what do you know about obsessive-compulsive disorder (OCD)?

my takeaway from this thread is that my habit of waiting for my wife to realign all of the picture frames in the hallway and then, while she's watching, deliberately moving of them out of alignment isn't cute or funny, but actually makes me a giant asshole

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but i've heard that ritalin wouldn't be good for something like OCD

dave85, are there particular treatments that you believe to be effective?

― surm, Tuesday, April 24, 2012 2:33 PM (1 hour ago) Bookmark Flag Post Permalink

(pharmaceutical or not)

― surm, Tuesday, April 24, 2012 2:33 PM (1 hour ago)

as dave said, CBT is the best bet for what are referred to as "motivated patients". our old friends the SSRIs are also used. as with any psychiatric illness, the goal is going to be minimization and management rather than cure

http://www.health.harvard.edu/fhg/updates/treating-obsessive-compulsive-disorder.shtml

just skimmed this article and it seems pretty good. it says that all SSRIs are equally effective, which is probably true, but iirc there's actual good data for only a few of them, which in practice is extrapolated to the class. i forget which ones in particular, off the top of my head

(xp this probably will not work ^^^)

lol dan

Mine is relatively controlled with SSRIs (Paxil) which I've been on for a long time, but I still get real difficulty once in a while. Mine has always been a "shape of thoughts" OCD more than a "content of thoughts" OCD.

My wife's is much fiercer, as in there were times in her 20s when it literally ruled her life. Today it's still extremely challenging; she goes to cognitive behavioral therapy for it but there are several serious struggles a week which sometimes kill me to watch/hear.

OCD comes from deep down in the lizard brain and IMO is basically an anonymous force which dresses itself up in real world details. I think of it as a kind of wave or wind devoid of any content-- the specifics (the things which are feared, the rituals observed, the verbal inner arguments) could be anything. Drugs can attack the wave part making it easier for therapy to battle the conscious part. IMO.

THIS is great, great and everyone should read it btw:

http://www.sethmad.com/my-ocd/

A Pantoum About OCD

I see that I must wash my hands once more.
I know I must, to keep the bugs at bay,
Each time I touch the handle of the door,
Although my hands are rather raw today.

I wash and wash to keep the bugs at bay
And straighten every book upon the shelf.
Although my hands are rather raw today
No one may touch these books except myself.

I must align these books upon the shelf
So all the spines present a pleasing sight.
No one may do this task except myself
For no one else knows how to do it right.

Now that my books present a pleasing sight
And I have wiped the handle of the door
(For no one else knows how to do it right)
I see that I must wash my hands once more.

My sister has severe OCD, which she has struggled with for years. It has taken a long time for her to find the right combinations of medications and therapy to regulate it. She had the obsessive behaviors but also a lot of violent/intrusive thoughts as well. She is doing much better now.

All I know is that it's self-diagnosed less than ADHD and more than bipolar and that most people doing that don't seem to understand the 'disorder' part. (Which is not saying anything about anyone here, it's just annoying to hear people talk about how they're, like, SOOOOOO manic depressive etc.)

Manic-depressive is serious business. No joking matter at all. Well, I mean ppl in a manic episode can do pretty hilar things, but it ain't a funny place to live.

I had a good friend with whom I have lost touch over the years who had very severe OCD before I met him. It drove home just how debilitating OCD is (I hadn't had any personal experience before) when he explained that one of his compulsions was while driving, he had to stop, back up, and make sure he hadn't run over anyone. He would do this until he ran out of gas. If he didn't check to make sure, he was sure his entire family would be dead when he got home. When we worked together, he was medicated and doing really well, although he said he felt like the compulsions were right there, ready to come back at any time.

