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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7661
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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I am an eighteen-year-old female, and have had mild obsessive-compulsive

Customer Question

I am an eighteen-year-old female, and have had mild obsessive-compulsive tendencies for as long as I can remember - however, these have been mostly just comforting.

From the age of fifteen I started having bouts of mild 'depression' - these have persisted since then in the following pattern: one bout in the Summer, which tends to centre on something mundane which I slowly become obsessed with (example: last year, my brother asked to borrow one of my DVDs, which I didn't lend him - this event slowly became more and more crucial to me, until I reached the point where I would lie awake at night, listening to my brother on his computer, telling myself that he was watching the film - 'my' film - anyway, even though I hadn't given him permission, and that he was thinking that I was stupid and pathetic as he watched it). I also tend to eat less during this time. These usually start in July, and last for just a few weeks, if that.

Then I have a bout of depression in the Winter, starting around October-time and lasting for a few months - these bouts tend to be centred more on darker subjects, like the fact that I'm going to die and there's nothing I can do about it, and instead of being paranoid and obviously distressed, I tend to be just miserable, irritable and introverted. But my eating is usually unaffected during these times.

In Summer 2011, I had another of my Summer depressions - this time, I went to the GP about it, and filled out a questionaire which concluded that I didn't have depression but was just 'down' in my mood. It lasted about a week or so before slowly petering out.

Then I went back to school in September. I had started my second year of A-levels, and was also volunteering to help out some evenings at a Literature Festival. In between achieving small goals at school such as getting my homework in on time, etc., the Festival, and my new Saturday job, I began to feel on top of the world in an almost manic way. I was eating rubbishly, but I didn't care - I felt like I was getting so much done. I was also aware that I was performing obsessive-compulsive behaviours much more obviously than I had before, although the impulses behind these actions were still familier to me - I was walking backwards up and down the street, for example, until it felt right, and stopping in the middle of the path until I felt that the parts of myself that I had left behind (because my mind was going so fast, I felt as though some parts of me couldn't 'keep up') had 'caught up', then setting off again. I was too cocky at this point to rationalise this, and told myself that I was 'experimenting with insanity', so indulged in it a bit. I sent in an application to join an open mic competition - and was accepted. This, again, felt brilliant. But when it came down to sitting down and re-writing my entry, I realised that I was too high to actually focus on the task at hand. I had to cancel - this made me break down, and I cried for quite a while, then felt guilty and miserable for a day or so afterwards. After that, I had one or two other breakdowns, where I would start to cry, then hate myself for crying, and see how disgusted my family seemed to be of me, and so cry some more at that, and so on, until I felt as though the more rational part of my personality was so disgusted with the rest that it was trying to tear itself away. This would last hours, and would drive my family away in fear and disgust, but eventually after a bit of quiet solitude and monologuing to try to understand my thought processes I would calm down, and become cooly detatched for a while afterwards (I suppose to try to block out the fact that I had driven my parents to misery in the process). The obsessive compulsions became more intrusive, becoming at their peak so intrusive that I was waking up at night and immediatly getting up out of bed to perform them. I became late for school, and my grades worsened. I hit a low point at Christmas - after that, I quit school, and began to feel slowly better. I went to a psychiatrist for a few sessions, but felt that dwelling on it was inhibiting rather than speeding up my recovery, so left. By the Summer, I was feeling relatively sane again; I was still very obsessive-compulsive (and still am, probably at the same level), but did not feel that it was as crucial that I perform these behaviours correctly. I began to take more control of my life, and stayed away from home more, doing my own thing (this helped).

Two months ago, I went on a backpacking trip. I had a few overly anxious moments, and still performed unusual behaviours in public, but this didn't get me into any trouble, and nobody commented. However, now I have returned, my parents are apalled that I am still performing these behaviours in public. My mum thinks it is a personal attack on her. So now I have come back to Earth with a crash, feel guilty and trapped, and don't know what to do.

What might be wrong with me?

