![[dr. bob]](/dr-bob-sm.gif)
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 21 of 21. This is the beginning of the thread.
Posted by TheMeanReds on March 21, 2007, at 11:37:26
My doctor thinks Im OCD. I dont think I am. But I never thought I was Bipolar because I dont go to the emergency room. How do you know if the way you do things are obessive and compulisive, if you think that is the way things should be done? My sister bites her fingernails bloody when she is stressed, I think that is obsessive and complusive.
But HOW do I know if I am, since I'm not someone else observing me? Is it all just relative? How do you know what color your eyes are if you dont ever look in the mirror? Someone tells you.
I'm very confused on this issue.
Posted by Phillipa on March 21, 2007, at 12:21:41
In reply to How Do I Know If I Have OCD?, posted by TheMeanReds on March 21, 2007, at 11:37:26
The cuticle biting I do too and know it's anxiety but used to count numbers and drink four times from a cup at the same time. I think it may be mild OCD. The hardcore is washing your hands till they bleed over and over again, fear of germs, thinking you ran over someone with the car, going back and forth to check that you did something. Basically it takes so much time it interfers with your life. Love Phillipa
Posted by Joe Bloe on March 21, 2007, at 12:43:35
In reply to Re: How Do I Know If I Have OCD? » TheMeanReds, posted by Phillipa on March 21, 2007, at 12:21:41
I may be wrong, but I think there is an obsessive component and an impulsive component.
I have the obsessive component: repeating thoughts over in my head like clockwork, until I am overcome with anxiety and even panic. This is the ideation aspect, that for me, doesn't cross the threshold into compulsive activity (at least in any apparent way).
The compulsion might be explained as a practice or physical action undertaken to remove or surmount the obsessive idea. The individual comes to believe that a particular action, although it may be unrelated to the original obsessive ideation, must be undertaken repeatedly to ward off or overcome the original thought.
In this regard, the compulsion may also become an obsession and has the capability to spin out of control, devouring a person's life experience.
This is how I've understood it from growing up around a relative with debilitating OCD.
Posted by TheMeanReds on March 21, 2007, at 13:09:04
In reply to Re: My understanding of OCD, posted by Joe Bloe on March 21, 2007, at 12:43:35
I like things very organized. If my roommate puts the cheese on the bottom shelf of the fridge I must put it back to the second shelf. And I like things clean. I suppose this is obessive, because I can leave the house if the fridge is not the way I like it.
I have insomnia because I cannot shut my mind off with thoughts that are not even worth thinking about over and over and over. I suppose that is obessive.
I check fire hazards alot. I'm certain I'm going to die drowning, but will swim almost anywhere. I'm going to die someday anyway, right?
I refuse to wear a sports jacket with a leather designer purse. Everything must match to my taste. I take forever to get ready to go out at night. If I had 'nothing suitable to wear', I would not leave the house. This I guess is compulsive?
Posted by psychobot5000 on March 21, 2007, at 13:20:53
In reply to Re: My understanding of OCD, posted by TheMeanReds on March 21, 2007, at 13:09:04
> I like things very organized. If my roommate puts the cheese on the bottom shelf of the fridge I must put it back to the second shelf. And I like things clean. I suppose this is obessive, because I can leave the house if the fridge is not the way I like it.
>
> I have insomnia because I cannot shut my mind off with thoughts that are not even worth thinking about over and over and over. I suppose that is obessive.
>
> I check fire hazards alot. I'm certain I'm going to die drowning, but will swim almost anywhere. I'm going to die someday anyway, right?
>
> I refuse to wear a sports jacket with a leather designer purse. Everything must match to my taste. I take forever to get ready to go out at night. If I had 'nothing suitable to wear', I would not leave the house. This I guess is compulsive?
>
>The symptoms you describe sound to me like OCD--maybe a moderate level of it. ...I have some such symptoms, and since I more or less grew up with them, I didn't entirely realize how abnormal they are, and so didn't realize I had OCD until long after I'd developed it.
There must be many websites listing symptoms and descriptions for OCD--maybe best to do a google search, then see if the things described match you?