I definitely feel off kilter if things are not just so in my physical world, but I cannot even imagine how difficult it must be to deal with actual OCD. Anyone struggling with it has my total sympathy.

fwiw a&e did an ocd treatment reality series called 'obsessed' that you can watch on netflix if you're interested in seeing different ways it can manifest

I used to count gaps between lampposts as my mom drove me to school

I count the gap between Lamp posts

hellolife?!

i am making an exerted effort to line up a meeting with a cognitive behavioral therapist to ask some questions, but it is hard to know who to go to and what would be effective. but it does seem like the best feasible option.

i'm curious what exercises they have you do -- would they work for basketball players wanting to improve their free throws, too?

i bet! sports are definitely influenced by this sort of thing.

steve blass disease

Even before I saw the first pitcher named in the last sentence, I wondered, "so is the antidote to play in the outfield instead?"

i'm curious what exercises they have you do -- would they work for basketball players wanting to improve their free throws, too?

― Philip Nunez, Wednesday, April 25, 2012 12:29 AM (18 minutes ago) Bookmark Flag Post Permalink

The link Jon Lewis posted upthread - http://www.sethmad.com/my-ocd/ - talks about some of the CBT exercises.

yeah, i actually have a friend of a friend who has had steve blass disease, and it is linked to OCD. just one example of how big its impact can be.

i was not expecting surm to be a friend of a friend of rick ankie1!

"The link Jon Lewis posted upthread - http://www.sethmad.com/my-ocd/ - talks about some of the CBT exercises."

the exposure therapy was a little disappointing -- i was kind of hoping for something like "visualize a blue undulating polygon with an impossible form" some weird mantra that would reboot your brain or something.

xp it was a really devastating story that this friend of mine told me. she said it was like one day, her friend just couldn't pitch right anymore. bc of obsessive thoughts. he had to quit playing.

did not know about the IOCDF, somehow

All I know is that it's self-diagnosed less than ADHD and more than bipolar and that most people doing that don't seem to understand the 'disorder' part. (Which is not saying anything about anyone here, it's just annoying to hear people talk about how they're, like, SOOOOOO manic depressive etc.)

― Kiarostami bag (milo z), Tuesday, April 24, 2012 4:26 PM (1 week ago) Bookmark Flag Post Permalink

I HATE when people say things like "OMG I'm so OCD" when what they really mean is that they're a neat-nick or slightly weird about certain things. No, dipshit. You're not. You're just an idiot. See also: I'm so bi-polar. Nope, just moody. Ugh.

I used to count gaps between lampposts as my mom drove me to school
I count the gap between Lamp posts

― kinder, Tuesday, April 24, 2012 6:04 PM (1 week ago) Bookmark Flag Post Permalink

I count the gaps or some times the posts themselves. I count a lot actually and to weird things like click my teeth to signify the counting. I think it's just my way of passing time. I count things like tiles and bricks too. My mom does this as well.

most ppl when they refer to themselves or other ppl as be being ocd actually mean ocPd

also wrt it being from the lizard brain---it is! someone won the Nobel prize some time ago iirc for identifying the neurological pathway in the brane that is associated with compulsive grooming behavior in birds/rats/dogs/etc (parrots plucking themselves bald, etc). they're all roughly approximate, and may underpin the symptoms of things like OCD. this has implications for things like deep brain sitmulation: one of my instructors had a patient who had been profoundly disabled by his OCD while in college (had been "normal" for most of his life, had a very sudden and steep decline, spent hours at the grocery store trying to choose between cereal that he would then be unable to eat), underwent deep brain stimulation, and is now more or less back to his baseline from a functional standpoint

most ppl when they refer to themselves or other ppl as be being ocd actually mean ocPd

Maybe, yeah, but I also think it's become common to the the point where it's frequently used to describe totally "normal" people who might just occasionally fixate on certain things more than others but not necessarily have any disorder at all.

At least I've heard it used that way.

deep brain stimulation! sounds scary. is that like ECT?

