What does it mean to have tendencies vs a disorder?

[adaptive1]

Hey guys,

I have a question that I was wondering if anyone knew the answer to. I have been doing pretty well, hope you all are fine as well. I am just in the process of moving to Saskatoon soon to be closer to my family, I checked in with my old therapist before I go because that support has been helpful over the past year.

The therapist said something I dont really understand. She said I had OCD tendencies and that having OCD isn't like having a cold, where you have it or not, and that these things exist a long a spectrum. So I should do things that are proactive to manage it, she compared it to not being in a bar if you were an alcoholic for example. She meant not doing things that would encourage the symptoms I think. But I don't understand, if I just have tendencies does that mean I don't have the disorder anymore or never did do you think or never will again? Does it mean I am fine and I dont have to worry about it anymore. I did tell her that right now i have a constant thought on my mind almost the entire day, but I am so used to it now that it isn't that upsetting anymore. It's like, yes, what ever brain, go right ahead already. But if I have the symptoms of it, then I dont have it?

Leave it to me to over analyze it I guess but what does it mean do you think. I no longer have OCD?

 

[Lana]

Ideally, it would be great if you could ask your doctor what she meant and have her answer any questions that you have. After all, isn't that what therapy is all about? Learning about ourselves and getting information from a knowlegable professional resource?

But if I were to guess, I'd draw this comparison: Someone who is prone to drinking or drinking binges, shouldn't put him or her self in the sitatuion where they can exercise their tendency. So, being proactive, to them, would mean ensuring that they dont' have access to excessive amounts of alcohol, or put themselves in a situation where they can gain access to alcohol, or if they end up in a bar, bring limited amount of money (no credit or debit cards) to ensure they don't go overboard. It's possible that that's what she meant. As for whether you have a diagnosis or had one, that's really something that none of us can answer as we do not have your medical history nor do we diagnose others here. That is really something that she should be telling you.

Can you call her or email her and ask her the questions posed here?

 

[adaptive1]

Sorry Lana, I didnt mean to imply that you guys should diagnosis me, I am just confused I guess as to why my brain does not seem to funtion normally and I interpreted it as though the therapist said there is nothing wrong with me. I thought about it some more and I think rather than e-mail and concern myself with a diagnosis I think I will just work on controlling my symptoms. One of the best ways for me to do that is to stop asking everyone for reassurance and over analyzing everything, something I have just slipped up and done on this forum...oops......

 

[Retired]

Would you care to share why your therapist suggests that you have OCD tendencies? What behaviours do your exhibit to merit this evaluation?

Have you undergone any treatment, either medication or CBT to address your OCD?

So I should do things that are proactive to manage it,

Psychotherapy
A type of therapy called cognitive behavior therapy has been shown to be the most effective form of therapy for OCD in both children and adults.

Cognitive behavior therapy involves retraining your thought patterns and routines so that compulsive behaviors are no longer necessary.

One approach in particular is called exposure and response prevention. This therapy involves gradually exposing you to a feared object or obsession, such as dirt, and teaching you healthy ways to deal with it.

Learning the techniques and new thought patterns takes effort and practice, but it's worth it. Most people with obsessive-compulsive disorder show improvement of signs and symptoms with cognitive behavior therapy.

Source Mayo Clinic

Has your therapist provided you with some pro active strategies to help overcome your OCD?

 

[adaptive1]

Well, I have been on and off with the therapist for over a year and a half, I dont go very often, just when I feel like things are getting out of control. Mainly the problem is that I have repetitive thoughts, its like my mind is split in two, one half is always obsessing about something like going crazy or having an illness and the other half sort of functions normally ( I have been sick this year though, but I have always done this obsessing). The trick for me is to ignore the half that thinks the same thing all the time. Its kind of like a neon sign that flashes me all day. I cant go for more than a few minutes without thinking it, unless I am really involved with something. My compulsions are writing things down over and over and checking my symptoms over and over to make sure I havent developed any diseases. I also have a problem where I cant stop counting which I do to keep the thoughts from bothering me when they get bad. I have gotten much better at tuning them out and I dont do compulsive behaviours as much anymore, but its the thoughts that I still struggle with. I have basically had this one repetitive thought for the last three years, you would think it wouldnt get a rise out of me anymore but it still does at times.

I cant say I have arrived at total acceptance, so thats why when I am told that I dont have OCD, just OCD tendencies, its kind of confusing. Now I am worried that I am doing this somehow on purpose for some reason I dont understand and that I dont have any mental disorder.