Posted by Phillipa on March 21, 2007, at 13:27:10
In reply to Re: My understanding of OCD, posted by psychobot5000 on March 21, 2007, at 13:20:53
Seriously? I think most or half of people are like that. And some have reasons as my Son grown is blind and a place for everything and he hates unmatched clothes don't we all. And if it doesn't interfer with you life don't worry about it. And OCD is anxiety related. When mine is down I care less when up more. Luvox is an antidepressant taken out of habit for me for years supposed to be for OCd. Love Phillipa
Posted by TheMeanReds on March 21, 2007, at 13:42:27
In reply to How Do I Know If I Have OCD?, posted by TheMeanReds on March 21, 2007, at 11:37:26
Thanks for the insight everyone. I'm alot less confused. Maybe I'll try mismatching on purpose in the future. With a benzo, of course =)
Posted by Ines on March 21, 2007, at 14:10:43
In reply to Re: How Do I Know If I Have OCD?, posted by TheMeanReds on March 21, 2007, at 13:42:27
Perhaps it doesn't matter so much what the diagnosis is as long as you get the right treatment for you? If the symptoms you have don't bother you enough to want relief from them, then your debatable ocd diagnosis is only is theoretical construct of no importance. From what I read a lot of people who score high on IQ tests have ocd-like characteristics and they don't even realise it.
Ines
Posted by Racer on March 21, 2007, at 16:03:49
In reply to How Do I Know If I Have OCD?, posted by TheMeanReds on March 21, 2007, at 11:37:26
Well, there's OCD, and then there's OCPD -- Obsessive Compulsive Personality Disorder. The easiest way to distinguish the two that I've ever heard is that OCD causes discomfort for the person who has it, OCPD causes discomfort for everyone around that person... That's a simplistic way of putting it, but it kinda does work, from what I understand about the two.
OCD can be purely obsessive, or it can include compulsions. The compulsions are a way to reduce the anxiety caused by the obsessions. The obsessions may be related to dirt or germs, or they can be anything. You know that old rhyme, "Step on a crack?" If you think of that and avoid stopping on any cracks in the sidewalk, at any time, for any reason, to the point of walking around an area with too many cracks, that might be OCD. Having a specific place for cheese in the fridge is more OCPD, I'd say.
There's a lot of overlap, though. My "official" dx includes a note saying "Obsessive Compulsive Personality Traits." I do have certain silly compulsions -- if I raise or lower the volume on the TV or stereo, it has to go to an even number; I have to use three paper towels in a public restroom, really stupid things -- but the bottom line on it is that they don't interfere with my functioning. (That I can tell...) OCPD is more a diagnosis meaning "perfectionist."
What is it that your doctor is basing his/her opinion on? Didn't he/she say what it is that makes you look as though you have OCD?
And even if it's true, OCD is basically a slightly more focused anxiety disorder. It's not a badge of shame.
Hope that helps...
Posted by yxibow on March 21, 2007, at 16:27:51
In reply to Re: How Do I Know If I Have OCD?, posted by Racer on March 21, 2007, at 16:03:49
> Well, there's OCD, and then there's OCPD -- Obsessive Compulsive Personality Disorder. The easiest way to distinguish the two that I've ever heard is that OCD causes discomfort for the person who has it, OCPD causes discomfort for everyone around that person...
OCD can cause discomfort for the person and be taxing on the family at the same time. Often psychiatric support is necessary for the family for a difficult case. The one thing the family should not do is "enabling", during CBT, for example, which is say, for example, seeing the pain of the sufferer, and giving them gloves so they don't have to touch something they think is dirty. The OCD sufferer, while under anxiety and pain, doesn't learn enough to do it on their own.
That's a simplistic way of putting it, but it kinda does work, from what I understand about the two.Yes... OCPD is not OCD and is a personality disorder.
>
> OCD can be purely obsessive, or it can include compulsions. The compulsions are a way to reduce the anxiety caused by the obsessions. The obsessions may be related to dirt or germs, or they can be anything. You know that old rhyme, "Step on a crack?" If you think of that and avoid stopping on any cracks in the sidewalk, at any time, for any reason, to the point of walking around an area with too many cracks, that might be OCD. Having a specific place for cheese in the fridge is more OCPD, I'd say.
>
> There's a lot of overlap, though. My "official" dx includes a note saying "Obsessive Compulsive Personality Traits." I do have certain silly compulsions -- if I raise or lower the volume on the TV or stereo, it has to go to an even number; I have to use three paper towels in a public restroom, really stupid things -- but the bottom line on it is that they don't interfere with my functioning. (That I can tell...) OCPD is more a diagnosis meaning "perfectionist."
