OCD & Aids : Anxiety for others instead of for me ?!

[mtlboy24]

Hello,

First of all, i'll try my best to be understandable since i'm French (from Montreal). I'm glad to find this forum since i sometimes feel alone in my issues.

For almost 3 months, i've been afraid of having HIV for no "realistic" reasons. No sex, no drug injection, no blood transfusion. Above all, i can even say that i'm safer then most of the population since i didn't have sex in months.

Four months ago, i got a real big panic attack when i learn that a previous partner "may" had sex with a seropositive guy (i'm gay by the way). Even though i had safe sex with condom with that guy, i got anxious to be hiv positive. It all pass in 24 hours : call my doctor for a hiv test prescription, when to a specialised laboratory to get my result in 24 hours. You should see me during that night and in the morning before my result. Never had a huge panic attack like this. It was like i already knew i had it. But finally i was tested negative... Hurray !

One months later, i cut my finger in the sink during washing my dishes. The next day i went to the gym (gay village) and while lifting a barbell, i got panic when i imagined i could have get hiv because i had a cut. Since then, days passed, and it feels like anything i could do is a risk of having hiv. On the moment it is frigthening, but i can be logical about it after some times.

The issue is i still feel anxious (really anxious) about risking giving it to my boyfriend, to my family, to people at job. I started a CBT with E&RP 3 sessions ago. It helps me understand what i have, and we are starting the exposure.

But i got a problem on friday. My head itched and i scratched it. After that i remarked a spot of blood on one of my left fingers. Panic and anxiety started to rise so i went to the toilet to wash my hands. Of course i took a klenexx with me with the bloodless hand. To open the door, i use my arms instead of my hands.... but to close it, i had no choice but to use my right hand with the klenexx.

When i come back to my desk after washing my hands, i come back to my desk feeling anxious about "maybe" having drop some blood on the doorhandle with my right hand. I resist the temptation to go clean it (a way to expose to the anxiety) but after 20 minutes, a boss at the job went to the toilet and, of course, used the door. Since then i'm terrorise by the idea that i've maybe contaminated her and i could not be sure i've hadn't. I don't know of the deal with that thought. I'm afraid i will never know and always be afraid of that.

I'm really starting to feel stupid to be that anxious. Can anyone have a suggestion on how to pass over this issues... how i could deal with it.

Thanks alot for listening, just writing it helped me feeling better, seing i had dramatised thoughts (and practicing my English writing).

Martin

 

[Daniel E.]

A previous post by stevel may be helpful. I don't know if you have seen it already:

...Throughout my life I have been worried about infection with HIV. Most worries are "multi-step" worries wereas a number of events must occur in order for the infection to happen. For instance, I will worry that if I don't wash my hands before I eat, I may become infected because I had HIV on my fingers, which would then come into contact with my food, which would then be injested, which would then cause HIV. My fear would then extend to the family, as I would be afraid of infecting my wife, who would then pass it on to my son, via breastfeeding. This just shows, how one simple worry can develope a life of its own and consume a victim with fear, regardless of how remote the possibility that the scenerio may occur.

Unfortunately, there really is no logical way out of these fears. In fact, trying to reason ones way out of OCD only brings one deeper into its clutches. You see, inevitably, as you have illustrated yourself, when you try to apply logic and reason to escape an anxiety, your brain will always find a new variable to further confound you. The more you spend doing this, the more your brain sees this threat as important and worth spending resources combating. In other words, the more you fight the beast, the stronger it becomes.

The only way I have ever had any luck fighting this, is by not fighting at all, which is the most difficult thing to do.

http://www.psychlinks.ca/phpbb/viewtopic.php?p=12236&highlight=#12236

 

[mtlboy24]

Strange situation

Thanks i've read stevel's story and i can definately relate to it.

During a typic day, i remark that the time period when i feel liberate from that fear is during the evening. I don't know why but it's like i don't care anymore since i'm tired on my day. So i don't battle it, i even don't think about it. The greatest moment during crisis is going to bed, it's when i'm tired, exhausted than i feel free for fear.

Maybe i also feel that way on evening is because i don't pay attention to those fear. When i feel relaxe, i feel more able to discard those irrationnal thoughts, like the probability becomes negligeable (instead 50% or even 100%).