I just read something somewhere about how ECT has changed a lot and is being used more frequently again.

well usually when I've heard it used colloquially it's in the context of someone being super tidy, organized, what have you. this is OCPD. In general (and plz correct me OCDers) ppl with say a hygiene obsession are often not tidy AT ALL because even ~cleaning~ is unhygienic (cf the extreme example of Howard Hughes living in filth). but yeah I guess sometimes it gets thrown around to mean "thinkin bout some things more than others"

at least ("at least") someone with a hand washing compulsion has something other ppl can see and associate with OCD. ppl with a "taboo" obsession and like a compulsion for prayer or something are totally invisible. cf the OCD mother who constantly has unwanted thoughts of killing her child, which she recognizes to be awful and intrusive, and feels compelled to stay away from her baby even though OCDers with homicidal thoughts are safe as milk. the very thing she needs to do in order to assuage her guilt/temper her obsession, is to hang out with her baby all the dang time (exposure therapy, like).

but OCD as "unwanted thoughts syndrome" is not commonly recognized by the public (or even some mental health professionals), and can look a lot like schizophrenia or some other psychotic disorder. which reminds me that yeah, having now spent some qt with patients in the grip of profound mania, I really want to wag my finger at dorks conflating "mood swings" with actual bipolar disorder.

xp DBS is sorta like laser guided ECT: they only "shock" a very very specific part of the brain, versus the whole thing. and yeah, ECT is back in use (or is at my institution), and while there's def not consensus on it, it's shed its bad rep, and can get some very good results for ppl in the middle of mega depression.

ECT first became popular because it showed good effects with some patients. The trouble wasn't so much the therapy, as it was the misuse of the therapy. Being effective in a limited set of circumstances was its downfall, when there were so few treatments that showed much promise at all. The old adage applies that "when the only tool you have is a hammer, every problem starts looking like a nail."

the lack of discussion on the obsessive streak of the disorder in the mental health community is strange; the compulsions have gotten attention for some time, and of course they are always intertwined, but i believe obsessive unwanted thoughts as a disorder in and of itself (pure o) is only recently getting in-depth attention. maybe because it's hard to talk about. not sure.

i have heard of very recent instances when a patient went to a psychiatrist with classic purely-obsessive symptoms, and the psychiatrist did not seem to know the research available on the subject at all, and even prescribed medication that agitated the situation.

(and obviously that patient was me)

yesterday was a particularly bad day. i spent about 2 1/2 hours fixing my hair. with scissors. luckily i don't look like exactly like frankenstein.

A couple years ago my first therapist suggested that I might have "pure o" because I was (and will no doubt one day again)become fixated on the idea that I'm going crazy. In the past I've also tended to ruminate excessively on and become quite agitated by "brain in a jar"-type fears--things that are basically pointless to think about. Right now I'm in the midst of a pretty debilitating year-long bout hypochondria (which is fun to make fun of but not to experience), which I think might be the same thing but with different content (it's also much harder to function with than existential obsessions, because I feel strongly compelled by the thought that I have some life threatening condition that requires immediate action, and I also have panic attacks with this). In the past when I've been REALLY depressed and stressed out, I've contended with some intrusive thoughts, like what if I harm someone or throw myself out of a moving vehicle on the interstate (I definitely DO NOT want to do these things). Not something you want to admit to the wrong person.

it's not--i have the same and my parents don't even get it. i'm pretty sure they think i'm a schizophrenic in denial or something.

on the bright side, telling someone about it won't actually make it any better, so you're not really missing out on anything

Well, I told the internet. And you're right, I still feel terrible!

oh emily! i'm so glad you told the internet. i haven't had a very bad attack in quite some time - 'til today. i felt compelled to come here + post something. glad you did the same and hope you're ok.

I really thought I would have overcome my OCD by now, it's been bothering me for over 10 years to varying degrees. It's become very tied up with a procrastination problem too.

I can deal with the annoying unpleasant thoughts, the locking doors and security measures but it occasionally becomes a problem; hygiene stuff is a pain but it isn't really terrible (although I hate it when I end up washing dishes for 2 hours).
What really troubles me is my reading problems: rereading to check I've read something properly and checking I haven't turned more than one page each time I finish a page. It's the fear of missing something important or misunderstanding. I really want to be someone who can finish books on a regular basis.
This happens with looking at images too long as well but it isn't as bad as it used to be.

reading can be tricky for me too, especially on a computer. and yes, it is always surprising when you think you're past it, but you're not.

