Friday, June 8, 2012

7 things I've learned about treatment for OCD and depression

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*A combination of tools works better than any one thing.
My treatment has included medication, talk therapy, cognitive behavioral therapy and CBASP, and well as self-treatments such as exercise, yoga, meditation and relaxation techniques.
None of these by itself has been enough. And that’s OK. I know there’s no magic pill. And I like the idea of a synthesis of treatments working for the good of my health.

*You’ll notice improvements before anyone else will.
  My first signs of improvement were so subtle that I thought perhaps I was imagining them. I felt a little less down, had a little more energy, was able to stop washing my hands a little more quickly, didn’t check the stove as long.
But I noticed them. Maybe no one else could see a change, but I did. And my therapists and doctors needed me to tell them of any improvements.

*At first, you won’t necessarily see the connection between the treatment and improvement.
My therapist told me that people tend to not want to believe that medication, for example, is the reason for the improved symptoms. It’s hard for us to make such a connection. A pill can help me not have obsessive thoughts? A pill can help me feel less hopeless?
I’ve found that to be true of medication and with the CBASP. I’m feeling better, but it seems like it is a little too good to be true.
And it’s hard for me to see the forest for the trees, so to speak. Therapy is intense and detailed. It’s hard sometimes to lift my head and see the results.

*It’s not easy.
The CBASP is hard. ERPs are hard. Dealing with medication side effects is hard. It takes dedication and discipline to keep doing the things that will make me feel better.
And there’s the fear of failure. Sometimes during a therapy session, I worry that I’m not doing it right, that it’s not going to work.
That’s when hope is so important.

*It’s usually not a quick process.
  I’ve been in treatment of some kind, even if it has just been medication, for 22 years. That’s hard to admit because there’s a part of me that believes I should have gotten it right by now. But that brings me to the next point.

*It will never actually end.
  Treatment for OCD and depression will go on indefinitely because there is probably no cure, only remission, by which I mean a lessening of symptoms. Even when I’m no longer in active therapy, the exposures will continue, the self-talk and learning will continue.

*Any treatment works better if you take care of yourself in basic ways.
It’s important for me to get enough rest and to eat properly. If I get very tired, I first get very anxious, then I crash and get more depressed.
If I eat too much or too much junk food like sweets and simple carbohydrates, I feel sluggish and my stomach bothers me, which in turn makes less energetic.
And having time for myself to read, think, and just relax is key to me being better able to handle what life brings.

What have you learned about treatment for OCD and/or depression or other mental illness? What suggestions do you have for others going through treatment?

20 comments:

  1. Really good post! A combination of treatments has worked best for me: my faith, CBT/ERP, meds, mindfulness, support group meetings, and strong support from family and friends. I agree that taking care of your physical needs is important - especially getting enough sleep. Another big thing for me was finally coming to an acceptance of the fact that I have a chronic mental illness. Instead of internally fighting it, I can take that energy to fight the compulsions instead. Also, recovery can be slow so it's important to not give up. All of a sudden, one day you will realize you are getting better. Yay!

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    1. Sunny, that is the way it has happened with me. I noticed subtle changes and then one day I realized I felt better. It was amazing! Thank you for your kind comment!

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  2. I loved this post. Some of those 7 points are hard to swallow (but so true). I have, in the past, desired it to be easy, quick and have a complete recovery-cure. But I am ok with all that now and that is a huge step for me, the acceptance of what I have is not in any way giving up but in fact keeping me focused daily in what I can do to be the best I can be daily.
    I personally have had to accept that OCD waxes and wanes. It is especially difficult for me to have a string of bad weeks after having a lengthy period of relatively light OCD & a happy heart. It is during those times when I reassure myself that if I persevere with ERP's, exercise, (all those tools) that I will get to a good place again. I call that Hope, but it's not really "hoping" I will get better because I feel confident and absolutely KNOW I can now. That is what I would pass on to someone in treatment: You Can feel better.

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    1. What an inspiring comment, Krystal! I love how you describe hope. And that is important especially for the newly diagnosed or those who haven't been treatment long--you can feel better.

      I like, too, how you say that acceptance is not giving up. I agree.

      Thank you for your comment!