Should I seek help?
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.
Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Dear friend,

It seems that your depressive states, for that is what you suffer from, in part, are affected by the changes in the season, from summer to fall or from winter to spring. This is called Seasonal Affective Disorder, or SAD.

I literally causes you to lose energy, oversleep, become sad, and increases your anxiety. It seems to be directly related to the change in the intensity of the sunlight. There are two forms, summer and winter, and you seem to have both.

This can be treated with medications, but MORE IMPORTANTLY, by full spectrum light therapy. This works quite well. You have also given indications that you have mania along with your depression. The two together are called bipolar disorder and can also be treated with light therapy.

Such equipment is readily available on line. One source is:

http://www.ei-resource.org/store/sad-lightboxes-and-full-spectrum-lighting/sad-light-boxes-&-full-spectrum-bulbs-%28united-kingdom%29/

Your sensitivity to seasonal changes may also be responsible for the obsessive compulsive behaviour (OCD) that you seem to be manifesting. It has been shown that the light therapy also proves beneficial to OCD.

For books and equipment concerning this disorder go to:

http://www.amazon.co.uk/s/ref=nb_sb_ss_i_0_15?url=search-alias%3Daps&field-keywords=seasonal+affective+disorder&sprefix=seasonal+affect%2Caps%2C310


When you see your therapist, MAKE SURE to mention all this to him or her so it is not overlooked. I think this may be at the heart of your problem.


Warm regards,

Elliott Sewell, LPCC, NCC, CCMHC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7661
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you
Customer: replied 1 year ago.

Thank you for your diagnosis.


 


I have not been to a doctor for an official diagnosis yet, but feel that yours makes sense - I have a relative who has the symptoms of BD, and another who has Winter SAD (although I thought that BD involved long periods alternate of mania and depression, rather than emotional fluctuations throughout the day/week, as mine seems to).


 


I have been doing a bit of self-psychoanalysis, and have come up with a possible trigger: when I was fifteen (around the same time my low moods started), I lost something at school, and have regretted not going back to look for it ever since. I worry about this a lot when I am down, and feel that my guilt and anxiety about this could be why I feel so out of control, and why I constantly worry that I have dropped something and need to go back to ‘check’.


 


Recently, I have made some changes. I have resisted my OCD urges, and people have noticed that I perform them far less now. I have dug out a light box, and attempted to use it for the recommended time on several occasions – however, I felt that it had little to no effect, and as I struggle to find times in my irregular schedule to use it, I have put it aside for now. I have bought a book on BD, which I intend to read (although I have put off reading it, as I am worried that labelling myself with BD will mean that the diagnosis will start to consume my identity – I went through a stage shortly after diagnosis of blaming all my emotions on BD, which wasn’t healthy).


 


I have also got a part time job, which keeps me busy, although the hours are irregular which makes it hard for me to get into a routine. I have been socialising more with distant friends via text, and have been accomplishing personal goals. I am still living with my parents, but, up until now, I thought we were doing alright.


 


However, I have recently been having strange mood swings. These vary, but as an example: I wake up some mornings with my heart pounding, have breakfast and feel a lot more positive, then do something during the day which I regret, to which I react with huge amounts of anxiety and self-loathing, which then subside, usually within a few hours but sometimes not until the next day, leaving me relaxed again, before the cycle repeats. I also feel that my thoughts are sometimes going faster than I can rationalise them (I think this is called being ‘wired’, in BD speak), leaving me anxious afterwards as I feel that I could have dropped something or left something behind in this careless state, and have no memory of doing it. One time, I had left a neighbour’s house in a rush, and felt sure I had dropped something; so I got up at seven in the morning, and spent the next hour skulking around their yard in the dark with a torch, making sure. Not my proudest moment.


 


I have mainly been dealing with these feelings by exercising hard, eating less (to stop ‘fuelling’ them), and busying myself with tasks and work. These all have made me feel more in control, although I have lost a bit of weight and think the physical conditions I am putting myself under might even be making my anxiety levels a bit worse.