It's actually not as bad for me on computers. It's mostly when I get to some prose or poetry that my OCD affects me worst, because it's more important to me and somehow a book makes it seem doubly important (also with the added problem of page turning). There's the added fear of misunderstanding a plot or a sentence and somebody making fun of you for that. It's not that I particularly fear the mocking itself, it's more about the general insecurity about my reading comprehension and ability to understand subtle and complex works.

When I was reading a book about exposure therapy there was a method for people with troubling thoughts to write down or record their own voice talking about the crimes they fear they are capable of, and to repeatedly say things like "I really would do this because I'm a terrible person".

I remember reading transcripts from courts saying what could fall under obscenity laws and things like these exposure therapy methods could technically fall under it if the feared crimes were extreme enough.

part of the reason why the issue is so taboo, clearly.

i have continued to struggle with it on a self-image level. it has gotten a lot better, but it's frustrating.

it gets better. but it's still fuckin' hard. but i'm still not going on fuckin' zoloft.

Trying to finish a book, trying really hard and it still taken me 5 hours to read 30 pages. Sucks.

I worry about typos occasionally but most of this doesn't apply to me.

http://www.steveseay.com/social-phobia-perfectionism-ocd-treatment/

Odd to think that a lot of people might be intentionally making themselves look bad to get over their fears of looking bad online.

it's an interesting article outside of the social media aspect -- "ERP" or making mistakes on purpose is in fact the only help that i have found for OCD. mine is still fairly extreme, but time and time again, every time i am having a real problem with it, this is the only thing that helps. speaking in incorrect grammar, blundering your words, messing things up a little, getting your hands dirty -- this is the *only* thing that helps when perfectionism transcends and becomes a significant problem.

http://www.worrywisekids.org/node/120

For younger children, the therapist and child can make up silly songs about the feared content (going to jail, poison, etc.) both to expose the child to what they fear but also change the tone from serious to humorous.

yea, i was reading a little about this too. like an inner wonderland kind of thing.

i guess i sound so redundant it's just so baffling to me that i've been dealing with these things for practically half my life

I said above, in May that I didn't have too much trouble with unpleasant thoughts but recently it has become awful. A few weeks ago, I had what feels like one of the worst days of my life.

It never ceases to amaze me how easily OCD spreads. If you start calming down about one fear, it'll invent another two things to be afraid of. If you try to examine the worrying subjects and your situation or even vaguely related subjects, it hijacks these thoughts and builds all these worrying associations. So it feels like you can't even rationally think about anything you're scared of. And avoiding thinking about these subjects makes it seem like you're ignoring something important and not dealing with it.

So I was always unconvinced about anything involving using rational thoughts to fight OCD because it never seemed to work. I had read quite a lot about OCD and using words as therapy always seemed to be a road to more suffocating rituals.

But then I read this article.

http://www.socialworktoday.com/archive/070212p22.shtml

Russ Harris, in The Happiness Trap: How to Stop Struggling and Start Living, discussed a skill called cognitive defusion, which helps an individual create room for intrusive thoughts. A client thinks, “I am a bad person.” To practice defusion, you would restate the thought: “I just had a thought that I am a bad person” or go a step further and say, “I just noticed I had a thought that I am a bad person.” This allows clients to occupy the same space with their thoughts but from a different vantage point. Instead of being crunched in a small closet with their thoughts, they are now in a gymnasium with them.

ACT also stresses showing irreverence to internal private experiences and instead choosing to live life based on one’s values.

It doesn't cure everything, you can't completely rely on this technique but these ideas helped me calm down immensely. Just stating the worrying thoughts and feelings in a very objective, plain and robotic fashion tends to calm me down when it's getting awful.

Although the OCD is obviously real, I often feel I'm subconsciously creating these problems for myself as a way to procrastinate and sabotage my life away. I need to keep reminding myself that I've lost a large part of my 20s to this shit.

i'm with you 100% Robert. You are not inventing problems. I lost so many years in my 20's. i am now 32 and i have thought so much about the sort of techniques you describe. they do help. very much. i know everything you're going through. i can't say that it goes away - but these things do help. what i want to say to you is that you are not creating these problems for yourself as an easy out. i have thought the same thing. the bigger problem is that it is one of the most difficult problems to get help for. hang in there.