Another thing i notice is when a new situation arrives, the last one is not important anymore, it is discredited. Yesterday i was in the subway, and someway somehow, i felt something on my lips like a tiny drop. I don't even know if it was really something on just the air from the subway vent. Of course, i thought it was a drop of blood ! So i close my mouth to make sure nothing came in, i look at the people around me and no one seem to be bleeding. When i came home, i went to the toilet to rince and clean my lips. I can't remember now if i checked my lips before washing it .... i think so and there were no sign of blood. But since i'm not sure of anything, so lost in my fears that i can't really remember things, well i'm afraid that there was blood and that i had a chance of getting hiv.

I know non-ocd people wouldn't even have felt a thing in the subway, not think about getting hiv. But i don't know how to let that go. For those who fear hiv, are those situation when you tend to think the slitest thing could get you hiv are similar ? How can i regain trust in life and in my self ?

Thank you for listenning

Martin

 

[David Baxter PhD]

You mention that you are or have done some CBT... are you still seeing a therapist now? Are you on any medication? Many people find the SSRI medications, especially Luvox, helpful with OCD.

 

[mtlboy24]

Medication

I am on medication for almost a year. When my AIDS crisis started on July, they augmented my medication. It's Effexor XR 150mg. Since i'm on medication for a long time and the AIDS crisis happened after, i don't know if medication helped. It must be. But as you know, medication doesn't stop intruisive thoughts.

And yes i still see my therapist. I seem him on a weekly basis and this week will be my 4th session.

But i feel sad of destroying my life like that. Not able to be strong. I would love to go back years ago like a child without preoccupation. I know i have to live of day at a time. But i want to have dreams. I want to make project. I want to take risks in my life like applying to a new job. I want to be me again : the martin i was 3 months ago.

Thank you for listenning

Martin

 

[David Baxter PhD]

No the medication doesn't stop intrusive thoughts but it can help to decrease the intensity or at least make them seem more manageable.

However, if the Effexor doesn't seem to be helping, you might want to discuss switching to Luvox (fluvoxamine), which for some people is more effective with obsessive thoughts.

 

[Daniel E.]

... But i want to have dreams. I want to make project. I want to take risks in my life like applying to a new job. I want to be me again : the martin i was 3 months ago.

At some point, the obsessive worrying can be worse than that which is feared. In the movie Jeffreyhttp://www.amazon.com/exec/obidos/tg/detail/-/B00008R9KE/104-5681872-5252729?v=glance, a gay man (Jeffrey) is so scared of getting HIV that he stops dating. For me, the best point in the movie was when a guy dying of AIDs said that he felt sorry for Jeffrey since Jeffrey was the saddest person he ever knew, feeling more sorry for Jeffrey than he did for himself. At the end of the movie, Jeffrey fully embraces life with its inherent risks. That's the happy Hollywood ending, but I found the movie interesting regarding anxiety, happiness, and death.

By the way, another good movie, more specific to OCD, is What about Bob?, which really does a good job (for a movie) with portraying the "baby steps" approach to mental health. The lead character in the movie (Bill Murray's character named Bob) also uses Kleenex when opening doors until he somewhat gradually weans himself off from using them. He also uses something he calls "death therapy" in which he realizes that his worrying is killing him as a person, using that insight as a motivation to continue treatment and become a psychologist himself.

Anyway, most people with OCD/anxiety/depression, do get better with treatment and the passage of time. It just takes longer than we would like.

 

[mtlboy24]

is there hope ?

Is there any hope that someday (soon i hope) that i will be able to laught at this (make a film out of it and win an oscar for it).

I know aids is a serious matter. But i know also that i am exagering alot. I need to be less sensible about it so i could see it clearly, objectively. Since i'm way too much emotive about it, i don't know where to draw the line.

But is it possible to succed and overcome this phase ? What is strange is that i wasn't like that at all 3 months ago.

Martin

 

[Daniel E.]

Here are some examples of people's OCD concerning HIV/AIDS improving significantly:

J Behav Ther Exp Psychiatry. 1996 Mar;27(1):51-6. Related Articles, Links

AIDS-related obsessive compulsive disorder: deconditioning based on fluoxetine-induced inhibition of anxiety.

Kraus RP, Nicholson IR.

Department of Psychiatry, University of Western Ontario, London, Canada.

Abel's (1993) review of treatments for obsessive compulsive disorder (OCD) indicated that both behavioral treatment (exposure with response prevention, and biological treatment (specific serotonin reuptake inhibiting drugs) are effective. It was recognized that having both available for patients is preferable because there would be situations where one treatment is more appropriate than the other. One indication for using drugs would be where situational constraints do not allow for effective exposure treatment. We present a case study of a microbiology technician with AIDS-related OCD who had an excellent response to the administration of fluoxetine without relapse when the drug was discontinued.

