Ask a Psychiatrist and Get Answers to Mental Health Questions ASAP
Thanks for writing to JA.
I'm sorry that you're going through a rough patch right now. I certainly wouldn't diagnose over the internet (neither appropriate nor ethical), but I do have some advice regarding the proper treatments for anxiety/depression.
I am glad to learn that you are seeking help for PTSD at the local VA. In addition to the treatment you are currently receiving, I would check into Eye-Movement Desensitization and Reprocessing (EMD-R). This is a somewhat controversial treatment that originated in California (and then extended from Chicago). The EMD-R employs cognitive behavioral strategies to process information, but also employs a visual scanning technique (emphasizing saccadic eye movement) which has been found to be helpful in processing some traumatic life events. I know that some VAs employ EMD-R almost exclusively - while others "forbid it." I would check with your therapist to see if s/he is familiar with the technique and if you might be a good candidate.
Regarding the OCD, research has consistently demonstrated that treatment plus medication is more effective than medication alone or treatment alone for depression and/or anxiety. Further research has shown that Cognitive Behavioral Therapy (CBT) is the most effective form of psychological treatment/intervention - particularly in dealing with mood and/or anxiety disorders (like OCD).
Ask the team treating your PTSD to explore your OCD symptoms - and determine if this relates to an underlying eating disorder or to an obsession with counting.
A licensed psychologist/psychotherapist with specific training in CBT modalities would be able to address your concerns. I would encourage you to find a licensed mental health professional with whom to work, employing CBT. If you are addressing OCD, a specific form of CBT is called Exposure with Response Prevention (ERP) [Lots of letters, I know... sorry.] ERP has been found to be as effective or more effective than traditional medications for OCD. Be sure when you speak to a possible licensed mental health professional that s/he employs CBT techniques - not just "influences from CBT" or "an eclectic approach."
With regard to medical treatment, many/most physicians appear to begin with a Selective Serotonin Reuptake Inhibitor (SSRI) to treat anxiety. Because I am not an MD, it is beyond my purview to address medication concerns, however.
Again, the mantra of years of research says: medication or treatment alone is not as effective as both working in tandem. Some research has also indicated that insight-oriented talk therapy is counter-productive with some forms of mood and/or anxiety disturbance... it actually exacerbates the condition(s) [This is especially true with OCD]. So, seek out a CBT therapist who will provide targeted, efficient, and effective therapy - not someone who signs you as a "lifer." If you're going to a therapist for years, something about the therapy isn't working.
Your VA-team likely employs CBT in much of their practice. If not, they *may* know of a CBT licensed mental health professional in your area. Please make certain, however, that they employ CBT practices.
Thanks. I hope you're well and that this was helpful.
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