I've learned that mental disorders take time to evolve and be understood.  Probably no one can answer precisely what your ds is dealing with right now.  But, he'll get help, and time will show what he needs help with more clearly.   It could be a combination of things.  There are some rigid thinking disorders where either everything is good or everything is bad, and there is no in-between.  The great thing is that there is so much help for these conditions now, since they are so much better understood!  I've been in your position though when I desperately want an answer and fix immediately.  I know how absolutely heart-wrenching it is.  

 

You take care of yourself too.  :grouphug:  :grouphug:

 

 

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As a Catholic, we don’t see that as a mental illness but call it scrupulosity. Often the guidance needed is spiritual and continuing reassurance of His forgiveness and love for us.

Even as Catholics we know that scrupulosity can be a sign of a mental illness, usually anxiety or OCD, and require mental health professionals to treat it. It's not always just a spiritual issue.

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Even as Catholics we know that scrupulosity can be a sign of a mental illness, usually anxiety or OCD, and require mental health professionals to treat it. It's not always just a spiritual issue.

Yes, it can be, but scrupulosity alone is not always a mental illness. Sometimes it is borne out of a rough time in life or a dry time spiritually, and effective guidance can be given without the need for a diagnosis and/or pills. Sometimes it is that, and mental health professionals and pills are needed. In all things, balance and moderation.

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In this particular case, it's absolutely mental illness. Scrupulosity is part of it, but not necessarily from a religious pov. After researching, I believe it's OCD with scrupulosity and panic disorder. Of course I'm no dr, but this is how he's presenting to me.

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I have dealt with similar after social interactions.  I think for me it was the adrenaline crash would drag me into it. it did make me not want to have social interactions with other people.  dealing correctly with my thyroid and adrenal - made a bigger difference than anything I did for depression/anxiety.  it really reduced/eliminated those crashes.

maybe because adrenals are tied to adrenaline.

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OP, you asked about typical meds.  I don't know everything available, but here's what we use.

 

DH has OCD, and so do all three of our kids.  Two are on citalopram (Celexa) and two are on escitalopram (Lexapro).  Both are also used for depression, and they are SSRI's. 

 

48 hours seems to be the magic number.  If someone forgets a dose, I can tell 48 hours later; and it takes 48 hours to recover from the missed dose.

 

It's worth saying, the meds don't make them completely symptom free. The therapist says that the meds make their thinking less rigid, so that they are able to respond to training, and can learn to recognize the OCD thoughts and set them aside instead of engaging in the compulsions.

 

DH, who is mature enough to explain what's going on in his head, says he still has some OCD thoughts, but meds help a lot.  

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