ocd, anxiety, derealization

I have  ocd and severe anxiety and my last "panic attack" brought about the some feelings of derealization.  that scared me.   I dont really HAVE those feelings now, i dont think, but I think that I am obsessing about the feelings...or something like that.  Are OCD and Anxiety disorders related in some way?  I feel like one thing here is feeding off the other.  My doctor upped my prescription of anafranil from 200mg a day to 250mg a day.  i was on 1 mg of klonopin a day. I was switched to Ativan 2mg 3 times a day.   I can sleep now, but stil obsess about those derealization feelings.  How long should I give the upped dosage to start making a difference?   Im hoping the Dr will chime in on this one.   I really feel I would do better on Celexa, but the Drs call was to up my anafranil.  any thought?

[Ted A Grossbart, Ph.D.]

It sounds to me like you are transferring your anxiety to the medications and dosages. One problem is definitely feeding off the other.   Are you in psychotherapy?  The meds will hopefully take the edge off things but you really need to be looking at causes and learning techniques,

Are you?

tg

[taraak]

oh,  I am also on 1 mg of risperidone a day.  my doc says it will help my anxiety/panic.   is this true?

[taraak]

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[taraak]

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[taraak]

i started therapy last week.    it seems that all i do is obsess about the derealization I felt before.  the feeling is gone, but the questions obsess my brain.    is there really any help for me?

[Ted A Grossbart, Ph.D.]

Good therapy is very effective for these problems, but not instant.  Have patience, be persistent and you can experience levels of calm and clarity you never thought possible.  good luck .

tg

[taraak]

what I am really obsessing on, is the feelings of derealization. people feeling unreal, and my brain trying to figure out what makes us real. things like that.   is derealization a symptom of anxiety or ocd?  or am I really going insane.  what questions can I ask my therapist to know that they are the right one to help me.  Ive only seen him once so far.


thanks -
Trace

[Ted A Grossbart, Ph.D.]

It is related to dissociation which is as common in college students as back ward mental patients.  Anxiety often triggers it and then your OCD picks it up and runs with it.  

Give the therapy some time, the main thing is to feel you are being heard and thy have some useful techniques and suggestions to offer.

It may be useful to ask yourself, What would I be thinking/worrying about if not the derealization?"

tg

[taraak]

my doc upped my anafranil, but that was only 5 days ago.  should I be feeling anything yet,  or is it the whole "wait a few weeks" thing like when they first put you on meds?

OH, thank you for answering all of my questions.  I really appreciate it.

- Tracy

[Ted A Grossbart, Ph.D.]

You guessed it!  Too soon to tell.

tg

[taraak]

I figured as much, but thats a good thing.  If I should be feeling better already,  Im not. lol.  i am a little just from your words of encouragement.

so, I am on:

2 mg of ativan 3 times a day for anxiety

1 mg respiridone at bedtime for sleep and anxiety, and I read somewhere that it has some ocd effect

250 mg anafranil at bedtime for OCD.

and I have therapy once a week, only went once so far.

in your opinion, if these meds dont pan out...where might be the next step?

Ive been on anafranil for 5 years, and I was on tofranil before that for 14.

[Ted A Grossbart, Ph.D.]

Specific meds are not my area of expertise.  while they certainly can help I would put your energy into the psychotherapy for a longer term sloution.

tg

[taraak]

oh, I am.  I have no intention of quitting therapy any time soon.