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Norman M.
Norman M., Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA
Category: Mental Health
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Experience:  ADHP(NC), DEHP(NC), ECP, UKCP Registered.
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I have really bad and severe OCD thats getting progressively

Resolved Question:

I have really bad and severe OCD that's getting progressively worse. The issue that bothers me more than the actual OCD itself is that nobody ever seems to understand the type of OCD I have, which are WAY too many to list. But it's something that nobody has ever heard or nor ever seems to understand, including and all the doctors, pshychiatrists, therapists, etc... What if there is no existence of my personal OCD? And if that's the case how am I ever suppposed to recieve the proper help I need?
Submitted: 2 years ago.
Category: Mental Health
Expert:  Dr. Vikas replied 2 years ago.


For any type of OCD symptoms the choice of treatment remains the same in terms of medicines. There can be variations in the psychotherapy according to the dominant symptoms.

Is it possible for you to describe your OCD symptoms and what exactly do you mean by "Personal OCD"?

Kindly also mention the medicines along with the dose you have already tried?

Have you ever tried psychotherapy in past?


Customer: replied 2 years ago.

Hello Dr.Vikas,


I am aware of the fact that treatment and medication to treat any kind of OCD is basically the same although the methods in which they are treated and control may differ. My concern is that I have tried therapy at an in-patient program and have also recieved various assessments which always seemed to differ according to each pshychiatrist. I did not get the help and support I needed when I was in the in-patient program so decided to discontinue the therapy I was recieving at the time.


Throughout many years I have been diagnosed with not only OCD, (which I would like to mention is the most bothersome and dipilitating of all the other disorders I suffer from). Apart from that, I also have ADHD, clinical depression, anxiety and mood disorder and bipolar disorder.


What I mean by when I say "Personal OCD", I mean that throughout the many years in which I have been put on and tried various (almost all) medications in order to help treat and control all the disorders I have, not one of any of the medications I've ever been put on and have always consistently and correctly been taking as prescribed have never really seemed to help me in any major way without altering my "normal" state of mind. If I am not bothered by just about everything surrounding me and have constant anxiety, the other medications I was prescribed always made me feel very loopy, almost like I'm "high" and have caused hallucinations. And now everything is just making a gigantic turn for the worse in terms of everything and my life, or lack thereof, right now and for the past few months is just a complete disaster that I've actually just ended up confining myself at home and almost never leave the house.


Not one of the all the therapists and pshychiatrists I've been treated by seem to ever fully understand my OCD because it is so complex and so spontaneous. I've been told so many times that they've never heard of these types of OCD symptoms and ritual patterns, to which I don't blame them for saying because I myself don't know what it is exactly that bothers me or what I can do to decrease my anxiety level. I just have SO many OCD symptoms to the point that it's genuinely IMPOSSIBLE to even count! And them on top of that, they ALL always spike up and down uncontrollably like a rollercoaster, and then they just come and go as they please without any kind of sequence or pattern. This is why I refer to my OCD as "personal" because it's just something that NOBODY seems to have or know how to treat. And so all of this is the reason as to why I've had to have the unnecessary numerous amounts of assessments as I've had so far. And after every re-assessment, I'm always told and diagnosed with something different or simply just diagnosed with ANOTHER disorder to add to my list. And this is the response I've gotten from each and every one of the various pshychiatrists I've been treated by.


I have extremely great difficulty just simply describing my OCD sypmtoms verbally, so for me to be able to write all or even just some of the countless OCD symtoms I suffer from on a daily basis seems would be impossible.


I'd also like to add the fact that I will soon be starting Cognitive Behavioral Therapy to help treat and control the severity of my OCD, however I can't seem to get my head around just HOW any therapist (regardless of how experienced and sought after) ultimately plans to successfully go about doing the last and most crucial part of CBT which is the Exposure and Response Prevention when I myself don't even know which of the OCD symptoms I have are the MOST bothersome, because to me ALL of my OCD symptoms are EQUALLY severe and equally dibilitating. And the botXXXXX XXXXXne being that I just simply have TOO many symptoms and unavoidable factors in my daily life that causes me to experience and feel moderately high to extreme anxiety and again, all equally, every single day, everyday.


Now, regarding the medication part, this is a list of the medication and the dosage of each medication I am currently on:


Adderall 20mg

Prozac 40mg

Cymbalta 30mg

Seroquel 300mg

Clonazepam 5mg





Expert:  Dr. Vikas replied 2 years ago.
Many thanks for a detailed reply explaining it all Mia.

Your problem is indeed very complicated and I guess discussing your problem on an online platform will yield no fruitful results therefore I am opting out from this question and will let our other experts try to answer your question.

Kind regards

Expert:  Norman M. replied 2 years ago.
Mia - I'll try to expand a little on Dr Vikas' answer.

In my view, your medication needs a thorough review. If it is not working for you, there is something wrong with the regimen. You may also want to talk to your Doc about Trans Cranial Magnetic Stimulation, a recent, non invasive therapy which has shown success where traditional anti-depressants have failed.

Secondly, everybody's OCD is personal - it manifests itself differently in each individual, and a well trained and capable therapist will tailor the CBT to suit you, and you alone. You see, CBT is not simply a series of steps ending in "Exposure and Response Prevention". That, frankly a great over simplification.

If the pattern of thinking we use, or our beliefs about our situation are even slightly distorted, the resulting emotions and actions that flow from them can be extremely negative and unhelpful. The object of CBT is to identify these ‘automatic thoughts’ then to re-adjust our thoughts and beliefs so that they are entirely realistic and correspond to the realities of our lives, and that therefore, the resulting emotions, feelings and actions we have will be more useful and helpful.

Cognitive therapists do not usually interpret or seek for unconscious motivations but bring cognitions and beliefs into the current focus of attention and through guided discovery encourage clients to gently re-evaluate their thinking. In other words, it's all about providing the clients with the tools and understanding to help them manage their own condition, and there is no 'one size fits all' approach

Therapy is not seen as something “done to” the client. CBT is not about trying to prove a client wrong and the therapist right, or getting into unhelpful debates. Through collaboration, questioning and re-evaluating their views, clients come to see for themselves that there are alternatives and that they can change.

Clients try things out in between therapy sessions, putting what has been learned into practice, learning how therapy translates into real life improvement.

Your therapist will take a fairly holistic view of your personal OCD, not treating it as a list of individual manifestations to be treated one after another. The goal of the whole process is to help you to re-structure your thinking, not to 'fix' things for you.

Also, there is a book called ”Feeling good - the new mood therapy” by Dr. David Burns. It has a hand book which gives you practical exercises to work through and further instructions on how to better use CBT. I really do recommend it.

Work with your therapist, but don't be afraid to disagree - that way you will win in the end.

Norman M., Principal psychotherapist in private practice. Newspaper contributor, over 2000 satisfied clients on JA
Category: Mental Health
Satisfied Customers: 2567
Experience: ADHP(NC), DEHP(NC), ECP, UKCP Registered.
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