Monday, 11 August 2014 4 comments

OCD medications

Largely over the years, my experience with medication for OCD has been centred around SSRI's (selective serotonin re-uptake inhibitors). In the scheme of mental health medication, these are relatively new medicines but have become widely used from everything from depression to eating disorders.

Over the years I have taken the following (some names might be UK only or brands, I'm not sure) -

Paroxetine (Paxil, Seroxat)
Citalopram (Cipramil, Celexa)
Escitalopram (Lexapro, Cipralex)
Fluoxetine (Prozac)
Sertraline (Zoloft, Lustral)

Tricyclic antidepressant
Clomipramine (anafranil)

Of all of these medications, in terms of impact on OCD, I think I found Clomipramine the best. However, the side effects made it counter-productive. I was getting a very dry mouth, tiredness, sweating ridiculously, trouble sleeping and absolutely no sex drive.

With paroxetine and Citalopram I couldn't stop my legs bouncing when sitting down. I think it's called something like restless leg syndrome or something. I kind of had this anyway due to anxiety but the bouncing of my legs was worse and was fuelling anxiety. In fact I think Citalopram heightened my anxiety more than anything else I've tried. That's when a change came and I was offered Escitalopram.

Escitalopram was the medication I was on the longest. It solved the problems I had with Citalopram and was reasonably effective. It came about that I had to stop taking this though as it was not getting approval from the medical community in the UK. It was proving dangerous for certain patients and some research had linked it to heart problems and some other stuff, but this was mostly in older patients. A decision was taken by various medical boards that it shouldn't be prescribed any more. It sounds like these doctors were being overly cautious, but my doctor was getting flack for prescribing it to me on an on-going basis despite the latest denouncing of the drug.

Fluoxetine was useless. It made no difference to me whatsoever. I was on 20mg, then 40mg, then 60mg and it was like I wasn't on any medication at all. Absolutely no impact. I tell you what, that was a hard few months going through the dosage changes and waiting for improvement. They say 4-6 weeks for every new medication or dosage increase. Working through different medications is a difficult thing. Not only can it increase the very symptoms you are trying to get rid of, but because you also know that you can't expect any improvement for the next several weeks, you end up wondering how on earth you are going to get through it? Today is too long for me to endure, never mind 6 weeks!!

Sertraline is my current SSRI and I have to say I am rather pleased with it. I have some side effects like almost falling asleep every afternoon while at work, but I try to fix this by standing up and having a walk around the office for a few minutes to wake up. I also sweat quite a bit more than normal (hyperhidrosis), but that's the worst of the side effects. Sertraline has not removed my thoughts, as I think they are quite normal thoughts anyway, but they help reduce the anxiety that normally accompanies them.

I have a level of anxiety all of the time and the sertraline doesn't remove that, but it's managed to the level that I can be functioning with the anxiety, even use it occasionally to my advantage. My mind still races and I can either zone in on a specific topic intensely or be jumping around frantically, but the sertraline seems to be preventing any debilitating bouts of anxiety, fear and any all-consuming compulsions.

Sometimes I think that if people knew what I was thinking, they'd truly believe I was insane. Especially when medication does not eradicate the whole problem.

The purpose of this post is not to dissuade anyone from trying these medications. I don't want anyone going to their doctor and saying "LDSruminations says Prozac is awful, so I won't take it".

This post is more about saying that if you try a medication and it doesn't work, there are other options. In fact Prozac might be the very one for you. While it didn't work for me it works for many other people. I have just found that some were better than others for me.

I was once close to being prescribed an anti-psychotic as well, but that scared me a bit and I told the doctor just to leave me on SSRIs. Just the name of that type of drug scares me. I went down the route of believing I was schizophrenic at the mere suggestion. That caused several weeks of anxiety and checking medical sources for symptoms that matched mine.

There are medical options out there, and it is very wise to consult professionals about them. As long as it doesn't exacerbate your condition, doing your own research is helpful too. It was my own research that led to the diagnosis of OCD in the first place.

