Aa
Where do I go from here?
I am a 35 year old male. I've had anxiety / ocd / depression my whole life. As a child, I didn't really "know" that I was "sick". It wasn't until I was older that I was sophisticated enough to understand. Looking back as far as I can remember I had the feelings/actions. It wasn't even until I was in my 30s that I acknowledged just how much of an impact all of this was having on my life. I knew that I was anxious / ocd / depressed, but I thought I was in a rut and could just "power through". I met a girl - who I am still with - that helped me understand that a 30 year rut was not a rut. I finally got help by seeing a therapist and taking medication. Just my awareness and acknowledgement was a huge step towards getting well.
My conditioned has changed over the years. As a kid I didn't want to step on the cracks in the pavement, I had to change the channels in a certain order, etc. I remember writing my name on a piece of paper to do homework and not thinking it was "right". I would crumple it up and start again. I would sometimes go through a whole pad doing this. I remember telling people that I was depressed (around age 10?). People would tell me I didn't know what that word was and that I was fine.
My mom is super anxious, my dad had some kind of personality disorder. My twin brother has ocd also.
In my teenage years, I developed social anxiety disorder and cleanliness phobias. I no longer have those. My condition morphs/changes. My main symptoms are perfectionism, neatness and list making. I will spend hours making lists. Everything needs to be planned so that I don't forget anything and things are done "right". I don't really have germ phobias anymore. I am constantly thinking/planning and analyzing. My brain NEVER stops!!! I also have/have had hypochondria and poor impulse control.
My main symptoms
-Depression
-Details/Lists/Organization
-Perfectionism
-Always trying to get things done / not having fun relaxing (I will do relax when everything is done)
-Constant thinking and analyzing and planning
-Hard time concentrating/Remembering
I dealt with this for the first 30 years of my life. It wasn't until I meant my gf and had a lot of other things happen that I realized I needed to do something.
In typical ocd fashion, I researched doctors and ended up seeing numerous doctors. I was diagnosed with ocd within 5 minutes of talking to them. I started seeing a therapist and taking medicine. I was always dead set against meds but I finally just became so unhappy and desperate.
I don't feel like I have ever been given a real accurate diagnosis. Of all the drs and therapist that I have seen, the following have been mentioned:
ocd
ocpd
bipolar 2
add / adhd
dysthmia
I haven't had good luck with doctors. I don't expect a magic bullet or something. I have seen 3 therapist and 2 nurse practitioners in addition to 4 pcps (for fatigue). I have had awful fatigue the last couple of years and many other side effects. I was told my fatigue is all in my head or a side effect of medicine.
I have been on:
zoloft - helped with anxiety as I was SO anxious, but we ended up changing because of side effects and not working on the ocd
around this time I was also prescribed ativan and similar meds to calm me down. I would fall asleep with 20 minutes.
I started on Luvox. Wellbutrin was added in to help with depression/combat side effects. I was on this combo for a year or two.
I was given ritalin which is the only thing that has made me feel better. Not so much the euphoria but just a general sense of well being/optimism.
I stopped taking that as it was prescribed for fatigue/focus and didn't improve either.
At this point, I went to see another doctor as I had been seeing that nurse for years and I just felt that I needed a second opinion. I also got a new therapist as I wasn't getting helped. I was determined to have a fresh start and finally get well.
This nurse came HIGHLY recommended by a friend of mine. She had me stop the wellbutrin and luvox and put me on prozac/lamictal/risperidone/amphetamine salts. I would fall asleep after taking the max dose of amphet salts (this blows everyone's mind) and ended up getting off the lamictal/risperidone too. We went to her "mentor" psychiatrist for a second opinion. He thought that the drugs I had done when I was younger may have done damage (even though I had all this before then) and told me to go up on the prozac.
She just put me on wellbutrin again (even though she took me off of it) and is lowering the prozac as it is not working. She thinks that SSRI's aren't working (I have been maxed out dose wise on all of the ones that I listed). She wanted me to get on Depakote. I researched it and didn't want to take it.
At this point I am frustrated.
I don't know if I should change meds or get off them altogether. Are they doing more harm than good? I have a hard time knowing what is "chemical" or "situational" as far as my depression etc is concerned. I am also concerned about the long term side effects of ssri's.
If I go off of them altogether and am a wreck, does it take long for them to start working again? Is there any harm?
I just feel like I have tried everything. Perhaps I am not "curable". Maybe this is as good as it gets.