That actually sounds like OCD. The obsession is the Volume must be 2,4,6,8.. The compulsion is doing it. You have a feeling you must use 3 paper towels in a restroom, you get anxious if you use 2. That is also OCD.OCD is measured on the YBOCS (Yale-Brown Obsessive Compulsive Scale) of 0-40, around 7 being the subclinical level that can be observed in most people to such a mild level that it is hard to differentiate.
I had a YBOCS of 39 when I exited high school and I could not control my showers which became at times up to 7 hours regardless if I was fainting. I probably had the worst case seen in recent times. I was hospitalized for more than 2 months and things reduced and was in a day treatment program at the same time and then a bit longer.
I am an anonymous pastiche (constructed character to hide identity) in an book by a specialist who I won't name for my own privacy, on OCD.
Today I probably have a YBOCS of 10 or so -- I have pure obsessions as a vestige of what is OCD, a lifetime disorder. They're annoying but if you learn CBT, and you essentially brush them aside, you go on. Some pure obsessions (garbage words, etc) can be really debilitating and can require SSRIs and neuroleptics to block them.
People with OCD know they have OCD about 99% of the time (occasionally it tips into psychosis territory and neuroleptics are needed -- it can also be comorbid with schizophrenia) but feel they cannot stop.
OCD forms a spectrum of disorders which we now know are somewhat related -- the OC Spectrum, OCD, Trichotillomania, Cutting, Tourette's, Tics.
The OC Foundation http://www.ocfoundation.org/ is a good place to start off.> And even if it's true, OCD is basically a slightly more focused anxiety disorder. It's not a badge of shame.
Definately not a badge of shame. No anxiety disorder should be. Its just something that if one is lucid and recognizes it and it interferes with life to a greater extent they should seek CBT and/or CBT with an SSRI as a standard protocol. Its not easy but what you learn you can apply later on.
Posted by nolegirl23 on March 21, 2007, at 20:00:18
In reply to Re: My understanding of OCD, posted by Joe Bloe on March 21, 2007, at 12:43:35
> I may be wrong, but I think there is an obsessive component and an impulsive component.
>
> I have the obsessive component: repeating thoughts over in my head like clockwork, until I am overcome with anxiety and even panic. This is the ideation aspect, that for me, doesn't cross the threshold into compulsive activity (at least in any apparent way).
>
> The compulsion might be explained as a practice or physical action undertaken to remove or surmount the obsessive idea. The individual comes to believe that a particular action, although it may be unrelated to the original obsessive ideation, must be undertaken repeatedly to ward off or overcome the original thought.
>
> In this regard, the compulsion may also become an obsession and has the capability to spin out of control, devouring a person's life experience.
>
> This is how I've understood it from growing up around a relative with debilitating OCD.I agree with this poster, I have been diagnosed with OCD. The majority of my symptoms are of an obsessive nature. Obsessional thinking tends to be my biggest issue. I obsess over things that I have no control over, thoughts and fears repeat over and over again and I can't get them out of my head. The fears that I obsess over cause me great anxiety and panic.
I do have some of the compulsive components as well, When I am getting out of my car, I walk around my car and try to open every door to ensure that it is locked.. When I get really stressed or anxious, I count, and it is a specific count, one one-thousand, two one thousand, three one thousand, and when I get to 4, I start over again. I also freak out if I miss a day at the gym.. I obsess over going to the gym all day, and if for some reason I think I can't go, I am overwhelmed with anxiety. I usually end up leaving work to make sure that I go to the gym..
I guess OCD is different for each of us.
Posted by johnnyj on March 21, 2007, at 20:14:03
In reply to Re: How Do I Know If I Have OCD? » Racer, posted by yxibow on March 21, 2007, at 16:27:51
I am thinking of a trial with anafranil if things don't improve. Have you ever tried it? I have heard it's one of the best and the side effects seem to be unclear. I have heard it really is not that bad, to it is terrible.
