Month: June 2009

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Obsessed – show on “A&E”

“a&e” began a show about OCD called Obsessed memorial day weekend of 2009.  To my knowledge, this is the first show about the disorder.  The series consists mostly of interviews and documentary style footage with each episode consisting of stories from two people who deal with OCD.  Each person then goes through weeks of CBT, usually with positive results.  At this point drugs are not a prescribed form of treatment on the series.

So far, we have seen characters who suffer from all different types and severities of OCD from hoarding to hand washing.  The consistent theme is that OCD has considerably intruded upon their lives and created unmanageable problems.

One particularly touching episode dealt with an older man who had not dealt with his mother’s death and had severe OCD that manifested in hoarding so extreme he had at points needed to sleep outside his apartment.

The CBT portion of the episode is a bit intense because the patient must face their fears through an exposure which is typically the last thing they would ever want to do.  Though seemingly cruel at the time, the patient seems better off after having gone through with it.

At first I kind of liked the show’s focus on people who reminded me of myself as well as the fact that it brought some attention to OCD.  The type of attention however was very disrespectful.  What a person with OCD obsesses about is often times the thing they are most ashamed off and therefor, do not enjoy talking about it.  I could not help feel like these people were being exploited.  After all, the episodes where CBT was not going well and the star of the show quit therapy early, the viewers first reaction is to blame the victim and why shouldn’t we?  Most of the time quitting is bad and rarely reflects positively on one’s character.

I also believe the bootcamp style of therapy to be irresponsible.  Sure, it works for the show, but go ahead and guess how many real therapists would ever recommend that in real life.  It’s like weight loss; people have a better chance maintaining the lifestyle if habits are put in place and practiced over time, not over night.

Lastly, the exposures portrayed on the show were highly unrealistic.  Before therapy, I had watched the show and the exposures were so intense, I decided then and there to never try therapy.  I eventually had to, and I learned that therapy for OCD is really not like what is shown on tv.

To summarize, the show brought some light to the world of mental illness which is still very much in the dark, but did not do so in a respectful manner.

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“Magic” Mushrooms (psilocybin)

I’ve read many studies that have come out in the last few years expressing how psilocybin mushrooms can help OCD, not just for a day, like many drugs, but indefinitely! I was so scared to try this, but I was desperate. To date I have done mushrooms just twice, but this has helped reduce my OCD symptoms by ~75%.

painting

The first trip was very enjoyable, and not at all scary.  I took .25mg ativan beforehand since mushrooms can increase the heart rate and when mine climbs too high, I usually go into a panic attack.  At first I felt very “buzzy”, almost like my whole body was tingling.   I also felt a bit warmer.  I giggled like a kid and my emotions felt very simple.  Like when I felt joy, it was pure joy.  The colors and patterns were amazing!  I did not take a very high dose so my visual hallucinations were minor.  I began to come down four hours later and was a little bummed.

I was expecting an instant epiphany and I didn’t get one, so I assumed it didn’t work.  I went to sleep and could hardly move the following day with a horrendous stomach ache and diarrhea.  I do not recomend taking mushrooms on an empty stomach!

And speaking of epiphanies, I can’t say that I didn’t experience one, as I did experience a mind-shift; a change in my perspective.  I feared acquiring a new personality, like drugs would change me, but it’s really not like that.  Mushrooms are fairly gentle.

The following day, I realized I had not done many of my compulsions! I was surprised that a substantial change had been made.  I was ecstatic and hoping it would last.  The effect is related to hyperactivity in the frontal cortex. I am not cured, but I am the most normal I have ever been, and this feeling has lasted for months. My OCD is at a minimum.

Mt second trip was much more intense.  I took them the second time more for recreational purposes, rather than medicinal ones.  I decided not to take ativan before hand.  Bad idea.  I started to panic.  My fear of another stomach ache snowballed and I left happy and went right into panic and nausea.  I hid my face under a blanket because the lights were insanely bright (pupils dilate a lot).  After my fiancé calmed me down by turning on Friends I was completely fine.  The bad trip lasted maybe 20 minutes and then I was fine.  I doubt it would’ve happened had I been in a decently relaxed mind set before taking mushrooms (which I did on a full stomach of carbs and fruit).

After I calmed down, the experience was incredible.  My paintings had come to life and my concrete ceiling had become a river with electric blue snakes.  The characters on Friends were much more beautiful that usual.  The silly jokes brought me joy and I was delighted in general.  I went to bed and had no stomach problems.

Taking only two doses over the last 8 months has changed my life immensely.  I think my OCD symptoms have emerged a little, but absolutely in no way like how I was before.  I would also add that a bad trip is nothing to fear.  Do not take mushrooms alone for your first time and take them in an environment in which you feel safe, like your home.  Do not use on an empty stomach, and for those who have a sensitive stomach, consume mushrooms in tea form with a little ginger.  If you are prone to panic attacks or heart conditions, please do your research and be careful.

If you google search “ocd mushroom study” you will find many valid results.  Here is one article by the BBC.

