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Dr. Keane
Dr. Keane, Therapist
Category: Mental Health
Satisfied Customers: 1378
Experience:  Clinical Psychology PhD, Licensed Professional Counselor with experience in marriage/family, teens and child psychology.
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I can't afford therapy or to see a psychologist. But I'm

Customer Question

I can't afford therapy or to see a psychologist. But I'm afraid something is wrong with me. I constantly repeat sayings, words, or count to myself either out loud or in my head. Like as I am putting clothes into the dryer, I'll repeat "put clothes in the dryer" or I'll count 1, 2, 3, 4, and start over again over and over even if im not doing anything at al, like sitting down. I constantly feel and think as of people are talking about me if I'm around others. If they laugh I automatically think it's about me. I always believe people are upset with me by what they do or say. I replay conversations or interactions in my head trying to figure out what they meant, or I'll play out scenarios of what could happen, to the point that I get freaked out and refuse to go anywhere. Its Stuff like that, that happens daily and it worries me. There's more to it but I just can't seem to find the right way to explain it.
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 in a Q&A format. 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 and thank you for using JustAnswer. I am very sorry that you are experiencing these symptoms, I can understand how distressing this can be for you. It sounds like you may be displaying symptoms of both Obsessive Compulsive Disorder (OCD) and Social Anxiety from what you described. And while therapy would only be part any type of treatment regimen normally, it would not be the sole treatment, so may I ask have you considered seeing your physician for the use of a SSRI antidepressant as this medication is the first line treatment for OCD and Social Anxiety or being referred to a psychiatrist for a medication regimen?

Customer: replied 1 year ago.
I have been diagnosed with anxiety and panic disorder about 15 years ago. I used to take Xanax 1mg 3x a day, but now I only take .25 klonapin as needed which is about 2-6 times a month. The feelings I get started way after that. Like recently in the past 3-4 years. But it happens at home too, with even just one person around, even its my kids or family. People I know that are not out to hurt me, but I get this irrational fear that they are sometimes. On top of the counting etc., I also will hold a conversation with myself in my head but like not in a typical way. It's hard to explain. It's like I'm talking to someone else if that makes sense?
Expert:  Dr. Z replied 1 year ago.

What you are describing is called "Self-talk" and it is a common coping mechanism people do to help lessen anxiety as it helps the individual to process their surroundings more, process their thoughts, etc...If you are worried that talking to yourself in your head is a symptom of a greater disorder like psychosis, than I can reassure that this is not because individuals with psychosis actually believe that they are talking to an outside force when in fact it is in their mind (e.g. auditory hallucination). You can differentiate between self-talk and voices outside of your head, a person in a psychotic state cannot make that differentiation. The Xanax and Klonopin are usually on effective for anxiety, but are ineffective as a monotherapy for OCD behaviors, such as the counting. So with that being said you should discuss with your doctor about trying an antidepressant like Luvox, Lexapro, or Zoloft as a first line treatment.

Customer: replied 1 year ago.
Well that is good to know. But would those medications help the paranoia and fear I get about others? I don't think it is all social anxiety because I know how I feel in social environments. I'll get nervous and stumble over words or stutter. And it's different than that especially at home where I feel safe and it happens with my family or kids. It's like I think they are conspiring something bad behind my back and stuff. I really wish I could explain this better.
Expert:  Dr. Z replied 1 year ago.

That is definitely more paranoia than actually Social Anxiety if you believe others are conspiring against you, but may I ask when you tell me right now that you sometimes believe others are conspiring against you do you believe that to be a fact that I cannot convince you is not real or do you just think it is all in your head?

Customer: replied 1 year ago.
In the moment I feel it is factual, sometimes for days at a time. But like right now as we're talking about it, I feel most of the times it has happened it was irrational but some of the times it could be real, I don't know if they really feel that way or not or if it's just me.
Expert:  Dr. Z replied 1 year ago.

Paranoia is a delusion which is called a fixed false belief meaning that no matter what evidence I provided or any rationalization on your part, you would always still believe the delusion to be an irrefutable fact. It sounds like you sometimes, in the moment, believe these others are conspiring against you, but then later you realize that the thought is irrational. This does not really fit the pattern of a Paranoid Delusion as one would not think it to be irrational. So it is possible this is just a severe type of Social Anxiety where you believe that others are conspiring against you at times because you believe you are being judged and watched by them, so the SSRI antidepressant can help with that. But also your Klonopin use should lessen this type of anxiety, if it is anxiety too. The other possibility is that you may have a weak or atypical delusion that comes and goes, this is not common, and you would need an atypical antipsychotic medication to treat that delusion.

Expert:  Dr. Z replied 1 year ago.

Please let me know if you have any other questions or concerns as I would be happy to continue assisting you regarding this issue.

Customer: replied 1 year ago.
Isn't there anything I can do at home to help because I cannot afford to go to the drs or pay for another prescription on top of what I am already paying a month. I don't have very good insurance and have a very high copay/deductible?
Expert:  Dr. Z replied 1 year ago.

Well I can recommend a two-fold approach. You can try the natural supplements of St. Johns Wort or Valerian Root to help lessen some of your symptoms, but these only work for mild to moderate levels of anxiety and may not be effective for treating OCD symptoms. In addition, you can try some self-therapy for treatment of OCD symptoms and Anxiety using these books:

"The OCD Workbook: Your Guide to Breaking Free from Obsessive-Compulsive Disorder" by Hyman and Pedrick

"Managing Social Anxiety, Workbook: A Cognitive-Behavioral Therapy Approach (Treatments That Work)" by Hope, Heimberg, and Turk

I do also want to mention though that if you are suffering from any type of paranoid delusion, than this only responds to the atypical antipsychotic as there are no natural supplements or therapy modality that will truly help.

Expert:  Dr. Z replied 1 year ago.

Was there anything else I can assist you with?

Customer: replied 1 year ago.
Thank you for trying but I've tried valerian root and St Johns wart for anxiety and it never worked correctly and didn't help the other symptoms as you said as well that it's not for that. I guess I was hoping there would be something other than going to the drs that I could do to help with my other concerns. I don't know what to do really, sorry for wasting your time and effort by not being able to help me with my question really
Expert:  Dr. Z replied 1 year ago.

Unfortunately the answer to your question is to go to the doctor as OCD symptoms cannot be treated on one's own as it takes a combination of medications and therapy. I can tell you that the SSRI antidepressants for treating OCD and Social Anxiety have generic versions and can be relatively cheap. But it does sound like you need to get a new prescription...if you had a heart problem you would not hesitate to go to the cardiologist, well this issue lies within your brain and the proper treatment can be with the medication and/or therapy I suggested.

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