Struggling with tic-like OCD

[pile_o_neurons]

Hello,

I just joined, and this is my first post. I've been struggling with OCD for 20+ years, but over the last few years, symptoms of "Tourettic OCD" (aka "Touristic OCD" aka "Tic-like OCD") have really emerged. Unfortunately there seem to be very limited resources online which discuss this. Here are a couple of articles ...

iocdf.org/expert-opinions/o...

verywellmind.com/just-right...

This could probably be lumped in with "Just Right OCD", but is a specific variant in which there are seemingly no associated thoughts, fears, obsessions, etc. Instead, what I experience is a 100%-physical tension or sense of unevenness in some area that causes an almost irrepressible urge to take some action. This could be anything from quickly flexing my abdominal muscles to spreading the toes on my right (always my right) foot to releasing and re-gripping a mug over and over until it feels (physically) just right. Is it (or at least seems) purely physical ... like having an itch and then scratching it. As I think about it, I'm realizing that most of the feelings/actions are associated with the right side of my body.

I've been on an SSRI for decades, but switched from Prozac to Lexapro 3.5 years ago. In addition, I switched from an SSRI-only regimen to Cymbalta + SSRI about 7 years ago. I have also taken Buspar for about 7 years.

My symptoms are quite variable - there are days or weeks where the urges are minimal and very easy to control, and other days or weeks where they are intense and nearly irrepressible.

My psychiatrist doesn't exactly seem to understand that this is a thing, and the last psychologist I went to (an OCD specialist) also didn't seem to understand that this was a thing.

I have lots of questions that perhaps can't be answered here, but I just wanted to share and see if anyone out there has experienced the same, knows of any good resources on the topic, or has any tips. Part of the problem is that the physical sensations are fairly sporadic, so I can't exactly trigger them on-demand in order to practice ERP. I've had some success using strategies such as pausing/freezing when the urges occur, or performing them very slowly.

Thanks for reading ...

[Hidden]

Thank you for sharing this info. It's interesting you mentioned feeling the symptoms on the right side of your body. This is also very true for me as well. I've had severe OCD all my life and had many tics as a child. With me, I would feel this mass of energy that would shoot out my right arm and in order to relieve the nervous energy, I would swing my arm up in the air and tense/squeeze all the muscles at the same time in order to get that awfull energy out of me. It often involved pointing out my second finger and shooting out my right arm. I would keep doing it until it felt right. As a child I would do this often in my bedroom, but managed to keep it hidden from others at school. Always, the right side, though. To me, it seems as though the feelings that need to come out are very tied into emotions. I would have to agree that it is on the Tourette's side of things. I just wanted to say thank you for sharing this!!

[pile_o_neurons in reply to Hidden]

Thanks for the reply! That's very interesting. There seems to be a lot of overlap between OCD and tics. It sounds like your tics aren't present anymore? Can you explain more about how you think they're related to emotions?

Thanks again!

[Hidden in reply to pile_o_neurons]

When I am thinking about something or ruminating about things that might be bothering me, that's when I feel that sudden burst of energy that wants to move through me. It always travels in a path and seems to want to come out of me through my second finger. My right limbs are involved many times as well. It doesn't happen as much to me now in my older years. Also, I always seem to do this when I'm alone. I just remember as a kid how awful it was. My mother didn't know what was going on, and back then, no-one knew much about Tourette's.

[bab5]

I was diagnosed with Tourette’s Syndrome in 2015. I doubted the diagnosis ever since that day and have since been correctly diagnosed with OCD. Everything that you described in your post is completely relatable for me. I felt as if I was skimming through a diary of my past as I was reading it. I have sustained numerous injuries over the last couple of years related to physical compulsions such as the ones that you described.

I had one where I felt the irresistible urge to stomp very hard when I was standing at the sink in my bathroom. Eventually, I broke the same bone in each of my feet due to the fact that I performed the compulsion on both feet. The compulsion alone didn’t cause the fracture, but it caused the specific bones to become weaker and then I injured them both while playing basketball.

I know exactly what you’re talking about.

I agree that they are based on emotions and the immediate sustain. An intense emotional situation or a very important event cause them to become more prevalent and irresistible for me.

This is definitely a lesser discussed form of OCD, so I appreciate your post.

Thankfully, it seems to be very inconsistent in nature.

Again, thank you for this post.

[pile_o_neurons in reply to bab5]

I appreciate your reply, bab5. I'm glad to hear you were eventually able to get a diagnosis that you felt fit better. Can you I ask why you thought OCD was a better fit than Tourette's? Where do you think the line between a tic and compulsion is?

[bab5]

Thank you.

I am very glad too

OCD was a better fit than Tourette’s because of the fact that the presence of intrusive thoughts were always combined with tics/physical compulsions. I would not simply belch out a yell or stomp my foot because I felt like it. I would do that in order to correct the situation (based on what was in my head at the time) or to get rid of a negative thought that may have been inside my cranium.

There is a fine line between a tic and compulsion.

However, I am positive that anyone that is afflicted with Tic OCD (or Touristic OCD as you said) suffers from a lethal combination of both tics and compulsions. Over time, tics and compulsions combine into one.

They go hand in hand

[Hidden in reply to bab5]

I completely agree with what you mentioned about doing a tic in order to alleviate an intrusive or unwanted thought. I have to wonder if people with full blown Tourette's tic after an intrusion, or just because they get the urge. Thank you for sharing your information. I'm glad things are much more manageable for you now, and I am sorry to hear of your struggles in the past.

[pile_o_neurons]

Thank you for clarifying. I understand what you mean, and I experience this sometimes as well. At times the urge to perform the physical compulsion is to "help" (ha - silly OCD brain) in the process of thinking the "right" way or correcting/addressing/neutralizing an obsession or mental intrusion. Other times, however, it is just pure ... the intrusion itself is a physical tension/discomfort, with no related mental event.

I found an interesting link on the Peace of Mind Foundation website - they refer to it as "Just Right OCD" - although I think that term can be used sometimes in other ways which include a thought event. The psychologist in the video states "There's a little less clarity on Just Right OCD in whether there's a fear or an obsession, because what's really uncomfortable for the person is a feeling. ... In a sense we look at is as - the obsession is actually the not just right state itself."

To me what's notable is the overlap between tic-like behavior and OCD, with one sometimes driving or exacerbating the other. For me personally I think it all boils down to trouble controlling certain kinds of internal impulses.

[ndools]

I'm struggling to find anything about this. You have described EXACTLY the same problems I have. It's like a physical itch that gets worse and worse until I flex the right muscle or tense something a certain way. And there is no "if I don't do this my mother will die." It's just a physical... Feeling

[pile_o_neurons in reply to ndools]

I'm sorry to hear you're going through the same. For me it comes and goes, which makes it more confusing. There seems to be no rhyme or reason. Lately it has mostly receded into regular sort of ... diaphragmatic tensing or something, in which do a weird forced exhalation, but it's the same thing in my brain.

The best method I've found to help is to focus on:

- Really noticing when the urge to act is arising (and checking in regularly)

- Trying to really observe what the feeling is and what the urged action is

- Seeing if you can briefly pause or delay the action, even if for a second

- Seeing how it feels in your body and brain if/when you delay the action

With a lot of effort you can get "the feel" for what it's like to feel that urge arise but not perform the action.