Cognitive therapy didnt seem to work for me, infact it made me obsess even more about whether I was doing it right. I read the Book Brain Lock and that did help somewhat, though I found it exhausting to tell myself every ten seconds the thoughts had no meaning. On the other hand maybe it did work some what because I dont feel as upset about having this problem anymore, though at times I am very upset about it.

I did try medication but I didnt really have much luck and I didnt like it. I thought that I could learn to manage this on my own. I suppose its tolerable in some ways because I am getting used to it, but on the other hand maybe I just gave up on expecting to stop my obsessions. I am not depressed and I dont feel sorry for myself, I guess I did give up hope or maybe I have sort of accepted it. I really dont see any chance of living a life without obsessions but I guess maybe I just accept that as my reality. I dont know if I should have given up hope, I guess it was just easier than endlessly asking questions to which no answer was never enough.

Thanks for asking.

 

[David Baxter PhD]

I won't try to speak for your therapist but I think s/he's correct in saying it's a dimension rather than a category. We all have certain routines and worries and we are all a bit obsessive or compulsive in certain aspects of our lives. If those tendencies are severe enough or widespread enough where they begin to significantly interfere with our day-to-day lives, we call that OCD. The question of diagnosis is whether you meet sufficient criteria for that specific diagnosis which is largely based on severity, frequency, and duration of symptoms.

I agree with you that the book Brain Lock is an excellent one. It's about acceptance of yourself and your condition, about recognizing that fundamentally OCD (or OCD tendencies) is an anxiety disorder reflecting a specific style of worrying and then resisting the OCD tendency to give special power to that style of worrying.

Both medications and "standard" CBT can be helpful for many, although not all medications are equal in this respect. What medications did you try?

 

[adaptive1]

Thanks for your thoughts Dr Baxter, you know alot about alot of things. I was given Zoloft and I asked my Doctor to try something else and he said that I didnt give it long enough to work so I tried a higher dosage of which I can't remember but it actually made my obsessive thoughts seem worse so I quit taking it and I didnt go back to the Doctor.

Perhaps I should have and still should, however, this is the part my simple mind can't seem to get. Why would I need medication for tendencies of OCD if I dont actually have the disorder, just tendencies. TO me, that seems like taking aspirin if you have a sudden pain in your head but you dont have a headache. Does this make sense? This is what I can't really get my head around and have been worrying about. So, now I am worrying about not having OCD but having the symptoms of it and worrying why.

 

[Retired]

I was given Zoloft and I asked my Doctor to try something else and he said that I didnt give it long enough to work so I tried a higher dosage

Medications like Zoloft which is classified as an SSRI are used to treat OCD. They do not work like, say, aspirin..that is to say and Zoloft is not used for symtomatic relief, but rather as a long term therapy by re-setting brain neuro chemistry.

It's not clear who ordered the dose increase in your case, but a dose change in itself may not produce an effect other than increase side effects.

Dosages are often determined by the condition being treated, and SSRI's require several weeks to a few months before effectiveness can be evaluated.

I quit taking it and I didnt go back to the Doctor.

In order to get control over your disorder, regardless of the degree of the disorder, mild or severe, you need to be patient and work with your doctor over a period of time. There is no "one size fits all" recipe and sometimes requires a modification in dose or even change in compound, so you need to be willing to take the time it needs.

OCD is treatable...all that is needed is your patience to continue working with your doctor.

 

[adaptive1]

Thanks Steve, I am still not sure I understand though. If a person has a tendency towards certain behaviours that in itself is not a mental disorder. So why would I seek treatment or take medication for something that is just part of my personality? Maybe I could do things that would be helpful to make the problem better but if these are just personality traits vrs a mental disorder then to me that means I am just kind of stuck with them or are to blame for them I guess, there is no chemical imbalance to them I guess. Having no diagnosis I guess just makes me feel like I caused them.

 

[David Baxter PhD]

It depends how severe or distressing the symptoms are, adaptive. What you describe certainly sounds like what I've termed "OCD-style worrying".

But Zoloft may not be the best medication for OCD in any case. My experience with clients has been that Luvox (fluvoxamine) tends to be more effective for many people (although there is evidence that the generic is not as effective as the brand name version of that drug).

 

[adaptive1]

Thanks Dr Baxter, once I get settled in my new town and find a new Doctor I will discuss it with them. I suppose I shouldnt worry about the diagnosis so much, just doing what I can to help manage the symptoms and have a better life. Thanks for the advice though, I will discuss your suggestion with a Doctor. I have to stop questioning everything I guess, that just fuels my obsessiveness.