I know

[AmZ]

It's all too much. I feel like an idiot going now and telling my psychologist after two years that I have this mild/OCD. I havent Done so. I've had it since I was fifteen or so. I count on my hands adding up fives and tens until I get to ten, fifty, one hundred or two hundred.

I also do other things which are kind of hard to explain in words like tapping my teeth together, again to make even numbers. Another example is circling my index finger on my thumb. Again, going around a certain number of times. There are more things too but that's the gist of it.

I think I read once that in order for it to be classed as OCD, you need to do it at least one hour a day. So it doesn't count, if like me, you do it on a daily basis and it annoys you?

Which medications are used to treat OCD? The same anti-depressants?

I know, I haven't brought it up with neither my psychologist or psychiatrist in the hospital. Duh.

Before I was hospitalised, I was with a private psychologist twice a week for 8 months and when we startd out, she thought the OCD was the worst thing so we were doing CBT to combat it. But then I got overwhelmed with depression and she said its something we'll come back to because there were other more serious issues to deal with. That was until, ultimately, she told me one day that she doesn't think she can help me in therapy so ethically she wants to stop therapy. Wow that hit me hard.

Thanks.

 

[Cat Dancer]

Tell your doctors. They will know how best to treat you.

 

[David Baxter PhD]

It will also help them with differential diagnosis for you. As just one example, OCD traits are quite common in Bipolar Disorder but less common in Borderline PD.

 

[AmZ]

Thanks CD I will tell them. It just feels like one thing after another. But really, perhaps the anti-depressants were working for the depression until they reduced it because I had the hypomania but it doesn't look like any meds have helped for my anxiety/OCD. I can't say that I want to end up on a ton of medications again as I know it messes with my moods too. It's tough.

And I was asking out of interest about the OCD needing to take up at least an hour of a persons time each day in order to be diagnosed with it? Or just it differ for different perple? Like me, it would be classed as mild OCD even though it doesn't really take up an hour each day. Thx.

 

[AmZ]

Well, Wikipedia may not be the best source but it states:

Moreover, the obsessions or compulsions must be time-consuming (taking up more than one hour per day) or cause impairment in social, occupational, or scholastic functioning.

 

[Banned]

I checked the DSM-IV-TR and it actually also states that BUT with numerous other inclusions and exclusions. That one factor is not a determining factor.

However, since no one here can diagnose you, and you cannot diagnose yourself, once again your best bet is to refer to the doctors you have and let them decide what is or isn't going on.

 

[David Baxter PhD]

Cleaning up this thread since I seem to have confused people - battling a cold the past few days...

My point was supposed to be that time is not the defining characteristic or factor for OCD and even where it is considered it needs to include ALL aspects of the symptoms, not just a specific ritual.

The relevant paragraph in the DSM-IV-TR criteria is:

C. The obsessions or compulsions cause marked distress, are time consuming (take more than 1 hour a day), or significantly interfere with the person's normal routine, occupational (or academic) functioning, or usual social activities or relationships.

Note that

1. the statement refers to obsessions or compulsions (which really should read and/or), and
2. the statement is "are time consuming (take more than 1 hour per day) OR significantly interfere with the person's normal routine.

I am not trying to diagnose you and I am not trying to encourage you to diagnose yourself, but my guess is if you considered ALL the OCD thoughts you experience and rituals you engage in during a day it would easily exceed an hour or two.

In the DSM 5 proposals this is rewritten as

B. The obsessions or compulsions are time-consuming (for example, take more than 1 hour a day) or cause clinically significant distress or impairment in social, occupational, or other important areas of functioning.

which to me implies a less strict or literal interpretation of how the time factor should be considered.

All of that said, my comments were primarily aimed at stressing the importance of revealing ALL your symptoms to your psychiatrists in the interests of accurate differential diagnosis. In that context, I stated that the presence of OCD traits is more commonly seen in Bipolar Disorder than in Borderline Personality Disorder - note the use of the word "traits". That doesn't mean that having those traits would meet the criteria for a diagnosis of OCD per se. And having such traits or even the full blown disorder would not rule out other diagnoses like Borderline PD or Obsessive-Compulsive Personality Disorder.

Differential diagnosis is an art as well as a science. It's not just a matter of adding up points against a list of symptoms but requires a thorough knowledge of the personality and psychopathology underlying alternate diagnoses. Failing to disclose symptoms to your mental health practitioners may well lead to wasted time in terms of an inaccurate diagnoses and in turn less than optimal treatments.

You have more than once indicated unhappiness about how long your treatment has taken. The primary point here is that failing to disclose symptoms may be one of the factors that will slow down the course of treatment. (In your case, we have previously pointed some other factors and have also pointed out that it is difficult to predict the time course of treatment for any single individual.)

 

[AmZ]

Thank you for taking the time to reply and put in the quotes.

Wishing you a speedy recovery Dr Baxter. I thought you'd been around less.

I will report this to my psychiatrist and psychologist on Tuesday/Wednesday when I see them. It's another festival here so more time off of work for the doctors.

My psychiatrist, well, I don't know how to explain her. She is trying her very best to make my diagnoses like they are nothing and is telling me that I'm quite normal and stuff. For example, this is amongst while I sit next to her sobbing my eyes outand shaking with rage inside. I try to explain her that and she seems to disregard it.

I see what she is doing with me. She is trying to be as positive as possible with me so as to help me, genuinely, but I feel like the matters aren't being addressed and are just being thrown under the carpet.

Anyway, I haven't been given a date to go back to the rehab program but its meant to be after all of the festivals which would be this Tuesday. But unless the move happens last minute, it seems that it will be a few more days than that.

I can see my psychiatrist twice a week in the rehab program and I know that he's very much got a different opinion of what to do with my meds. In fact, he has similar ideas than that of my psychiatrist in the hospital but what stops my psychiatrist from making changes in the hospital is the HEAD PSYCHIATRIST in which he makes all final decisions and doesn't want to change my meds (asides from the Prozac because of the hypomania).

I imagine that I will go back and he'll change the meds again. He wanted to try Cymbalta for example. But we'll see about the hypomania - maybe I'm not going to be able to take anti-depressants. Right?

I'm reading the budda and the borderline book and it paints a very negative view of medications being used to treat BPD mood swings for example. Don't mood stabilisers help with this?

I don't know when I'm ever going to get the right set of diagnoses - maybe I can ask if one of the hospitals in the city does diagnostic testing. Shall I just let it continue on for now? I guess that's all I can do, is go with it.

Thanks.