therapist and psychiatrist keeps mentioning antipsychotics for treatment and is driving me insane.

[KatMoonight]

so, i was I diagnosed with OCD in June 2024 after a mental breakdown. I started to get intrusive thoughts about causing harm, obsession about food, and more. I was taken to a dr who performed badly TMS on me which caused me to have another breakdown. Then, I went to another psychiatrist who upper my med, and added antipsychotics. Which, I refused. I left because we could not have a middle ground, and finally I found someone who listened to me, yet doesn’t want to close the doors for antipsychotics. The TMS that was performed one me got me very unbalanced. I was more anxious, moody, etc… it was performed in one week for two hours, and i learned that it should last 6/8 weeks, 20 minutes, so yeaaah.

i did my research because i am not going to allow any doctor to mess with my brain and body. Like the previous one. I was too vulnerable, but not anymore.

I’ve mentioned to my dr that I am in no way going to take antipsychotics because of the effects it has on people, I had SEEN movement disorders in real life, and believe me I’d be devastated if that happened to me as I’m an artist. Healthy people getting that? Not to mention the problems with glucose and lipids, and metabolisms? How can my two professional say that antipsychotics are a very noble medication?

while my psych is giving me options, and putting antipsychotics as a last resort, i feel pressured. Because, it feels like I need to get better or else I’m going to be put on on antipsychotics and that’s not the point. Therapy should make me feel safe. My recovery should be about getting better, so i can be at ease.

ocd is forever, it has treatment, but it won’t go away. That’s why I told my psych that I’m doing CBT with my therapist and soon ERP. Yet, i feel like if I do a misstep then Im going to be put on that medication. I don’t want to feel that way.

my symptoms began with horrible intrusive thoughts which caused me to have constant anxiety and panic attacks, and self harm. I did compulsions, but learned and educated myself about OCD, so i told my therapist that I want CBT and ERP. I’m not letting my intrusive thoughts get to me because i know recognize them that it is OCD, so I’ve decided to take them no mind. That has helped me to stop self harming and the panic attacks have stopped. The psychiatrist has seen and acknowledges the progress, so she added supplements like vitD3K2, omega 3, l theanine, and vitb12 which has helped me a LOT. My hemoglobin has lifted to 11.6. (Before it was in 9.9) my vit d was on the floor!

yet they keep telling me that with antipsychotics I would feel so much better. No, I will get better with CBT and ERP, grounding techniques, and perhaps explore other options that does not involve antipsychotics. They respect that, but they still have the door open for that med and i fee like i have a hyper responsibility. I want my recovery to be at ease, learn about myself, be mindful, focus on my work which im now doing, and fix my sleep hygiene. I don’t want to have this nagging fear or getting better or else I will be put on antipsychotics.

can somebody help? Or give me some insight?

[PaperTigers]

Honestly, antipsychotics have helped me significantly but OCD is not my only diagnosis. I know you have made up your mind and that's okay, I'm not here to change it. I just wanted you to know that as a fellow artist who draws and paints daily, I have only had issues with one of the meds they tried causing movement issues and they took me off of it right away. I have been on them for years and am doing SO much better than when I was on bipolar meds which I was misdiagnosed with since childhood. It took many years to get to where I am and I'm just now starting therapy specifically for my OCD. I hope that your therapy goes well and that you get relief, especially from the intrusive thoughts cause they are absolutely awful to deal with. I understand your concerns and wish you the best.

[Coffeelove4444 in reply to PaperTigers]

I agree , antipsychotics have helped me as well. Just a small dose made a difference. It was added to my antidepressant to give a little boost. Each individual has to build a toolbox of things that help them cope. It is about managing the OCD.