Thanks. I'm wondering where all the other OCD members are.

But I've always procrastinated, been a bit lazy, not prioritized enough, maybe a bit of a sabotager too, so I don't feel like that's all totally OCD. I'm not being hard on myself, I think these flaws might have invited OCD into my life.

I'd imagine OCD tends to affect more relatively idle people than it does people who constantly need to be on the move. Surely worriers who are full of doubt must be more prone?

I think it's like OCD and procrastination collaborate. There's so many times I completely chosen to do the rituals in what I knew was a futile attempt to straighten things out, I knew that I risked making myself worse.

Unpleasant thoughts were only a real OCD issue for a relatively short time in my early 20s and for 6 or 7 years it wasn't a problem at all.
There are some obsessions I managed to drop and haven't been an issue in a very long time. So if I could drop the unpleasant thoughts and read properly, I'd be very happy.

i'm over here btw.

Welcome and hope you're coping well.

sometimes? sitting out on ilx for awhile is not hurting too bad.

don't sit out on this thread though. we all need people to talk to. sometimes i feel like i don't have anyone to talk to about this sort of thing.

okay, i guess it just feels weird to discuss? Like the nature of my posting to ILX is often enabling to my OCD which, har har, except when it's not. At the moment, I'm about to go walk a dog at the local animal shelter. I find that the best way to overcome this stuff (and I think i'm a bit older than you guys, so lots of hills and valleys with the process) is to remove myself from wherever I feel too comfortable. That makes me have to shift out of the little OCD box of this then This then THIS THEN THIS THEN THIS THENTHISTHENTHISTHENTHIS that drowns me because I have to honestly think on my feet. Exercise helps too.

good points. i appreciate those. it definitely feels weird to discuss. that's been my biggest thing. i can't even talk to my boyfriend about it anymore. like, lots of ppl just don't get it.

i'm also just presuming as I'm not diagnosed but everything i read and feel points me in that direction. I totally appreciate the anxiety/depression spiral that creeps up as everything gets "out of control" and I'm panicking just typing that tbh. But I'm very high functioning! So the majority of this just reflects on the inside where only I'm aware. When I talk about this with my girl she tells me that I don't seem stressed or anxious at all, so it doesn't come through.

i self diagnosed and then confirmed with an MD. also just because it doesn't come through doesn't mean it's not real. but that's GREAT that you function highly and that your girl is telling you the same. it's not easy to be high functioning.

hope y'all are doing ok today

hahahahaha, i was gonna bump this thread!

:-)

Generally better than last week anyway.

a little worse for me for a lot of reasons but one of the big ones is needing to close this tab.

yo, i just wanna pop in here and say actually paying (even if out of pocket) to see someone who can prescribe drugs for this is one of the smartest and best things you can do with your life

yyyyyyyyeah i hear you but

i dunno maybe it's worth thinking about

i just made an appt with my doctor for tmw

i'm going to keep making more frequent appts with him he keeps up with all the medicine

Been wondering a lot about how many things in my life are OCD and what the first thing was, sometimes it's so subtle you don't notice a disorder. I think it only became a major problem in my 20s but I can see minor phases of it possibly stretching back to early childhood.

i remember exactly the day when mine started. like the moment. the girl, the conversation, the cafeteria.

i just met with my psychiatrist and he said it's not a bad idea for me to try some medication again. it's not specific to OCD but since my "symptoms" are mixed i'm giving it a shot. i tried it before but not under the right circumstances!

mmmmmaybe

it's been years since i've tried something - i get the major hesitation

Doing much much much better than the hole I was in when I last posted here. Still need to fix my reading OCD problem though.

I was talking with a bunch of OCD people recently and they pointed out how the trend of youngsters in fan communities and social media being extremely puritanical often seems a lot to do with OCD. The idea had crossed my mind, but discussing this and thinking about the paranoid dogmatic behavior, it makes a lot of sense. Really scary and sad that they're hanging out together and freaking each other out like this.

https://amp.kentucky.com/opinion/op-ed/article269080207.html

Kentucky mayor opens up about having OCD and urges people to stop making it a punchline.