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Dr. Z
Dr. Z, Psychologist
Category: Mental Health
Satisfied Customers: 10547
Experience:  Psy.D. in Clinical Forensic Psychology with a background in treating severe mental illnesses.
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I have serious 'Transformation obsession' (see: as a form

Customer Question

I have serious 'Transformation obsession' (see: http://en.wikipedia.org/wiki/Transformation_obsession) as a form of OCD. Fear of losing myself the only thing I have, and becoming somebody totally opposite from myself. It is horrible, unspeakable fear.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Dr. Z replied 1 year ago.
*This website DOES NOT constitute treatment and only provides information and advice. For treatment (therapy and/or medications) you must go to a licensed professional in your area. Please note that anything said here is not private or confidential, as this is a public forum. Hello, I believe I may be able to help you with your concern. I am sorry that you are having this issue with a transformation obsession, I can understand how distressing this can possibly be for you. I would like to ask you a few questions to get a better idea of what you are looking for, so that I can better assist you 1. You did not pose a question in your description, so may I ask what exactly is your mental health question concerning this situation? 2. For how long have you had this issue? 3. What treatment have you tried so far (e.g. Therapy and/or Psychotropic medications)?
Customer: replied 1 year ago.

my ocd is a consequence or result of severe anxiety which itself is a consequence or reaction of obstacles, stresses and hardships in my life. so, everything is like ugly concentric circles. and then all that create inevitably depression although I'm not originally depressive. I'm not psychotic never been, but this neurosis is even harder to bear. neurosis can be even tougher to bear for a sufferrer than a psychosis.
My ocd is actually constant intrusive thoughts of horrible fear of losing myself (the only thing I have), of developing psychosis my horrifying phobia is developing schizophrenia, depersonalization, derealization, dissociation... horrible I can't comprehend those things and they scare me the most, worse than death. then, counting, numbering, horrible. I've never had obsessions with germs nor excessive handwashing, I wish I had that type of ocd I think that type is easier a little bit.
I was so stable and strong on Paxil for 11 years but it made me gain weight. so, last year I carefully weaned myself off Paxil, started Prozac and ...whole hell broke loose. lost sleep, anxiety attacks, panick attacks, ocd like never before in my life. last year from last April onwards was a horror for me, the hardest time of my life. and still unfortunately is. Now I'm on Lexapro, Anafranil, Neurontin and Clonazepam, I've never been on so many medications but I'm cautiously optimistic, although just these days I'm going through difficult time again and still, it could be side effects of Anafranil that I just started little more than a week ago, although I've been on it for several weeks last July and it just didn't help. Hope it will finally help this time.

I am so, so scared, it's unspeakable....

Expert:  Dr. Z replied 1 year ago.
I am sorry that you are struggling with this level of OCD, and that the treatment has not been as effective for you recently, although there is hope regarding the Anafranil. But may I ask you still did not state a mental health question that you would like to ask, so that I can better assist you
Customer: replied 1 year ago.

What do you mean, what mental health question I didn't ask?

I actually have a question whether neurosurgery procedures such as capsulotomy, leucotomy, ...... are more effective than deep brain stimulation or vice versa, because I am at the stage that some invasive therapy might help better hopefully because no medications nor therapy has helped.

Expert:  Dr. Z replied 1 year ago.
Okay so your question is about deep brain stimulation or even more to the extreme if neurosurgery would be recommended, is this correct? Give me around 10-20 minutes to formulate my answer for you regarding this.
Customer: replied 1 year ago.

Thank you, ***** ***** I've been suffering unspeakably and been ravaged by most extreme anxiety and these ocd symptoms for 2 years now. I can not handle this anymore!!!

Expert:  Dr. Z replied 1 year ago.
Treatment resistant OCD is very difficult to treat, especially if you and your doctors believe that medication is not going to be effective for you. The one thing I want to mention is that the use of a Ketamine IV has been shown to be an effective off-label treatment for OCD, but so far this is purely experimental and only a few clinics around the country provide Ketamine IV use. Now the deep brain stimulation and neurosurgery, Cingulotomy is the most common form of surgery done to treat OCD related disorder, are irreversible and the success rates for both of them are about the same and it is considered a fair treatment for resistant cases of treating OCD, which means it has a little over 50 percent chance to significantly resolve the symptoms of OCD. For the Cingulotomy it does take anywhere from 6 months to 24 months to really see the results, while deep brain stimulation can see benefits more quickly. Before you consider these invasive techniques, I would still recommend the IV Ketamine or the Repetitive Transcranial Magnetic Stimulation (rTMS) which has shown limited success in treating OCD. The ElectroConvulsive Therapy (ECT) and Vagal nerve stimulation (VNS) are also not as invasive methods to help lessen OCD, but the outcomes for these methods have not shown great benefits, but the risk is low compared to the neurosurgery and the deep brain stimulation. I hope this answers your questions and gives you some guidance on how to approach your treatment. I wish you all the best and I hope your symptoms of OCD lessen very soon for you. My goal is to provide you with excellent service, so if you ever have any further questions or concerns please do not hesitate to contact me at anytime. If I answered your question satisfactorily I would very much appreciate if you could rate my performance in helping you so that I can get credit for this question. Thank you very much
Expert:  Dr. Z replied 1 year ago.
Please let me know if you have any questions or concerns as I am here to help and support you with anything that you need.