OCD apparently...

[cjemc]

GI reckons I am retching due to severe OCD aggravated by lack of sleep.

I have been given Paxil which I am not going to take as I am not willing to suffer from the blood curdling side effects that I have read about.

My barium x-ray was completely normal with no webs, strictures, pouches and no hiatal hernia. My duodenal cap looks normal and there doesn't appear to be any esophagael mobility issues.

[MyNameIsTerry]

Its possible that this is Sensorimotor OCD. It doesn't have to be severe, it depends on the bodily process in question, but it often seems to be. For instance, the need to constantly swallow, blink or control breathing.

Equally though, could it be that the act of retching is a compulsion to an underlying obsession?

The trouble is, recently you also mentioned how you become anxous in various situations and there didn't sound like an OCD cycle in there. So, whilst this element could be OCD, what about the presence of a comorbid condition such as GAD for instance? Then it also matters determining which is the primary disorder as therapists usually target that as it has the effect of reducing the secondaries.

By "GI", do you mean GP or the Gastro people? This type os OCD, for my liking, is a complex one and its not well documented (even some of the charities don't even mention it!) so its not well known.

[cjemc]

Its possible that this is Sensorimotor OCD. It doesn't have to be severe, it depends on the bodily process in question, but it often seems to be. For instance, the need to constantly swallow, blink or control breathing.

Equally though, could it be that the act of retching is a compulsion to an underlying obsession?

The trouble is, recently you also mentioned how you become anxous in various situations and there didn't sound like an OCD cycle in there. So, whilst this element could be OCD, what about the presence of a comorbid condition such as GAD for instance? Then it also matters determining which is the primary disorder as therapists usually target that as it has the effect of reducing the secondaries.

By "GI", do you mean GP or the Gastro people? This type os OCD, for my liking, is a complex one and its not well documented (even some of the charities don't even mention it!) so its not well known.

I feel horrific all the time. Everyday feels like death is imminent. I still cannot decipher whether it is all purely all psychological or if I have some underlying medical illness causing this horrific perception. I am starting to fear brain tumours and cancer now which is not nice. It could even be a labyrinth ear nose and throat disorder maybe or even severe spasms of the throat muscles contracting and causing these violent spasms.

What the hell am I going to do? How am I ever ever going to get to the bottom of this disgusting affliction?

[pulisa]

You've also got health anxiety along with GAD and sensorimotor OCD in my non-medical opinion.

You've had so many tests now-please don't move onto other potential diagnoses as you will just torment yourself more and more.

Can you access some therapy for severe anxiety but targeting the sensorimotor form of OCD? My anxiety first manifested itself as a small child with retching and continued for decades.. I know you also have issues with alcohol and you'll need to deal with this as well

[Fishmanpa]

You really need to pursue the meds but it's not recommended to combine with alcohol. IMO, the meds will cause less issues than what you've been doing for yourself for some period of time now.

Mixing Paxil and Alcohol

People who take Paxil should avoid alcohol while they’re on the medication. One reason is that alcohol can make Paxil less effective. If the drug doesn’t work as well, your symptoms may come back.

Alcohol can also increase some of Paxil’s side effects, especially dizziness, sleepiness, and trouble concentrating. Other side effects that may be exacerbated with alcohol include:

abnormal thoughts
changes in vision
dizziness
hallucinations (seeing or hearing things that are not really there)
high or low blood pressure
increased sex drive
intense excitement or lack of emotion
irregular heart rhythm
joint pain
loss of feeling
nausea, vomiting, or diarrhea
paranoia
racing thoughts or excess energy (mania)
rigid muscles, poor muscle control, or uncontrolled muscle movements
suicidal thoughts or actions
uncontrollable laughing and/or crying
weight gain


Seeking the professional help you've started and expanding it to therapy along with meds can and will help.

Positive thoughts

[cjemc]

Could prolonged trauma and extreme stress and life changing events set off Sensorimotor OCD? Because I cannot think for the life of me what else could have triggered this off way back in 2011.

