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  • tempbcba


Updated: Jun 21, 2023

Have you ever started a medication with so much hope that it will make things better only to find that there are lots of side effects, but no improvement? This has happened to me so many times especially with my OCD medicine, and it can be really discouraging.

Most of the time, OCD is treated with SSRIs, or Selective Serotonin Reuptake Inhibitors. That means that they are commonly used for depression because they increase your mood. Unfortunately, because I have bipolar, we have to be very careful about SSRIs because even just small doses can trigger a manic episode. PLUS, I am very med resistant, so even when I have been on huge doses of mood stabilizers so that it’s safer to use an SSRI, it doesn’t seem to make a difference in my OCD, or at the most, it’s a minor difference.

When I was at the residential program, I learned about a different kind of treatment, called ERP or Exposure and Response Prevention. Instead of avoiding your fears and using compulsions (repetitive actions) to calm them down, you face your fears head on. You do it in small steps, starting with the least distressing, and over time you have less and less of a response (called habituation). It worked really well for me at the time, and I thought I could just keep doing it when I got home, but it was a lot harder than I realized.

Now, a year later, my OCD is strangling me. I have so many obsessive fears, and so many compulsions to cope with them, that I am barely hanging on. Now that I’m starting a committed ERP program, I’m tryin really hard to make a change. I had to list my fears and rate the level of anxiety. I had at least twenty fears on the list, and many of them were in the 8-10 level, with ten being the highest. For example, I have to watch the same shows over and over and over…right now I’m watching Monk during the day (I’m almost done with my second time through all 8 seasons) and Harry Potter at night (I have to start at the first one every night, and usually just get through #3). I’m also terrified to drive. I am sure that I am going to cause a car crash and someone will die and I will get twenty years in prison. I don’t think I would do well in prison. It’s amazing how much of my life is taken up by OCD right now.

So, I started with a new organization that only does ERP. It’s really expensive, I have 2 therapy appointments and 3 support groups a week, plus homework to do the actual exposures. Also, and probably the most difficult, is the fact that I had to come off my Ativan (anti-anxiety medicine). When I first started, I was taking 1 mg three times a day, but I had to get down to no more than 1 mg as needed per day. Of course, because I am an all or nothing person, I quit cold turkey. At first it was okay, but as we get closer and closer to the exposures starting I am a hot mess. I’m having trouble breathing and shaking all over and my pulse is racing all the time.

In order to do the ERP, we are going to make a list of my fears in order from least difficult to most difficult, and then start with the easiest. But there are a lot of challenges even there. I like my compulsions. I feel safe with them. I can’t imagine my life without them. It makes me sad and terrified. The reason you start with the easiest one, though, is because it will be the easiest to get through, and when you get through it you build some momentum. You feel like, “I can do this! I can do hard things!” and you’re ready to take on the next fear.

It all sounds great, and it really is, but it is so overwhelming and terrifying. Also, because it is super expensive, it’s scary to think what a huge, long-term investment it is. BUT this could change my life. To be free of all the things that are holding me back, keeping me in my house day after day, being able to drive and get my own groceries or go to doctors appointments by myself would be so life-changing.

And so I’m going to fight through. I’m going to use every coping skill I have to help myself habituate, and I’m going to believe in my ability to get through this. If you or someone you know has OCD, I highly encourage you to try ERP. It is an amazing tool to have in your arsenal, and I’d be happy to support them. You can do hard things, too!

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