Question:
Dear Doctor Heller,
I was diagnosed with OCD when I was 18. I received
treatment and got a lot better and was able to get
on with life again. I'm nearly 24 now. I just wanted
to know is it possible for OCD to make severe
relapses, even without no potential trigger? The
past few months have been hell, I've obsessed about
anything and everything, and I don't know what's OCD
or what's not anymore. Thanks for your time.
Dr. Heller's Answer:
OCD (obsessive compulsive disorder or neurosis) is a
neurological disorder causing intrusive repetitive
thoughts, usually accompanied by ritual behaviors
that seem to reduce anxiety. These rituals can be
minor or severe, commonly involving repeatedly
checking doors or other items and counting. Like
most psychiatric disorders it can get worse or
better, often relating to stress (which makes it
worse). While some people get a remission from the
symptoms, most have the problem to some degree
permanently. Some cases of OCD in children occur
after strep infections.
SSRI medications like Prozac (fluoxetine) and others
can markedly reduce or stop the obsessive thoughts
and ritual behaviors. High doses are usually
needed. If the genetic generalized anxiety disorder
is also present, SSRI medication may make the
condition worse until BuSpar (buspirone) is also
taken, then most people tolerate the SSRI without
difficulty. Sometimes benzodiazepines and/or
antipsychotic medications are needed.
OCD commonly is associated with other diagnoses such
as ADHD, depression, the borderline disorder, OCPD
and others. Everything you have wrong with you
makes everything else you have wrong with you worse.
Treating all the medically treatable diagnoses is
very important and can make a huge difference when
treating the OCD.
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