 


Also, when once I would have made decisions on the basis of how I ‘felt’ about each option (another OCD trait), I have recently been finding it very hard to come to a decision. I have little moments of panic, and spend ages flitting back and forth between two options, feeling in the moment that whatever decision I make will have huge consequences. Sometimes I panic because I have not performed an OCD behaviour, but I usually just ignore that. But when the decision has ‘real-life’ consequences, like whether to go to the library or the shops first or whether or not to leave something at home, I can spend up to ten minutes of panicked indecisiveness before I eventually pick an option. When I do this, I tend to power through the anxiety and regret which follows, and eventually feel ok. However, this has been affecting my family.


 


Last night, a stupid indecision about whether to take or leave a book when going to a restaurant with my family made us ten minutes late, stressed out my parents and ruined the evening. Afterwards, my mother gave me the same talk she had given me when I had been exhibiting OCD traits: basically, that I couldn’t possibly cope on my own and that I would have to either see a psychiatrist or take drugs. I did not tell her about your online diagnosis, for fear that it would just fuel her concerns and make her force me into a therapy that I am not ready for, but the whole ordeal made me feel trapped again, and as if all the progress I felt I had made had been for nothing.


 


I am currently evaluating my options, and am writing again to ask your advice.


 


Ideally, I would like to move away from anyone I could hurt, to explore and understand my ‘condition’ at my own pace, maintaining maximum control over my life. My family is more for an instant course of drugs and/or therapy. I understand this view; however, I feel that if I went through a process like CBT or drugs therapy to alter my personality simply to keep my parents happy, I would regret it. I do not feel that I know myself enough or have enough control over my life to freely consent to something like this.


 


At the end of the day, I am eighteen and know that it will be my own decision. But I would really like some professional, objective advice on: what my options are, any options I have overlooked, and whether my plan of moving out and going unmedicated while I learn about my new mindset is feasible, or just plain dangerous.


 


Thanking you in advance, H.

Expert:  Elliott, LPCC, NCC replied 1 year ago.
Dear friend,

I do not think that you need to go to a psychiatrist, but rather to a therapist who deals with anxiety disordersl You seem to have several varieties of anxiety, including general anxiety, panic attacks,and obsessive compulsive thinking.

You would do best if you got some therapy.

Some antianxiety medicatijn may also be indicated, but you need therapy as well.

Now that you tell me more, it seems that anxiety is one of your chief problems.

You may have SAD as well, but make sure that you use a proper light box with the right wave lengths - one specifically made for seasonal affective disorder treatment.

Search SAD lights online.

Best wishes,

Elliott
Customer: replied 1 year ago.
That makes a lot of sense, thank you.

How would I go about finding a therapist?

Also, do you still think I'm bipolar, or are my problems purely the result of an anxiety disorder?
Expert:  Elliott, LPCC, NCC replied 1 year ago.
Dear friend,

I have reread your entry a couple of times more to try to get all the details and the full flavor of what you have told me.,

I do not think that you are bipolar but are suffering from a variety of anxiety disorders, particularly OCD and some panic attacks.

I believe that it may be very stressful living at home, as your mother seems to have little empathy or understanding of you, and probably makes your situation more difficult.

You cannot confront her about this, but instead must try to politely and nonchalantly stay out of her way. Cope with her by smiling at her and keeping the peace.

If you go to a psychiatrist, he or she will probably just give you medications, which is what they usually do, nowadays.

You need talk therapy.

I can direct you to three UK websites where you might be able to find someone near you. Not all therapists have equal skills and abilities, so try to assess THEM carefully too. If you don't feel comfortable then that is a good sign that they are not communicating well with you.

Here are three websites:

Here is one place to look:

http://www.psychfinder.co.uk/


Here is another:

http://members.psychotherapy.org.uk/find-a-therapist/


Here is a third place:

http://www.itsgoodtotalk.org.uk/therapists/


Here is a good workbook:


The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder by Bruce M. Hyman PhD LCSW and Cherlene Pedrick RN

and here is one for panic attacks:

Panic Attacks Workbook: A Guided Program for Beating the Panic Trick by David Carbonell


Please let me know if I have helped you.

Warm regards,

Elliott

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