Or is it purely genetics? I.E. I was doomed to get this through my inherited genes regardless of anything setting it off I.E. Death, moving house, etc?

---------- Post added at 14:56 ---------- Previous post was at 14:56 ----------


You really need to pursue the meds but it's not recommended to combine with alcohol. IMO, the meds will cause less issues than what you've been doing for yourself for some period of time now.

Mixing Paxil and Alcohol

People who take Paxil should avoid alcohol while they’re on the medication. One reason is that alcohol can make Paxil less effective. If the drug doesn’t work as well, your symptoms may come back.

Alcohol can also increase some of Paxil’s side effects, especially dizziness, sleepiness, and trouble concentrating. Other side effects that may be exacerbated with alcohol include:

abnormal thoughts
changes in vision
dizziness
hallucinations (seeing or hearing things that are not really there)
high or low blood pressure
increased sex drive
intense excitement or lack of emotion
irregular heart rhythm
joint pain
loss of feeling
nausea, vomiting, or diarrhea
paranoia
racing thoughts or excess energy (mania)
rigid muscles, poor muscle control, or uncontrolled muscle movements
suicidal thoughts or actions
uncontrollable laughing and/or crying
weight gain


Seeking the professional help you've started and expanding it to therapy along with meds can and will help.

Positive thoughts

Thank you FMP. You always give me words of advice and I really appreciate your time in helping and reassuring me.

---------- Post added at 15:37 ---------- Previous post was at 14:56 ----------


You've also got health anxiety along with GAD and sensorimotor OCD in my non-medical opinion.

You've had so many tests now-please don't move onto other potential diagnoses as you will just torment yourself more and more.

Can you access some therapy for severe anxiety but targeting the sensorimotor form of OCD? My anxiety first manifested itself as a small child with retching and continued for decades.. I know you also have issues with alcohol and you'll need to deal with this as well

Thank you for your reassurance.

[MyNameIsTerry]

You've also got health anxiety along with GAD and sensorimotor OCD in my non-medical opinion.

You've had so many tests now-please don't move onto other potential diagnoses as you will just torment yourself more and more.

Can you access some therapy for severe anxiety but targeting the sensorimotor form of OCD? My anxiety first manifested itself as a small child with retching and continued for decades.. I know you also have issues with alcohol and you'll need to deal with this as well

I think this one is quite complicated and I wonder if a diagnosis from a specialist might be more appropriate as I wonder if this is too complicated for a GP to diagnose properly.

For instance, because of the focus on the bodily function this could fall under the HA bracket in the form of a specific Somatoform Disorder known as Somatoform Autonomic Disorder as I remember mentioning on this previous thread:

http://www.nomorepanic.co.uk/showthread.php?t=170426

It could be OCD. BUT, I'm not very clear on this because it is getting into such specialist forms of OCD that are largely not well documented (even OCDUK don't mention Sensorimotor OCD!) and this one doesn't fully fit. The reason I say that is because Calum has been in what looked like a HA cycle of chasing for a diagnosis and having all these tests. Thats less likely in OCD. The forms that can include that type of behaviour are such as HIV feares or serious mental illnes such as Schizophrenia fears, both of which are seen in Pure O. There is also one called Somatoform OCD but I haven't seen much about it but it "could" be related to obsession over a bodily function but the problem is that I saw this on a US psychologists website and we use a different diagnostic manual over here so that one might fit into the somatoform disorder mentioned above? :unsure:

This is why I wonder about whether a GP can make such a complex diagnosis. There are some links between retching and OCD but it seems pretty unclear to me. The reason I say this is because I would see the OCD sufferer as knowning they do consciously do it, as seen in Sensorimotor OCD to control a bodily function, or seen in a more conventional sense as purely a compulsion in the same context as a touching ritual might be performed. Then we have Calum mentioning about situations that cause him anxiety and these are less likely OCD for me.