I had no clue about OCD until I googled my thoughts. What a mind bending trip I was put on when my compulsion to check the internet and medical symptoms actually yielded some beneficial fruit. I was astounded that I was reading exactly how I felt. I wasn't trying to make it fit, it just did.

Reading and knowledge can be your friend in the right circumstances.

If you are on or considering medication, it is my belief that it is a worthwhile course of action. I don't know if I will ever be off medication again, as I've proven to relapse very badly when I'm off medication but I am losing my pride in this instance and submitting to the prospect I may need them long-term.
Tuesday, 15 July 2014 0 comments

Call it what it is

I started thinking yesterday back to when it was first confirmed that I had OCD. I chose to reflect a little bit because it’s easy to often get lost in just getting through the day.

I remember one of the first things I learnt about how to deal with OCD.

It was the idea of every time an obsessive thought comes, you are to stop a second and label it.

Labelling means telling yourself it is an OCD thought and not coming from you per se.

At first I remember starting to do this and it not making any difference at all. In fact in some ways it made me feel like I was lying to myself and it was just another way for me to not face the truth.

I mean how can a thought you have in your head, which goes with an emotional reaction so deeply felt and poignant, be wrong?
That is the $64million question.

I struggle all the time with this still, but labelling it is a necessary process.

Don’t get me wrong, I am not perfect in this and I have certainly not overcome OCD, but when this labelling is done regularly, over an extended period of time, you can start to believe it as a possibility.

Separating yourself from certain thoughts and suggesting that they are not really you is a useful technique.

I have come to identify OCD thoughts with something almost like a passenger who follows me around, and is a terrible conversationalist.

It’s a bit like that nagging kid in the back of the car on a long journey, but the journey doesn’t seem to end. What’s the destination?? I dunno.

For a time I was very disciplined in labelling thoughts as obsessive or not. It worked relatively well. The challenge is in being consistent and that’s where I fail a bit.

My wife and I do not like talking about OCD as OCD. It all sounds very doom and gloom. So, although slightly crazy, we have given it all a name.

Ladies and gentleman, let me introduce PETE!

We call it Pete. That’s it’s name.

So when I am feeling a bit consumed in thoughts etc I can say to myself “Pete is an asshole”.

I say to my wife “Pete is being an asshole again”.

Sorry for the sudden appearance of a swear word, but that’s how it goes. This statement doubles up as a labelling of the thought and also an exposure to scrupulosity worries.

In the scrupulous mind swearing is akin to taking someone’s life or something close.

So I say that swear word to describe OCD.

It’s surprisingly refreshing.

Who would have thought that a good swear word could calm anxiety.

Is God going to disown me or leave me alone for simply saying “asshole”??

Sanity says no, but OCD says yes.

I have to take that chance.

Labelling alone is not enough. It's a great start, but other stuff has to follow I think. I've got some ideas and thoughts on that, but maybe for another post.
Monday, 14 July 2014 0 comments

Triggers and the descent into the inner mind

I have noticed all of my images on the site have disappeared. Well isn’t that a tad annoying!!

I have gone through all of the processes to try and locate the images, but it seems like my whole gallery has disappeared from google. Maybe my fat fingers hit a big ol’ delete button without realising.

Whatever the reason, the images are gone.

Sorry about that.

They were probably the best things on here.

One really interesting thing about OCD, or my OCD, is that I end up having OCD about OCD.
Boy does that get confusing!!

Many times I obsess about whether what I have is actually OCD. Maybe I’m just trying to make it fit. Maybe it’s just another lie and distraction from the TRUTH of my thoughts.

After all, surely it was lying and distraction that got me in this confused mess in the first place right?




Or so my head tells me.

I was having a chat with someone over the weekend and they were asking me if I thought I knew what the triggers were. I stumbled. I couldn’t come up with an answer.

Cue spending the rest of the weekend worrying about whether I actually had OCD or not. Maybe I’m just lying? Maybe I’m just deceiving myself? The diagnosis all seems a bit too convenient does it not?

I mean what are the chances that there is a medical condition whose symptoms completely match up with my general daily feelings. I know! Sounds way too convenient right. I must be lying to myself!! There is no other possible explanation.
I may as well have had this to obsess about, because if it wasn’t this it would just be something else.

