Is it OCD or Tourettes??

I have a diagnosis of OCD due to a history of obsessions, and countinual counting in my head, and touching things. Mostly my OCD is 'internal', so people don't notice unless I'm somewhere that makes me very anxious. However, the numbers/counting/touching are now 'externalising' more, and people are noticing. I feel I need to touch and count my elbows a lot, and sometimes have massive urges to touch other peoples (which i try my best not to do unless I know them very well!), I feel the need to put my hands up to expose my wrists to people, twice each time, which again I have no explanation for except to say it's a massive urge. If someone touches, say my hand as they're passing me a drink, I can hardly bear not to touch their hand back until it's even. I have strong urges to make noises when I am anxious, which I try to disguise with a cough, and sometimes to move my head back suddenly, twice, and take a sharp intake of breath, or make clicking sounds with my throat. Sometimes i stare at things or people and blink hard, until it feels right that I can look away. This can be bad if i am in public and continually looking over my shoulder to look at someone 'just one more time'. I have also been scratching the skin on my head and am developing small bald patches, so I now need to wear a headscarf as i can't resist the urge to stop doing it. People notice me doing these things, and it looks like tics. Is it? I can stop if neccesary, they don't do it by themself, but it is difficult to resist the urge,.Someone asked, lightheartedly, if I was sure I didn't have tourettes rather that OCD, and now I'm worried I do. I'm assuming (and hoping) that the fact I can stop these things temporarily with effort means it's just a part of the OCD. What do you think? Not sure I could handle having tourettes :-(

[Ted A Grossbart, Ph.D.]

More CBT hopefully with someone who knows both those techniques and dealing with overall life issues as well.

tg

[Ted A Grossbart, Ph.D.]

The OCD spectrum includes the more familiar obsessions and compulsions, Tourettes, and hair pulling and skin picking and scratching.  People with one of these will often have bits of another.  It is not like you suddenly have a new set of problems.  

I suggest you not focus so much on the label but rather on getting more effective treatment.  It sounds like you are working hard on your own but really need more professional help.

Are you in treatment?  Is it with someone who specializes in these problems?  

[arual18]

So far have had counselling, CBT (twice), hypnotherapy, meditation, tried lots of meds: citalopram, fluoxetine (made me SUPER anxious), paroxetine (no good) rispiridone (too sleepy), quietipine (much too sleepy!), apipirizole (horrendous dyskinesia that made me want to rip off my skin and somehow crawl out of my own body!) , pregabalin, beta blockers, venlafaxine (took away all emotions), lamotragine, and am currently on fluvoxamine maleate (200mg a day), and prn lorazepam and diazepam. Magic mushrooms help loads and take it all away through the 'trip' and for couple days afterwards, but as far as I'm aware, psychlobin isn't licenced??
Do u have any info/thoughts on glutamate-modulating drugs (eg riluzole)? I have pretty bad GAD, and anxiety-related intrusive thoughts, so any meds that make me anxious are a no-go, and ??bipolar2, so not sure if that complicates things? .But no, not in any treatment as such at the mo-kind of given up a little.  Perhaps a brain-transplant is the way forward?! lol. Thanks for your time by the way :-)

[Ted A Grossbart, Ph.D.]

Sounds like you have been very patient and persistent on the drugs side (not my area) but have a lot more to be potentially gained on the therapy front.  Generally that is very helpful if you stick with it.

tg

[arual18]

What therapies whould you suggest?

[Ted A Grossbart, Ph.D.]

More CBT hopefully with someone who knows about working with general life issues as well.

tg

[Kookay]

Doc, is it normal for a person that when shes angry, intead of fighting back or yell, she fix things so orderly, like the label of the cans shud face one way, bedsheet so neat like in hotels, cleans pots even if they are clean already while sort of talking back in her head but not blurting it out?