Since typing this I was told:
The last I heard from the np
Depress that coexist with ocd is particularly serotonegic. which means u need higher dose of SSRI and theraputic effect is delayed to 12 weeks or longer. The average response of an ocd pt is abt 35 percent reduction in symptoms the theraputic repsonse in ocd maybe less dependant on d immediate avail of 5 ht than is the theraputic resp in dep. Thus, when tryptophan is depleted from dep pts and 5ht is diminished pts who have respon to ssris transiently deteriorate until 5 ht synthesis is restored. By contrast when tryptophan is depleted from OCD pts who have responded to ssri their ocd symptoms are not worsened. by contrast when tryptophan is depleted from ocd pts who have responded to ssri their ocd symptoms are not worsened. This suggests that ssris work via diff mech in ocd than in depr
ocd response to ssri
a specifically require 5 ht, thd responses are slower and less robust. Although ssri's are the foundation if TX for ocd, many pats are refractory and require augmentation
1. adding klonopin
2. adding buspar
3. lithium
4. trazadone
5. conventional or atypical antipsychtc
6. behav therap
Thoughts?
My conditioned has changed over the years. As a kid I didn't want to step on the cracks in the pavement, I had to change the channels in a certain order, etc. I remember writing my name on a piece of paper to do homework and not thinking it was "right". I would crumple it up and start again. I would sometimes go through a whole pad doing this. I remember telling people that I was depressed (around age 10?). People would tell me I didn't know what that word was and that I was fine.
My mom is super anxious, my dad had some kind of personality disorder. My twin brother has ocd also.
In my teenage years, I developed social anxiety disorder and cleanliness phobias. I no longer have those. My condition morphs/changes. My main symptoms are perfectionism, neatness and list making. I will spend hours making lists. Everything needs to be planned so that I don't forget anything and things are done "right". I don't really have germ phobias anymore. I am constantly thinking/planning and analyzing. My brain NEVER stops!!! I also have/have had hypochondria and poor impulse control.
My main symptoms
-Depression
-Details/Lists/Organization
-Perfectionism
-Always trying to get things done / not having fun relaxing (I will do relax when everything is done)
-Constant thinking and analyzing and planning
-Hard time concentrating/Remembering
I dealt with this for the first 30 years of my life. It wasn't until I meant my gf and had a lot of other things happen that I realized I needed to do something.
In typical ocd fashion, I researched doctors and ended up seeing numerous doctors. I was diagnosed with ocd within 5 minutes of talking to them. I started seeing a therapist and taking medicine. I was always dead set against meds but I finally just became so unhappy and desperate.
I don't feel like I have ever been given a real accurate diagnosis. Of all the drs and therapist that I have seen, the following have been mentioned:
ocd
ocpd
bipolar 2
add / adhd
dysthmia
I haven't had good luck with doctors. I don't expect a magic bullet or something. I have seen 3 therapist and 2 nurse practitioners in addition to 4 pcps (for fatigue). I have had awful fatigue the last couple of years and many other side effects. I was told my fatigue is all in my head or a side effect of medicine.
I have been on:
zoloft - helped with anxiety as I was SO anxious, but we ended up changing because of side effects and not working on the ocd
around this time I was also prescribed ativan and similar meds to calm me down. I would fall asleep with 20 minutes.
I started on Luvox. Wellbutrin was added in to help with depression/combat side effects. I was on this combo for a year or two.
I was given ritalin which is the only thing that has made me feel better. Not so much the euphoria but just a general sense of well being/optimism.
I stopped taking that as it was prescribed for fatigue/focus and didn't improve either.
At this point, I went to see another doctor as I had been seeing that nurse for years and I just felt that I needed a second opinion. I also got a new therapist as I wasn't getting helped. I was determined to have a fresh start and finally get well.
This nurse came HIGHLY recommended by a friend of mine. She had me stop the wellbutrin and luvox and put me on prozac/lamictal/risperidone/amphetamine salts. I would fall asleep after taking the max dose of amphet salts (this blows everyone's mind) and ended up getting off the lamictal/risperidone too. We went to her "mentor" psychiatrist for a second opinion. He thought that the drugs I had done when I was younger may have done damage (even though I had all this before then) and told me to go up on the prozac.
She just put me on wellbutrin again (even though she took me off of it) and is lowering the prozac as it is not working. She thinks that SSRI's aren't working (I have been maxed out dose wise on all of the ones that I listed). She wanted me to get on Depakote. I researched it and didn't want to take it.
At this point I am frustrated.
