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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10643
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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For several years I have had a problem whereby I analyze the

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For several years I have had a problem whereby I analyze the content of my conversations with others, even people close to me. I review the conversations for content but, moreover, for the way in which I talk, ie, am I hesitating, am I stumbling, using the wrong words, trying to hard searching for the rights words. I then review the conversation and reword them. I have been on Cymbalta as I have attributed this to social anxiety (I also have pain issues), but now wonder if these symptoms are more related to OCD. The Cymbalta helped a great deal but it made me feel very tired and unmotivated. I lost my sense of creativity which has always sustained me. I would like to go back on the Cymbalta, perhaps I need to spend more time on it and the side effects will pass.

Dr. Z :

Hello I believe I can help you with your concern

Dr. Z :

Give me a couple minutes to read over your question, so that I can better answer you and ask pertinent follow-up questions.

Dr. Z :

It is possible that you have OCD, but social anxiety can present symptoms that are similar to OCD and they are consistent with the symptoms that you described.

Dr. Z :

You mentioned that the Cymbalta side effects made you tired and unmotivated, may I ask for how long were you using the Cymbalta for?

Dr. Z :

Also you mentioned that you were seeing a therapist for CBT therapy, but the therapist was not trained in CBT. Would you be willing to go to a real CBT trained therapist in the future? Because CBT is considered the best type of therapy to treat social anxiety and OCD

Customer:

I have only been on the Cymbalta for about 10 days and at a low dose. The fatigue was just overwhelming as well as the feeling of being disengaged. It was great not to analyze conversations though. I have tried to apply the CBT techniques but have found it difficult but have never been involved in a structured program. Am I correct in thinking that you think the problem is social anxiety rather than OCD? Do the Cymbalta related problems usually resolve. My MD says I should stick with it but it is difficult, especially the emotional flatness.

Dr. Z :

So regarding the Cymbalta side effects, they usually resolve in 4-6 weeks, but it sounds like you were particularly sensitive to that medication, so you can stick with it and most likely the side effects are temporary for you. The other possible medications that work to treat both social anxiety and OCD really well are Lexapro (this is the most effective medication in this class, with the least amount of side effects typically), Zoloft, Paxil, and Effexor.

Dr. Z :

Now it sounds like your symptoms are more obsessive thoughts related to social anxiety, so I do not think it is true OCD. OCD is a type of anxiety disorder, and individuals have the obsessive thoughts and compulsions as a way to cope with their anxiety. It becomes a separate disorder when the obsessions and compulsions because problematic to your daily life. Now it is possible that your behavior could evolve to OCD though, that does happen, but I think right now it is just social anxiety where you are experiencing some "OCD-like" symptoms related to the anxiety.

Dr. Z :

But a true diagnosis by a professional would be more accurate.

Dr. Z :

Concerning the CBT. I would definitely recommend it and going through a structured program as the medications can lessen they symptoms of social anxiety and OCD, only therapy can truly cure you. I would like to recommend some CBT books that can truly provide you with some structure to start off on until you find a good CBT therapist

Dr. Z :

I gave you the structured technique CBT books for both OCD and anxiety, as it is possible you may have OCD, but I still think your symptoms are more closely related to social anxiety at this point

Dr. Z :

Do you have any questions or concerns with everything I have written?

Customer:

Thank you, XXXXX XXXXX is very helpful Of the three books, can you recommend one you think may be most appropriate to my situation?

Dr. Z :

I personally think the second book I recommended is the best for social anxiety and anxiety like disorders, so if you are diagnosed with OCD it will help you a little with that as well.

Dr. Z :

And the second book is used at most CBT institutes around the Western World as well.

Dr. Z :

Is there anything else I can do to assist you tonight?

Dr. Z and other Mental Health Specialists are ready to help you

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