When I get to this stage, my normal reaction is to google it and read everything I possibly can about OCD to either confirm or denounce my diagnosis. Ahhhh blessed reassurance, which never lasts!!

The hours I have spent on google reading about OCD is obscene. I could have used that time and effort to become a millionaire. Heck maybe I’d be ruling the world right now, the effort and time spent was so significant.

Google and I have a love hate relationship. Not only is it my number 1 re-assurer, but it is also my number 1 nemesis.

I flippin’ hate/love Google.

It is tough to identify triggers and hold on to that definition or clarity because when Obsessions flare up again it doesn’t really matter to me what the trigger was, I am too lost in the thoughts and anxiety.

Something decent came of it though. It made me think of my triggers for a post. Hopefully posting them here gives me a physical as well as a mental reminder of what these are. I mean I guess I know them, but I just haven’t nailed them down for long enough to make an impact, due to second guessing whether I have OCD in the first place.

Generic triggers
Stress – busy life, lots to do

Tiredness – if I miss sleep then I really feel anxious

Specific triggers
Reading scriptures – I am just like the bad people the scriptures talk about. I can see all my sins and the damnation awaiting me if I don't change. Oh and have I denied the Holy Ghost? - Wow that’s a strange one huh

Hearing controversial or ‘anti Mormon’ discussions or topics – The mere suggestion of disagreement leads to the question ‘Is my whole life a lie?’ (My biggest challenge right now)

Work/employment – It’s like my brain is annoyed that I have to focus on something else, other than OCD. I spend all day at work fighting for headspace to concentrate on my job. A good example of this is that I am at work typing this right now. I have to get this out in the hope I will be able to work a bit later on. Maybe my blog is becoming part of a compulsion to this obsession with OCD.

Any kind of discussion of an existential nature – MIND BLOWN – back to square one

There are more I reckon, but these are the main current ones. I can see how OCD has changed over the years. It started with scrupulosity, confessing everything!! It moved to relationship OCD, fear of who I loved and who I didn’t. Then it was existentialist stuff. Now it’s scrupulosity and existentialist stuff all wrapped up together.

I am almost intrigued as to what is coming next.

So, what a lovely life it is when you are freaked by the idea of going to work and sitting there for 8 hours a day, anxious when you have anything to do, on edge with even slight tiredness, can’t turn to the scriptures for uplift and support, feeling like your whole life is a lie and then questioning if you or Neptune really even exists, and if so, where and how?
Every thought as it occurs is so powerful and consuming.

But I will tell you one thing……… I actively try not to give in to any of it.

Do I go to work every day? YES.

Do I get on with my busy schedule? YES.

Do I read Scriptures? YES.

Do I go to church and teach lessons? YES.

I will tell you one thing…. It’s hard!! However, these hard things are the things that will save me in time.
I used to avoid reading scriptures, and I must have gone about two years without even opening them. However, every day is now my exposure therapy. This makes every day a challenge. It almost feels easier to just give in to the thoughts. At least then it would just be the thoughts and not an active fight against them. But the fight is necessary.

While a ‘fight’ sounds very active, it can actually be passive. Involved in the exposure therapy for me is trying to ignore what I am being told in my head and then just engaging with the thing I’m scared of. It’s really tough sometimes, but it gets easier. I just wish it lasted longer.

I fight all day long. The frustrating thing is once I’ve broken down the barriers a bit one day, the next day I wake up and they are all back again.

I think I’m making progress, but then there’s just those days that grab you by the throat and choke any sense of safety and wind out of you. The chest tightens. The brain races. The legs twitch constantly and you feel hyper aware of everything around you, even though the truth is you are only aware of your own feelings.

I need to figure this stuff out a bit better. I do quite well pretending. This just adds to the sense of living a lie. Sometimes I over compensate, trying to be all light and jovial. I’m pretty sure that becomes annoying.
I am going to make a post about my compulsions soon as I am beginning to see more of them. I also want to try and put my thoughts down about scrupulosity at some future point, but one step at a time. I have work to do.