Another issue is that therapists normally look for the primary disorder. In my case I have GAD & OCD (I know you know all about me, this is for Calum's benefit) and my therapist saw how much my OCD dominated my day and tried to treat it. Massive fail, very little progress. Switching to my GAD did a lot more. This was because my GAD had been there for years before the OCD and whilst the OCD was driving me insane at the time, it was the GAD that was fuelling it. I notice this all the time because increased GAD means increased fights with my OCD but the other way around and my GAD doesn't move much. I've spoken to people on here on the OCD board who say the same. It may not be the case for Calum, and treating this OCD might work for him even if it is not the primary disorder, but if it doesn't it could mean working on the primary sees more progress and I know WHO advice states to look to classifying on this basis.

I think Calum needs to spend more time looking at his anxiety as a whole and determing each disorder but he has been absorbed, just like HA people are, with a very specific symptom and I think this is clouding things.

---------- Post added at 04:48 ---------- Previous post was at 04:37 ----------


Could prolonged trauma and extreme stress and life changing events set off Sensorimotor OCD? Because I cannot think for the life of me what else could have triggered this off way back in 2011.

Or is it purely genetics? I.E. I was doomed to get this through my inherited genes regardless of anything setting it off I.E. Death, moving house, etc?



Calum,

I had GAD for abour 4 years before my OCD kicked in. Since then from learning about OCD I have traced it back into my childhood to see that there were some traits there which later went as I became an adult. For me, I took a medication that ramped up my obsessiveness and this resulted in a fast onset of tons on compulsions and some intrusive thought themes.

So, yes it possible but not Sensorimotor, any form of OCD or other anxiety disorder. The thing is though, can you say you had no anxiety disorder prior to this starting? If not, you need to explore it to determine what else needs resolving. If during this starting you have seen anxiety cause issues outside of this specific symptom, you need to question that too to determine again if there is a comorbid condition.

You need to look at your previous thread that I posted above. In that thread you were trying to get your doctors to see that it could be an anxiety related disorder and not a physical issue. What has changed for you now to be saying the opposite?

For you question about genetics - No. It doesn't work like that and if you read about a science called epigenetics, it will explain why. A gene can be passed on and never "activated" because it needs a trigger because the gene is effectively set to the "off" position. This trigger could be a traumatic event or it could be a combination of factors such as poor diet, various deficiencies, lack of exercise, etc. For the gene to be switched to the "on" position, it has to be triggered by something, as above, that causes the process known as methylation to change that genes setting to make it start. There is academic works that explain this if you look for them. They allso explain how that switch can be set back to its default. Since epigenetics has been a subject of research for cancer, and they are now trying out drugs that reverse this process, its promising because its had a lot of money thrown at it.

Its true that there are some articles about OCD being inherited by parents with OCD and some linkes between OCD parents to children with BDD, but I don't know how accepted it all is.

Has your GP mentioned about the later withdrawal from Paroxetine? Its one of the 2 difficult ones so they should let you know this but that doesn't mean it will be hard as there are people on here who say they have come off it no problem. As usual, its all so individual. I know you have mentioned your fear of trying these meds but you have to consider the possibility that they could help you and the alternative is you stay as you are. This is the attitude I had to stick to when I went back on meds and I was dreading it as I suffer badly with the start up side effects. You get through it though.

---------- Post added at 05:01 ---------- Previous post was at 04:48 ----------


You really need to pursue the meds but it's not recommended to combine with alcohol. IMO, the meds will cause less issues than what you've been doing for yourself for some period of time now.

Mixing Paxil and Alcohol

People who take Paxil should avoid alcohol while they’re on the medication. One reason is that alcohol can make Paxil less effective. If the drug doesn’t work as well, your symptoms may come back.

Alcohol can also increase some of Paxil’s side effects, especially dizziness, sleepiness, and trouble concentrating. Other side effects that may be exacerbated with alcohol include:

abnormal thoughts
changes in vision
dizziness
hallucinations (seeing or hearing things that are not really there)
high or low blood pressure
increased sex drive
intense excitement or lack of emotion
irregular heart rhythm
joint pain
loss of feeling
nausea, vomiting, or diarrhea
paranoia
racing thoughts or excess energy (mania)
rigid muscles, poor muscle control, or uncontrolled muscle movements
suicidal thoughts or actions
uncontrollable laughing and/or crying
weight gain


Seeking the professional help you've started and expanding it to therapy along with meds can and will help.

