How much should medication help?

[adaptive1]

I'm kind of confused about something and I wondered if anyone has any thoughts. How much should medication help with OCD obsessive thoughts? Should it be fifty percent better, twenty five percent better or should it almost erase them completely. If its ten percent then, is it worth being on medication or should I be glad it's better at all. I'm not sure what to think. I'm not sure what percent it is, but maybe I don't have realistic expectations?

 

[Banned]

Hey adaptive,

I think medication for OCD effectiveness can't be measured in percentage but like other medications you want to see a marked improvement in the quality of your life, remembering again that medication can't do it all, and there are things you can do as well for your OCD. Similar to my depression, even though I've found the best med combo to date for me, I'm still not 100% depression free, nor will I ever be, and there is still quite a bit of work I have to do to manage my depression along with taking my medication.

If it's only 10% improvement for you at this point, maybe you can work with your doctor to find a medication that can offer better relief from your symptoms, or maybe 10% is better than nothing. I think everyone is different in what they experience and expect. My friend just went through major, major surgery for what she was told would be a 10-15% improvement in her pain. For her, the surgery, being off work, the recovery, rehab, everything was worth that chance of a small improvement.

Only you and your doctor can decide "if it's worth it", but if it's offering you even a bit of a better life than you had before, it probably is, in my opinion.

 

[adaptive1]

I guess I should go back to my doctor I'm not sure. I'm finding now that I am on a 200mg dose of this zoloft (setraline) I don't need much in the way of sleep. I don't know if that's ok or not, I'm not super tired at the moment and I just cleaned out my clothes in my closet at four am. I don't know if the medication is making me feel off or if I am just off. I have spent hours online looking at websites and I have gone on a huge spending spree in the last week I don't know if I am bored or the lack of sleep is making me lose touch with reality. I have never been one to spend huge sums of money on stupid things but I have and I guess I will have to send all these things back. I can't afford huge credit card bills and Idont know what I was thinking

I guess it's just more compulsive behaviour and maybe it's tied to my Ocd somehowy but maybe it isn't. I am not trying to make excuses for my behaviour, I can walk away from these behaviours but I guess I wish medication would control my compulsive behaviour too but I course it doesn't work that way.

 

[David Baxter PhD]

Yes, you should definitely go back to your doctor and tell him what you are experiencing, adaptive1. Among other things, it's possible that the Zoloft has pushed you into a hypomanic state and that you would be better to switch to something else (e.g., Prozac or Luvox are two other medications with good antiobsessional properties).

It doesn't happen frequently but in some people certain SSRIs can trigger hypomania even in individuals without bipolar disorder.

 

[adaptive1]

Thanks for the advice. I didn't take the medication today. I'm having a major anxiety attack over the amount of money I spent in the last week. I don't know what possessed me to that. I don't feel like myself at all, it's normal for me to be somewhat compulsive and obsessive but I don't normally do reckless things. I feel like I could easily repeat the behaviour again so I am going to lock my credit cards somewhere until I return to normal. The past couple of years have been trying, in someways I have grown and learned so much but in other ways I am a complete disaster. Thanks again for everything.

 

[Cat Dancer]

I have ocd and have struggled with similar compulsions. it seems like there is always some battle to face and to fight and win.

 

[Banned]

I worked long and hard to get my spending under control. At one point not very long ago I had over $90,000 in credit card debt. At least you are recognizing it and doing something about it before it's too late. Good for you.

 

[adaptive1]

Thanks very much. I can't get in to see my doctor for three weeks. I stopped my medication which I don't know if I should or not but I did. My mind feels like its goin so fast and people are talking so slow I can't follow them. I am definitely not bipolar, I have never been but I don't feel normal. Everything is moving too slow and I can't focus.

 

[David Baxter PhD]

As I said above, adaptive, it sounds very much to me as if you're in a hypomanic state, which can happen occasionally with an SSRI even for non-bipolar patients. I would suggest you call your doctor and tell the office what happened. He may want to try to squeeze you in earlier, or at least flag you for a cancellation.

 

[adaptive1]

Thanks for your thoughts. I think you may be right and I will see if the receptionist will put me on the list for a cancellation. I have an appointment with my therapist on Wednesday too. I am not looking forward to telling her about this, she's been really helpful with the doctor and I hate feeling like I'm a burden to these people.

 

[David Baxter PhD]

It's never a burden to let your health care practitioners know about a bad reaction to a medication. They need this sort of information to help you.

 

[adaptive1]

I know it's just a bit embarassing but I know they are professionals trying to help. You guys are so helpful on here. I wish it was as easy to talk to my doctor, he makes me so nervous.

 

[Retired]

my doctor, he makes me so nervous.

What happens in your doctor's office that makes you feel that way?

Does your visit feel rushed, is is it your doctor's style or personality that causes you to feel anxious?

 

[adaptive1]

Thats a good question Steve. Part of it is his style, he is abit cold and clinical I guess if I could describe it and sits behind the computer typing what ever I say. I know thats his job though to record what I say. Honestly, I dont really know what it is. I am not sure another doctor would make a huge difference. I get so nervous that it is feels like sheer torture going to medical appointments. I have no idea what is behind the anxiety or what to do about it. This "white coat syndrome " I know is illogical I know, I rationalize that they are medical professioanls trying to help me but as soon as I get to the office with a Doctor I turn into a babbling idiot, I cant speak and I sometimes have anxiety attacks right in the office.

 

[Retired]

Through my work, I had the opportunity to deal with many doctors. There are as many personality types among physicians as there are among everyone else. Generally your doctor should be able to adjust to your particular needs, but sometimes his/her own personal issues can get in the way.

Depending on where you are located and the availability of doctors, you could investigate making a change....perhaps looking for someone close to your own age and gender, if the latter is important to you. Younger doctors are often easier to deal with.

On the other hand, since your current doctor is already familiar with your medical history, you may want to try reaching out the next time.

Perhaps use a bit of psychology in your dialogue, by first saying, something like "Doc, I really like you as my doctor, and I need your help with a problem I'm having." Then go on to explain explain that you doctor visits make you anxious, and ask what he could suggest as ways to help alleviate that feeling of stress during your visit with him.

IOW start by saying you like your doctor and that you have a problem which you need his help to resolve. Explain the problem as being your anxiety during a visit rather than his seeming "cold and clinical".

That way your doctor is not put on the defensive and you are asking the doctor for what you can do to make your visits more comfortable.

You may find your doctor will open a dialogue where you might both discover ways to deal with one another.

Depending on how that goes, you can consider your options.

What do you think?

 

[adaptive1]

That's a really good idea actually Steve and it feels like something I could do. Thanks for suggesting it. I will try that and let you know what advice I receive and maybe someone else will find it useful.

 

[adaptive1]

My psychologist said she thinks this was medication induced mania. I will be at the doctor in a few weeks and see what he thinks unless something comes up sooner. I am feeling like I am crashing from it anyway, I am super tired, hopefully I sleep well tonight.