OCD and Addiction

OCD is a monster. One that we feel we must constantly keep pacified out of fear that the next spike will be unbearable. My OCD is mostly gone, save a few bad days and irritating moments, but I kind of appreciate those moments because they never let me take for granted what I now have. The OCD is mostly in remission, but the habits I developed to deal with it are still around. In my desperate attempts to escape, I developed a problem with addiction, which is now the new monster I am fighting.

Drugs is a controversial topic and one I have been shying away from, but many of us know the unpleasant stigma of mental illness and I think the only way we can get rid of that is to speak the truth. I know there are many others out there struggling with their OCD and hiding their addictions, which is why I am also choosing to discuss this; because it is when we suffer alone that we truly suffer.

I began to treat myself before I knew I had OCD. I was not diagnosed until I was 21. In my teen years I developed an eating disorder. It had nothing to do with body image, but entirely about control and escaping my emotional discomfort. I think the most important thing a lot of people misunderstand about eating disorders like Anorexia and Bulimia is that they are anxiety disorders, not issues concerning low self-esteem.

I deprived myself of food to induce stomach aches which would distract me from my racing and obsessive thoughts. After it was getting out of hand, I started smoking weed. Every night, it put me to sleep, for years. Then, one fateful day in hte hospital, I was prescribed Ativan for my rapid heartbeat, which I explained was normal due to my anxiety. I started taking the drug every day because it made me feel “normal”, but I became dependent on it and the side effects were so awful I decided to get off of it. I did this safely.

I replaced Ativan with narcotics, sex, drinking and cutting. To me, it didn’t matter what the vice was, as long as it was something that changed how I felt. The one thing all these vices had in common was that they all altered my mental state, but lead me to a crash the following day.

I had gotten so used to escaping my feelings and running at the first sight of OCD or discomfort, I stopped feeling anything… anything bad, anything good. And trust me, the thought of feeling numb sounded pretty fucking good, but it wasn’t numb, it was just kinda down all the time. No joy, no color, no vibrance, just gloom.

Therapy has helped me tremendously to learn how to not only tolerate my emotions, but to accept them. I realized that my use of drugs and such was because I didn’t know any coping skills for feeling emotions, and feeling emotions was and still is scary.

Drugs still have a place in my life, like once in a great while when I am really anxious because of traveling or something, then I do take an anxiety pill, but other than that I am learning to deal with my emotions and such without self medicating.

The complication for me was that my need to compulse and need to use drugs or alcohol got intertwined (like when I cut) sometimes I felt like stopping, but my OCD brain felt like the number of times I cut was wrong, so I would cut more than I wanted to. It was weird to lose control doing what I started to do because I thought it gave me a sense of control.

The addiction monster and OCD monster can feel the same, but what I’ve discovered to help both is learning to accept myself and learning how to deal with emotions. I have also learned that when the need to cut or use comes up or the need to compulse comes up, I take a deep breath, remember what I learned in therapy like journaling, and most of the time I get through it, and the more times I get through it, the more I learn I can get through it.

If you struggle with addiction or OCD or both, you are not alone. Please seek help if you want it, because you can get through both if you want to. Stay strong.

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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!

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.

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.