I don't know if I should change meds or get off them altogether. Are they doing more harm than good? I have a hard time knowing what is "chemical" or "situational" as far as my depression etc is concerned. I am also concerned about the long term side effects of ssri's.
If I go off of them altogether and am a wreck, does it take long for them to start working again? Is there any harm?
I just feel like I have tried everything. Perhaps I am not "curable". Maybe this is as good as it gets.
Since typing this I was told:
The last I heard from the np
Depress that coexist with ocd is particularly serotonegic. which means u need higher dose of SSRI and theraputic effect is delayed to 12 weeks or longer. The average response of an ocd pt is abt 35 percent reduction in symptoms the theraputic repsonse in ocd maybe less dependant on d immediate avail of 5 ht than is the theraputic resp in dep. Thus, when tryptophan is depleted from dep pts and 5ht is diminished pts who have respon to ssris transiently deteriorate until 5 ht synthesis is restored. By contrast when tryptophan is depleted from OCD pts who have responded to ssri their ocd symptoms are not worsened. by contrast when tryptophan is depleted from ocd pts who have responded to ssri their ocd symptoms are not worsened. This suggests that ssris work via diff mech in ocd than in depr
ocd response to ssri
a specifically require 5 ht, thd responses are slower and less robust. Although ssri's are the foundation if TX for ocd, many pats are refractory and require augmentation
1. adding klonopin
2. adding buspar
3. lithium
4. trazadone
5. conventional or atypical antipsychtc
6. behav therap
Thoughts?
I hope I can remember everything you wrote while I'm writing this. You have had it rough!
In any case, I too have had OCD for a very long time. Teenage years it was very evident and from there it just kind of snowballed. I had other issues as a child as well.
OCD does change over the years. What I think is happening is that we sort of develop our own coping skills toward certain things that we do and at some point we are able to get control of them and they go away only to have something else take its place.
I cannot relate to the cleanliness OCD or germs other than HIV Anxiety which I did have for a while. My OCD is tethered in the thought process realm. You name it I can forward think it and catastrophize it.
I have often thought that for me at least that OCD is my first diagnosis. With untreated OCD comes the anxiety and the constant anxiety leads to depression. I mean really, who wants to live this way. So I highly advocate treating the OCD first. Also, I believe I have undiagnosed ADD just from what teachers said when I was younger. However, I am very successful so I obviously learned coping skills for that as well. So don't be surprised if you have both OCD and ADD/ADHD. I am famous for asking a questions and not bothering to listen to the answer only to turn around and ask the same question again. Drive my husband nuts!
The first and formost therapy I think a person with OCD needs is cognitive behavioral therapy. Without these tools, I would probably never leave my house. I say that because I do still have panic attacks in certain situations and I do control them effectively with CBT...breathing and self-coaching.
As far as meds go, I have been on a few different ones. Started on Prozac and that worked but it has side effects that I didn't like and after a number of years on it, I stopped taking it and was Med free for maybe 10 years (I can't remember exactly) but I was never OCD free. It was always a battle. When stressors just became too much for me I tried lexapro and celexa. Didn't like the side effects especially the one that interfers with my sex drive. So in talking to my GP we decided to try Wellbutrin and I was leary but it did work. When I became even more stressed, the 150 mg was just not enough and I jumped up to 300 and that is what I am currently on. I also take 1 mg of klonopin at night to sleep becasue otherwise I wouldn't sleep at all. Am I addicted...I'm sure of it but you know what...I don't care. I have absolutely no plans to ever go off of the medication because I don't want to go back to the way I was before.
When you said your mind is always going it reminded me of my trip to see a social worker at my work during a particularly hard time. During the walk there I found myself rehearsing what I was going to say...how stupid is that! Anyway I told her and then I told ther that I don't have a quiet mind and that there is an ever ongoing dialog going on in my head. Sounds like you.
I feel like I have jumped all over the place in response to your post. But I say if you don't have a good handle on CBT, then find a psychologist that can teach it to you and practice it. The meds, if they are not working after 4 weeks, then they probably are not the right one for you or it is the wrong dose. I don't need klonopin during the day...only at night...and I just realized I didn't take my medication this morning...I hate when that happens although I never feel any different...just pick up tomorrow.
If there isn't anything I have addressed, please let me know.
Take care!
In any case, I too have had OCD for a very long time. Teenage years it was very evident and from there it just kind of snowballed. I had other issues as a child as well.
OCD does change over the years. What I think is happening is that we sort of develop our own coping skills toward certain things that we do and at some point we are able to get control of them and they go away only to have something else take its place.