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Tramadol

Tramadol is an atypical opioid used to treat moderate to severe pain.  Because of its effects on serotonergic system, it has been suggested tramadol could be effective in treating anxiety, but at this time, the FDA has not given it a green light for use in treating anxiety or depression.

I came across tramadol on accident.  I purchased some because it is marketed as a pain killer, but upon taking it, I discovered not only were my OCD symptoms relieved quite a bit, but I was in a bit of a happier mood.  I took tramadol a few more times and got curious if there was any information on the internet in terms of tramadol being used for OCD, and as it turns out…

Tramadol has a half life of 5-7 hours.  I find that if I take it, I must do so in the morning because it will still be going strong (even at a small dose) till nightfall.  By the next day, I feel mostly back to normal.  The other reason I do not recommend taking it at night is because one side effect is insomnia and this was definitely the case with me.

Tramadol is not a miracle pill though.  Besides insomnia and other possible side effects, dependency is a risk.  The other drawback is the crash.  Sometimes I find my OCD spikes the following day after taking tramadol.  I take tramadol only on serious days, maybe once a month.  This drug should not be used with MAOI’s. Please use caution.

*UPDATE* 12/1/09

I thought I would take tramadol today because my OCD has been a bit annoying since I got back from my vacation. I don’t travel well and when I do, I usually have my OCD spike a bit.  It has spiked and tramadol seemed like a good idea, but I remember a couple times back my jaw tensed up and I couldn’t hear as well, and the last time I took it, my jaw locked a little and I got tinnitus (ringing in ears) that lasted about 18 hours.  I have since read that tramadol is ototoxic (can cause temporary or permanent damage to ears including tinnitus).  Because of this information, I have decided to not use tramadol anymore.  As much as I appreciated the drug, it’s not worth it to me.

Stay safe!

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Am I Gay or is it my OCD?

I first started to worry about the possibility of being bisexual when I was 12.  I was afraid of being gay, like many people who are confused about their orientation.  I remember having my first crush on a girl in elementary school, but  I struggled with sexual obsessions from my early teens, which casued me to repeatedly question my orientation.  Was I bi?  Was it my OCD?

I got relief once I learned it is very common for OCD sufferers to have obsessions regarding their sexuality.  This was only partly the case with me.

I did suffer from some sexual obsessions, but not all of my thoughts made me anxious.  An intrusive thought causing anxiety is an obsession, but a repressed thought that causes no anxiety is not.  I knew many of my sexual obsessions stemmed from OCD, but the attraction I felt towards women caused me no anxiety, no strife and in fact was not something I obsessed over because it fit into my shameful loops, but because I had repressed my desires along with many other sexual obsessions I wished to ignore.  It all got mixed together.

The key for me was to separate my thoughts into what caused anxiety and what did not.  This was difficult because I had to get through the confusion and bias in regards to my orientation.  I had to think about what it really meant to be bisexual or gay.  I had to listen to my true feelings and decide what was OCD and what was not.

Understanding OCD brings a lot of clarity.  Understanding my thoughts was crucial in separating my OCD from my real self.

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Scrupulosity and Atheism

I did not really grow up in a religious environment, but scrupulosity (obsession with sins), was a major player in my OCD.  I believed my sinful thoughts would manifest into something terrible.  I performed OCD rituals to “cancel out” these thoughts.  I feared the supernatural to an extreme.

Each night I would ask my siblings to come into my room to see if they could sense any spirits or ghosts.  I would request a different table at Claim Jumper if we were seated next to an old black and white photo of a most likely deceased person.  I also feared negative energy, wether being around it or causing it.  I believed my thoughts, if negative, could cause something terrible to happen.

When I became an atheist, I drastically got better.  Tormenting Thoughts and Secret Rituals by Ian Osborne discusses possible ways to deal with OCD if you are religious and having problems with scrupulosity, however, religion was really the wrong fit for me.

I did not simply abandon any religious belief due to OCD, but really I had held on to those beliefs because of OCD.  It was the “what if?” factor.  I believed because wouldn’t it be better to believe and be wrong than to not believe and be wrong?  Not really.  Believing because of fear hurts.

I think maybe all this has something to do with the fear of the unknown and uncontrollable.

I feel I am more true to myself now.

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In a world where certainties are few…Ativan

Lorazepam is the strongest benzodiazepine on the market.  It is used for short term anxiety and short term insomnia.  It is also used intravenously in hospitals in patients before surgery.

I was admitted to the hospital for a kidney infection and the doctor asked me why my heart rate was so fast and I told her I had OCD. She gave me a prescription for 15 ativan and they worked. I did not feel high or doped, I felt normal, just calm, but not zombie like. I lived near the border and got enough ativan for a year, even though it is not recommended to take them for more than two months.

It has a fairly short half life and kicks in really quickly.  The side effects are a bit nasty and may include:

  • confusion
  • hyperactivity, agitation, hostility
  • hallucinations
  • feeling light-headed, fainting
  • drowsiness, dizziness, tiredness
  • sleep problems (insomnia)
  • muscle weakness, lack of balance or coordination
  • amnesia or forgetfulness, trouble concentrating
  • nausea, vomiting, constipation
  • appetite changes
  • skin rash
  • sexual disfunction

I began taking ativan nightly.  A small dose, but it’s strong.  It helped alleviate my anxiety and helped me sleep.  I took it regularly for seven months, and got addicted.