Positive thoughts

I think we need to separate this issues over "alcohol and anxiety don't mix" in this case, its too complicated. Providing Calum has been straight with his GP about his alcohol consumption, his GP has overridden the manufacturers advice. I think we all know that GP's in the UK are not very knowledgeable about these meds, so there is an element of doubt for me, but if Calum's GP has the experience or has looked for guidance, then this could be ok. The GP should be monitoring, probably more closely than normal at the onset. The manufacturers warning is thankfully a less serious one than some which could mean it won;t cause that, just as how alcohol can increase the effects of Citalopram yet my GP advised moderate drinking could be ok.

I notice that in Drugs.com, Paxil mentions alcohol in the same way as Citalopram and doesn't list the other side effects. Drugs.com does also say (I've highlighted one part):

Using PARoxetine together with ethanol can increase nervous system side effects such as dizziness, drowsiness, and difficulty concentrating. Some people may also experience impairment in thinking and judgment. You should avoid or [COLOR="Red"]limit the use of alcohol while being treated with PARoxetine. Do not use more than the recommended dose of PARoxetine, and avoid activities requiring mental alertness such as driving or operating hazardous machinery until you know how the medication affects you. It is important to tell your doctor about all other medications you use, including vitamins and herbs. Do not stop using any medication without first talking to your doctor.

Use of the word "limit" would suggest its not a complete no-go and its a moderate interaction marker which means "Moderately clinically significant. Usually avoid combinations; use it only under special circumstances." So, GP guidance could cover that scenario. Citolopram seems to have the same worded warning and level. Neither show as a major interaction which would be classified as "Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit." So, it could be said that a doctor weighs up the benefits vs. the potential issues and decides to try it.

For instance, Diazepam is one of several Benzo's used to treat the withdrawal effects of alcohol addiction. What does the manufacture say about use of the 2 substances:

Do not drink alcohol while taking diazepam. This medication can increase the effects of alcohol.

It says the same for Lorazepam and Chlordiazepoxide, both of which are also used.

So, whilst I agree with you that caution is needed here, we need to encourage Calum to ensure he has been clear with his GP over how he uses alcohol. I know he uses it to control the retching but I recall you asking him about his overall consumption and I wasn't sure if his drinking extended beyond this specific symptom control.

Between what we have posted, hopefully at worst it means Calum has some questions to put to his GP if they have not already resolved them.

[Fishmanpa]

Sorry Terry, your defense of the above point is just obsessive at this point. One word, "limit", does not make it Ok. Even for myself, when I take a course of Buspar for "scanxiety", I avoid alcohol completely during that time as to not compromise the effect of the med or cause undue side effects. It's common sense.

Granted, there are probably millions who have anxiety and drink or mix alcohol and psychotropics with no ill effects. However, what we see on these boards is the complete opposite.

Positive thoughts

[MyNameIsTerry]

No, it's not obsessive. If you care to look a bit higher up you will see that I posted prior to you so I did not join this thread solely to challenge your point, you chose to raise it.

Spin it anyway you wish, medical professionals have a different opinion. I notice you did not show the moderate warning and what it meant. Without doing that you are not presenting the true facts.

Besides, a doctor has issued this prescription and unless Callum had concealed his alcohol consumption, shouldn't we be trusting that doctor?

The word limit does also not mean "must not" either. Notice the moderate drug interaction warning, nor a major one.

We are not talking about someone drinking for fun, we are talking about someone using alcohol to treat a symptom and that needs resolving and bares no comparison to your example.

We also have people on here who have said they can drink so let's not deny that again and I don't think this thread is the right place either to go into that as it's irrelevant to this case.

[simonlacree]

I though ocd was like me. eggs have to line up and always twos. no odd number.