Ssri's just cause too much akathisia for me. Maybe, and thats a big maybe, I could stay on a dose of 12.5 of luvox, just can't tolerate anymore than that. Since luvox at 25, and paxil at 5 caused major problems I wonder if all ssri's won't work for me? My BIGGEST problem is with sleep and songs that won't leave my head. The songs are something new about 5 months ago after going off all meds. Right now I may have to do with Remeron. Adjusting to the dose is rough though.
Benzo's are out too. Cause depression.
Do you have any idea about the best clinics out there for OCD?
thank you
johnnyj
Posted by Phillipa on March 21, 2007, at 20:33:45
In reply to Re: How Do I Know If I Have OCD?, posted by Racer on March 21, 2007, at 16:03:49
Racer thanks that describes me perfectly. So it's a personality defect in me. I don't really care as I have cut down seemed to be getting a little ridiculous to do those things so now I purposely step on cracks or walk under ladders. My way of getting rid of superstitions too. No counting either a waste of my time. Love Phillipa
Posted by yxibow on March 22, 2007, at 3:19:18
In reply to Re: How Do I Know If I Have OCD? » yxibow, posted by johnnyj on March 21, 2007, at 20:14:03
> I am thinking of a trial with anafranil if things don't improve. Have you ever tried it? I have heard it's one of the best and the side effects seem to be unclear. I have heard it really is not that bad, to it is terrible.
I haven't tried it -- it is the "gold standard" for hard to treat OCD. It could be called an SRI. Clomipramine has typical side effects for a TCA, sweating, fatigue, dizziness, etc., anticholinergic effects, as well as possibility of EPS though you may or may not experience any or some of these.
> Ssri's just cause too much akathisia for me. Maybe, and thats a big maybe, I could stay on a dose of 12.5 of luvox, just can't tolerate anymore than that. Since luvox at 25, and paxil at 5 caused major problems I wonder if all ssri's won't work for me? My BIGGEST problem is with sleep and songs that won't leave my head. The songs are something new about 5 months ago after going off all meds. Right now I may have to do with Remeron. Adjusting to the dose is rough though.
Songs that don't leave one's head for a period of time is a common condition and isn't necessarily a sign of OCD. However the level of distress sounds like it could be for you.Problems with sleep are not necessarily an issue of OCD unless pure obsessions keep you up at night. (I have had that before.)
Have you had a sleep study before ? Are there any other possible conditions such as sleep apnea (and obesity) that may contribute to less than satisfactory sleep? Have you tried all the standard sleep medications out there as well as ones used for their side effects (a small dose of Remeron may improve REM sleep).
It is unfortunate that SSRIs cause akathisia to this extent. It is certainly possible, and I know it is a unpleasant state to be in. Luvox really is one of the best SSRIs for OCD in my opinion but one needs to be at a level of 200-400 mg to have an effect. 12.5mg of Luvox is a placebo for most people but I grant that you are sensitive to SSRIs. Are you positive that this is not initial agitation as SSRIs can broadly cause this? I assume you have tried most all SSRIs and would not like to try others. Generally newer SSRIs are more targeted and have less unintended transmitter effects but this is not always the case.
Remeron is a very good antidepressant; I don't know if it has been challenged much for OCD. There was one small double blind study from what I can see. It carries a burden of increased weight, largely through increased appetite though this of course is not completely settled. Higher doses rarely change this effect unlike some predictions of transmitter offset.
> Benzo's are out too. Cause depression.Some benzodiazepines can cause depression as they are CNS depressants like alcohol. Not a primary drug for OCD though, usually used as a secondary (e.g. clonazepam), especially as a secondary for SSRIs and to reduce anxiety during CBT.
> Do you have any idea about the best clinics out there for OCD?
Well the best place to start is the OC Foundation, as mentioned, http://www.ocfoundation.org/
On the site there is a compilation of interviews with people associated with intensive treatment programs for OCD
http://www.ocfoundation.org/ocd-intensive-treatment-programs.html
I happened to know vaguely about one of these clinics but I cannot say for my privacy. However, I can say that the OC Foundation is among the premier sources of information for OCD.
> thank you
>
> johnnyj
Posted by cubic_me on March 22, 2007, at 13:01:52
In reply to Re: My understanding of OCD, posted by nolegirl23 on March 21, 2007, at 20:00:18
> I do have some of the compulsive components as well, When I am getting out of my car, I walk around my car and try to open every door to ensure that it is locked..When my pdoc asked me about OCD I said that I do this - he said that that was normal, just safety concious!