I cannot relate to the cleanliness OCD or germs other than HIV Anxiety which I did have for a while. My OCD is tethered in the thought process realm. You name it I can forward think it and catastrophize it.
I have often thought that for me at least that OCD is my first diagnosis. With untreated OCD comes the anxiety and the constant anxiety leads to depression. I mean really, who wants to live this way. So I highly advocate treating the OCD first. Also, I believe I have undiagnosed ADD just from what teachers said when I was younger. However, I am very successful so I obviously learned coping skills for that as well. So don't be surprised if you have both OCD and ADD/ADHD. I am famous for asking a questions and not bothering to listen to the answer only to turn around and ask the same question again. Drive my husband nuts!
The first and formost therapy I think a person with OCD needs is cognitive behavioral therapy. Without these tools, I would probably never leave my house. I say that because I do still have panic attacks in certain situations and I do control them effectively with CBT...breathing and self-coaching.
As far as meds go, I have been on a few different ones. Started on Prozac and that worked but it has side effects that I didn't like and after a number of years on it, I stopped taking it and was Med free for maybe 10 years (I can't remember exactly) but I was never OCD free. It was always a battle. When stressors just became too much for me I tried lexapro and celexa. Didn't like the side effects especially the one that interfers with my sex drive. So in talking to my GP we decided to try Wellbutrin and I was leary but it did work. When I became even more stressed, the 150 mg was just not enough and I jumped up to 300 and that is what I am currently on. I also take 1 mg of klonopin at night to sleep becasue otherwise I wouldn't sleep at all. Am I addicted...I'm sure of it but you know what...I don't care. I have absolutely no plans to ever go off of the medication because I don't want to go back to the way I was before.
When you said your mind is always going it reminded me of my trip to see a social worker at my work during a particularly hard time. During the walk there I found myself rehearsing what I was going to say...how stupid is that! Anyway I told her and then I told ther that I don't have a quiet mind and that there is an ever ongoing dialog going on in my head. Sounds like you.
I feel like I have jumped all over the place in response to your post. But I say if you don't have a good handle on CBT, then find a psychologist that can teach it to you and practice it. The meds, if they are not working after 4 weeks, then they probably are not the right one for you or it is the wrong dose. I don't need klonopin during the day...only at night...and I just realized I didn't take my medication this morning...I hate when that happens although I never feel any different...just pick up tomorrow.
If there isn't anything I have addressed, please let me know.
Take care!
Wow. I'm just like you in a lot of ways. I know I've had it my whole life although I never really did anything about it until I was about 28, and I'm 39 now. Ive been to different doctors too and they all seem to have a slightly different opinion it diagnosis although ocd is always thrown in there.
I feel for you. It's hard when everyone thinks something different. I haven't been to anyone in years and I recently decided to see someone to make sure in on the right meds and to sort of check on with therapy. And just a like you, my issues have changed over the years, with some things coming back and others going away.
I don't really know what to say to you here, other than that you are not alone and everything you are dealing with is not uncommon. It's not an exact science. Ocd has many layers and cycles and its just something that always needs tweaking to stay current with what goes on in your mind and life. I've waited too long to go back and see someone, which could be good or bad, but my gut is telling me its time.
It might just be time for you to see someone new, someone up to date with all the current knowledge, and start completely over. New therapy, new cycle of meds.
I'm sorry I wasn't much help but I also didn't want your post to go ignored. Just remember that you are as normal as everyone else. Sometimes our brains just work differently and you have to find the right course of action. But you will, and at the end if the day, you'll figure it out and everything will be okay.
I feel for you. It's hard when everyone thinks something different. I haven't been to anyone in years and I recently decided to see someone to make sure in on the right meds and to sort of check on with therapy. And just a like you, my issues have changed over the years, with some things coming back and others going away.
I don't really know what to say to you here, other than that you are not alone and everything you are dealing with is not uncommon. It's not an exact science. Ocd has many layers and cycles and its just something that always needs tweaking to stay current with what goes on in your mind and life. I've waited too long to go back and see someone, which could be good or bad, but my gut is telling me its time.
It might just be time for you to see someone new, someone up to date with all the current knowledge, and start completely over. New therapy, new cycle of meds.
I'm sorry I wasn't much help but I also didn't want your post to go ignored. Just remember that you are as normal as everyone else. Sometimes our brains just work differently and you have to find the right course of action. But you will, and at the end if the day, you'll figure it out and everything will be okay.
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