I started to think about getting off of it after a few months because of the side effects I had developed, the worst ones being sexual disfunction, gloomy mood, and hallucinations.

I had forgotten to take ativan one night and then following morning I woke up with shaking, sweats, confusion, anxiety, stress, crying…  I didn’t know what was going on until I realized I missed my self prescribed dose.

I weaned myself off of ativan over a month.  Like I mentioned, I was taking a very small dose, so getting off of it did not take too long, but if you find yourself needing to get off of ativan, please use caution and do your research to do it safely, and seek help if you need it.

My side effects faded away, all but the hallucinations.  At my eye exam, I asked my optometrist about the hallucinations, and he said that if too high a dose of certain drugs are taken, the brain can respond with hallucinations. My hallucinations ceased after I took psilocybin mushrooms.

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Tormenting Thoughts and Secret Rituals by: Ian Osborne

This book was not only a good read for me, but for my family as well.  My mom blamed herself in some ways for me having OCD, but when she read this book, she learned that it was no one’s fault and that OCD is biological.  The author is a therapist who also suffers from OCD, which gives him some authority on the subject.  The book goes over different types of OCD, various therapies, histories and breaks down a lot of what OCD really is.

The author also accounts varies case studies detailing real people and their stories.  I did not find it so in depth as to cause me further anxiety, but I found it comforting to read about others who had OCD and what it was like for them.

The most important thing I gained from this book was the understanding that OCD is rooted in chemical imbalance, which helped me to stop blaming myself.

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Group Therapy

I did not like group therapy one little bit. The one time I went was because my therapist recommended it. The group consisted of OCD sufferers and some of their family members, along with those suffering from hoarding and trichotillomania.  I sat very uncomfortably in my chair.  Everyone took turns sharing stories an venting.  I did not benefit from this because I really did not want to vent.  I would have benefited more from hearing tips and ways to succeed. Group therapy is free in many places and may be a good option for some, but I did not like it.

Click here to watch my video post about Group Therapy on my youtube channel.

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Cognitive Behavioral Therapy

I only went through a month of cbt because I didn’t see a counselor until my final semester of college and each student was only allowed 8 visits per semester.  Going to the therapist for the first time was horrifying.  It was helpful to talk about my OCD though.  She taught me that OCD is not my fault.  I blamed myself for my OCD, believing I must have done something to deserve it.   I told her I felt scared of getting help because I have had OCD for so long, who would I be without it?  We discussed acceptance and possible solutions in dealing with OCD.

We started cognitive behavioral therapy (a type of psychotherapy in which the patient confronts his/her fears to learn how to deal with the anxiety) near the end, mostly because I kept putting it off.  I was terrified.  I also doubted its efficacy.  She started by having me resist compulsions for very small things at my home.  I didn’t really do the assignments she gave me.  I did at the beginning, but as they got more intense, I stopped.  She wanted to do an exposure (when a patient confronts his/her fear without compulsing) with me so we decided a relatively small but significant one would be to unlock my car door, sit inside, get out and lock it once, then walk away.

I walked next to my therapist and breathed while she told me to breathe.  I was upset.  My teeth chattered, I talked a lot about nothing, got dizzy, hazed and felt nervous.  She kept telling me to breathe and asked me to rate my anxiety at each increment of a few minutes.  We got inside and she told me that I hid my anxiety well.  I said thanks.

Exposures are not easy, but they are not supposed to be.  I am glad I did it though; it made a lasting impact.

I recommend cbt when you are ready.  It’s scary, but it can work and give you important coping skills.

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SSRI’s

I have never tried one.  After my first visit with my therapist, she referred me to the college psychiatrist.  I told her I had no interest in drugs and that I wanted to try other options first.  She insisted I keep my options open so I went to see her.

The Psychiatrist listened as I described my OCD.  She said:
“I am shocked you have not been diagnosed until now with such severe OCD.  I don’t like to do this on the first visit, but I would like to prescribe you zoloft”.

I brought up all of my concerns.  My fear of commercial drugs, fear of side effects, fear of becoming a zombie and getting addicted for life.  I told my therapist I didn’t want to lose whatever edge OCD gave me.  I have always been like this so if drugs could take away my OCD what else would it take away?  Great, so now I don’t want to be cured?…

I purchased the bottle, but never opened it.  The rate of improvement in symptoms from these drugs are not really impressive.  CBT has a much better track record without the side effects.  CBT is not on my to do list either.  I am doing this on my own.  I did learn some coping skills from CBT and it has really helped me since.  And back to the SSRIs, I am scared of of them, though I recently watched the season 6 premiere of House M.D. and House brings up the same concerns about taking anti-depressants.  He agrees to take them when his therapist assures him that he won’t lose himself, that Van Gouh would have still been just as creative, but with both his ears in tact.

I guess I am more open to the idea at this point, but I feel like I’ve got things under control by other means and SSRIs still seem too extreme.