I do have other traits, but nothing that really interferes with life, like racer, I can only have the radio on at an even volume or in increments of 5, anything else feels uncomfortable.
Posted by TheMeanReds on March 22, 2007, at 13:36:07
In reply to Re: My understanding of OCD, posted by cubic_me on March 22, 2007, at 13:01:52
I do the volume thing too. I like numbers in increments of eleven. Or if not that it needs to be an even number like 28. I suppose that means my volume my be louder than yours at times. Not that I'm keeping score. =)
Posted by Racer on March 22, 2007, at 16:39:33
In reply to Re: My understanding of OCD » cubic_me, posted by TheMeanReds on March 22, 2007, at 13:36:07
> I do the volume thing too. I like numbers in increments of eleven. Or if not that it needs to be an even number like 28. I suppose that means my volume my be louder than yours at times. Not that I'm keeping score. =)
I've got a thing about numbers in general. I just got done taking a year's worth of math classes, and let me tell you -- it was either heaven or hell for my OCD fixation on numbers! I couldn't drive down the freeway without some weird number/graphing things going through my pathetic little mind! It was truly a time, and what a time it was...
There's actually a theory out there that some cases of early-onset anorexia nervosa might be related to the number fixation sometimes seen in autistic spectrum disorders. That some young girls express undiagnosed autistic spectrum disorders through an obsessive interest in calorie counting. Interesting idea...
Posted by TheMeanReds on March 22, 2007, at 17:35:36
In reply to Numbers... » TheMeanReds, posted by Racer on March 22, 2007, at 16:39:33
I envy that you can sit through math classes. I am the worst at anything past algebra 1. I would get instant ADD in math class. I skip too much, dredding sitting through two and a half hours in a math class. Thinking anything would be better than that. Then the two hours studying afterwords. Waste of money for me. I'm resistant to it, but I always use the excuse 'I'm an artist'. Sadly there is always Devinci to debunk that theory.
When a teenager I would starve myself for days. I think I was acting out towards my mother, who I thought at the time was too controlling. And thought I would gain more control somehow with food. Trying to have the control in some aspect.
Posted by cubic_me on March 23, 2007, at 4:59:12
In reply to Re: My understanding of OCD » cubic_me, posted by TheMeanReds on March 22, 2007, at 13:36:07
> I do the volume thing too. I like numbers in increments of eleven. Or if not that it needs to be an even number like 28. I suppose that means my volume my be louder than yours at times. Not that I'm keeping score. =)
In my car I love my music loud, but the exact number depends how fast I'm driving (engine noise!), usually 25-32, perhaps if I was going in increments of 11 I'd always have it at 33 and have no hearing left!
Posted by jonathanupr on March 26, 2007, at 0:56:58
In reply to Re: My understanding of OCD » TheMeanReds, posted by cubic_me on March 23, 2007, at 4:59:12
you're making me anxious just talking about sitting in a math class for 2 1/2 hours...geezus, I actually gulped.... I could find a zillion more productive things to do than sit in a frikk'n math class. though if you gotta take it as a pre-requisite then I'd say just hack it and feel the relief when you're done with it.
Posted by TheMeanReds on March 26, 2007, at 11:22:35
In reply to Re: My understanding of OCD, posted by jonathanupr on March 26, 2007, at 0:56:58
I do need to take it as a prereq. Three more to go. Which is a year (3 semesters). I think teacher selection makes a big difference. Not that I think they are there to keep me entertained, but teachers have a wide variety of methods/styles.
I just cannot stand the last one I had. The guy is like a rocket scientist, he'd go off on tangents from math levels far above my class. Algebra II with some Calculus, AAAACK!!!! And he would draw weirdo pictures on our midterms. For example a big lizard looking thing mixed with a Chiuaua, and make a 'word problem' out of it.
I suppose thats why my email address has the words mathwrathbath in the beginning. =)
This is the end of the thread.
Psycho-Babble Medication | Extras | FAQ
Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.org
Script revised: February 4, 2008
URL: http://www.dr-bob.org/cgi-bin/pb/mget.pl
Copyright 2006-17 Robert Hsiung.
Owned and operated by Dr. Bob LLC and not the University of Chicago.