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  3. Such a nice post! I have both been treated with various medications and therapies, and have finally reached a state where I've got the feeling I have found the "right" ones. I'm not sure what the therapies are called in English (I'm from Holland) but I'm pretty sure they are similar to the ones you describe. I also have had therapy learning to understand my dreams and that is a great help as well, as the medication makes me have very vivid dreams at times. They encourage me a lot, but it has taken quite a while before I trusted myself with understanding them. (7 years of therapy) And it's so true that looking after yourself is so incredibly important. I find that the moment I have to rush things the OCD plays up a lot.
    I hope that people who are still struggling a lot can read your post as I think it's very encouraging. As yes, it is possible to come to a stage where the OCD is manageable.

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    1. Thank you, Klaaske. It's taken me a while to find the "right" combination also. That's interesting that you have learned to understand your dreams better. Dreams have always fascinated me.

      When I feel pushed to hurry faster than I'm comfortable with--in work or whatever--it ramps up my anxiety and OCD, too.

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  4. I am (unfortunately) still in the mindset of "I need to overcome my anxiety by myself; I don't need medication." And, thankfully, it hasn't been at its worst. I've tried two different medications, one of which made me worse when I took it (pretty sure that was because the medication was for depression and not anxiety, though!) and the other made me sick.

    It scares me to think of a medication messing with my mind...and that's definitely my anxiety talking. Two bad experiences makes me very cautious about trying another. I s'pose if/when it does worsen, I may come around to giving it another try. For now, however, I'm hoping that my natural remedies will continue to work. We'll see, I guess!

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    1. Alisha, medication is not for everyone. And there are treatments that don't include meds. I'm glad that your anxiety has not been at its worst. If you ever need something more, there are lots of treatments to choose from. But I hope you don't need it! :-)

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  5. These are great observations. I'm always impressed by how self aware you are.

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    1. Thank you, Lisa. Maybe it's all the thinking . . . .

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  6. Great post! Your comment that you will notice improvements before anyone else does reminded me of when my son Dan was trying different meds over a long period of time. Every time he started something new, a few days later he would say, "I think it's working," even though we knew that it usually takes longer than a few days for the meds to have any effect. But maybe he felt something we couldn't see, or maybe it was just the placebo effect......I guess we'll never know. And as I've written before we never did find the right combination of meds for him. Thankfully he is doing well, though I would like to see him eat better and exercise more!

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    1. I'm glad he's doing well. As I commented above, medication is not for everyone, and I'm so glad there are other forms of treatment available. I think the placebo effect can step in, especially in the short term. But I've found that real improvements do take a while.

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  7. Tina,
    I actually find people attribute most of the success to the medication not giving themselves acknowledgment for the work that they do to get better. I want people to see that their own actions are making a difference so that those skills are visible to them.
    Also, I do believe people can be cured and I have seen it. Never give up, but don't judge yourself if you are not there. Time is relative. You, my dear are on the path to recovery. Yes it can be total. Believe it!

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    1. Thank you, Jodi. You are right, and my therapist echoes you. He wants me to see the connection between the work I'm doing and the improvement I'm seeing.

      I do believe that some people experience cure. I'm not married to the idea that I will be cured. In other words, that's not my goal. I don't feel down on myself for not making that my goal. My goal is improvement and to keep moving towards recovery. And I think healing comes in many forms.

      Thank you for your insight and encouragement! :-)

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    2. Your comment Jodi gives me hope <3
      This post is great Tina. In fact, I didn't have a good experience with therapy nor with medical treatment, but now that I have stopped both, I realize I might be wrong. As long as I was taking a treatment, I thought it wasn't helping but once I stopped, and symptoms got worse, I don't really know.
      Much love <3

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  8. As always, a great post!

    I find, though, for me and for other people I love who deal with anxiety, sometimes others see our progress before we do, especially when we are brutally hard on ourselves. When we start making healthy changes, they don't always feel "right," and loving feedback can help us stay on track. In moments when hopelessness makes a return visit, they can remind us of how far we have come.

    That said, I think this is an incredible list. Thanks for sharing it!

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    1. Nadine, I have found that true sometimes, too. I've also found that I'm not always the first to notice that I'm slipping back into depression or that I'm more anxious than usual. I've had others tell me things they've noticed about me before I realized it myself.

      Thank you!

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  9. You are so right. It is the combination of may things that heal. It isn't just simply medication or therapy.. it is a whole lifestyle.

    I am still working on exercise and eating right .... those are my biggest treatment challenges.

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    1. That's a good way to put it, Elizabeth--a whole lifestyle. Each part is important, but combined, they become even more important.

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  10. --Great Post, Tina.

    Does it help when you write? <3

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