Behavioural treatment of AIDS-focused illness phobia.

Br J Psychiatry. 1991 Sep;159:422-5.

Logsdail S, Lovell K, Warwick H, Marks I.

Maudsley Hospital, Denmark Hill, London.

Seven cases are described in which the central symptoms were fear of contracting AIDS, avoidance of related cues, rituals and reassurance-seeking. Associated features include previous illness phobias and obsessive-compulsive disorder. Treatment with exposure and response prevention (plus a cognitive session in one case), led to improvement sustained up to three months after discharge, although one patient stopped treatment prematurely. Controlled trials of behavioural treatment in hypochondriasis are required.

A case of obsessive-compulsive disorder related to AIDS: psychopharmacologic treatment.

Can J Psychiatry. 1991 Mar;36(2):118-20.

Schechter JB, Myers MF, Solyom L.

Department of Family Practice, University of British Columbia, Vancouver.

It is well known that delusions, obsessions and phobic reactions may centre on items which are of current topical interest. We report a case of obsessive-compulsive disorder manifested primarily by intrusive thoughts about AIDS. The patient eventually responded to an unusual combination of medications.

 

[David Baxter PhD]

Kraus RP

I think that's the same Dr. Kraus who's now practicing in Ottawa - he is one of the best psychopharmacologists in the area.

 

[Peanut]

Hi Mtlboy24, I had that exact same obsessive fear of catching AIDS. I too was tested and became utterly convinced that I had it while I waited for the results. When I went to get the results apparently I looked so relieved that the test was negative that the nurse was like "Did you think that you had it?'...I can really relate to how distressing it is. I used to spend a long time "disinfecting" everything. The AIDS obsession eventually passed. When I started to obsess I would try to talk myself down. Acknowledge that I tested negative and that I had not done anything that would expose me to the virus. Like I said though, it eventaully passed (and then I repeated the same thing with hepatitis and then that passed too). Anyway, I think a lot of people have that phobia...it obviously just stems from fear of death that most people have...it's just waaaaay exaggerated. I bet you won't always be so afraid, although I don't know if you'll be sitting around laughing about it! Good luck and hang in there.

 

[mtlboy24]

Thanks alot toeless

Thanks for your message.

I know it will eventually pass. I take it day by day. I just hope i'll be able to let go of that fear. You know, sitting in front of the lake and saying to myself that everything is fine.

What is bugging me, are the small things that remind me my fear of aids. if i have little cuts on my fingers i wonder if i could transmitted or received hiv.... it makes me anxious at the moment. After some times i realized or accepted that there were no danger. It's been more than a month now that i am in therapie. I learned techniques of relaxation. We'll do exposure. What i remarked is my crisis, spike are less effective on me.. if i had a 8/10 anxiety at the beginning .. now it's around 5/10 and less..... crisis don't last long. So it's working.

My question these days are those :

1- Why am i so afraid of AIDS and transmitting it ?
2- Am i afraid of AIDS... or am i afraid of being afraid of AIDS ? Meaning am i more afraid of the anxiety than AIDS itself.
3- Why simple and irrationnal thing remind me of AIDS.
4- How to fight irrealistic ideas such has getting aids touching doorknobs, i've read that thinking of the realistic facts or convincing yourself with the reality is not that good 'cause it is a form of neutralisation... instead i should live throught anxiety... feel it... till it drop... like dessensibilation... Is it true ?

Martin

 

[Peanut]

Hi Martin,
That's really great that you've been going to therapy. I've read that exposure therapy is usually very helpful with OCD, as it sounds like you're finding out. I was curious to hear more about your therapy if you feel like sharing. I've never heard examples of what it would be with fear of AIDS...do you do things like touch door knobs with cuts on your hand or something along those lines? My therapist friend told me of one person who had a fear of toliet seats and eventually worked up to putting their face on the toliet seat. I thought that was pretty interesting.

Anyway, the other thing that I wanted to pass along to you that I read in my text book was that "People who develop obsessive-compulsive disorder before age 20 are less likely to improve over time; most people improve, even without treatment, over a period of five years or more" (Skoog & Skoog, 1999). I thought that was pretty encouraging, and even though I developed it before age twenty I have improved a lot, so it sounds like there is hope=)
One other thing it mentions is that "Family support and family psychotherapy are also helpful; families are taught that they should neither encourage the behaviors nor participate in the person's rituals" (Lefton & Brannon 2003).

I hope you continue to improve, I'm sure that you will.