[SCC1]

I understand you not wanting to take medication. There are some side effects to most, but personally, if I would notice that any current therapy I might be doing wasn't working the way I had hoped, or worked continuously, I would consider taking meds. The drs are leaving it open for you, which I actually think is a good idea because they are "saying" that there is another option with meds if something MAY not work as you would like. Meds can be very helpful, especially if one might be having a particularly hard time with something. I think it's great that you're doing CBT/ERP and that those have helped. Do what keeps working! If you do have to be on a medication somewhere down the line, that is okay. Myself, I would do anything it would take to feel better if I had symptoms I found especially hard to deal with. Your dr will do what's in your best interest, knowing you prefer not to take any medication.

Good luck!

[Lauragbr]

I believe each individual should decide their own treatment and I agree that CBT and ERP is the gold standard. I know people who could not take any meds and recovered with the tools of CBT and ERP. I personally take an SSRI which helps me, but again you are your best advocate. You may want to check out Shannon Shy , he is on social media. He suffered greatly with OCD and does videos giving advice about how he recovered l he also has some wonderful books. He has helped me.

[deValentin]

I've heard of antipsychotics being used to treat OCD, but, you're right, it should be as a last resort. You now feel under pressure to improve fast, or else...

Personally, I see therapy as a collaborative approach. You and your therapist discussing possible treatments given what science and you have to say. The days when psychiatrists used to perform lobotomy on their patients without their consent (at least in the U.S.A between the 1930s and 1960s) are over. Do you remember the film One Flew Over the Cuckoo's Nest?

[Sallyskins]

I do get where your coming from - I had a bad experience with an antipsychotic called sulpiride which made me gain 35 pounds without doing anything at all to help.

I don't know the reasons behind your psychiatrists' wishing to prescribe you antipsychotics, but it's known that some antipsychotics, prescribed at a low dose, help to boost the good effects of an SSRI antidepressant.

I came off the sulpiride and was reluctant to supplement my SSRI with another, when it was suggested. This one is called aripiprazole, and at first I was on a very low dose of 2.5 mg a day, upped to 5 mg a day after a week or so. I agreed to take it after a lot of thought and a lot of reading up.

I'm glad I did, because it has helped me feel like my old self. It's as though colours had regained their brightness.

It might not help all patients, but it has certainly helped me. Don't dismiss drugs altogether - they can help. Though CBT and ERP do the heavy lifting, medication can make them easier to do.

It has to be your choice, of course. I should be surprised if your psychiatrist forced you to take the antipsychotics. Being creative is therapeutic in itself.

But don't let them put you on sulpiride - it also goes under the brand name of Dolmatil. From all that I've heard, anyone who goes on it puts on weight, and rapidly.

[Natureloverpeace]

The frontline treatment for OCD is ERP/SSRI. ERP is a type of CBT. It is often augmented with ACT and/or some elements of DBT such as mindfulness. Other types of CBT have not been found to be effective for OCD and some can be harmful. Medication should be prescribed by a provider who is very knowledgeable about OCD. The SSRI dosage levels for OCD are typically higher. They can be supplemented by some antipsychotics but that wouldn’t be a frontline treatment. I encourage you to discuss any medication concerns with your prescribing provider. You can say no to taking any medication you don’t want to take. ERP should be done by an OCD Specialist. Many therapists claim they can provide this treatment but aren’t qualified to do so and then the treatment ends up being low quality or even makes the OCD worse. TMS can be used for treatment resistant OCD but isn’t a frontline treatment for it. It needs to be done by someone who knows how it is applied for people with OCD. Most cases of treatment resistant OCD aren’t really treatment resistant but rather situations where the provider wasn’t skilled enough in applying ERP or the client was doing compulsions that the provider wasn’t aware of or the client was not accepting uncertainty. There are some people with truly treatment resistant OCD but there are options and hope in those cases.

[Phoenyx]

Honestly from what I’ve found out the new way of treating OCD is SSRIs in combination with antipsychotic. If the OCD symptoms don’t have significant improvement only with SSRI or NSRIs, antipsychotic is usually added to boost the job antidepressants are performing. I am on very low dosage and feel fine. No side effects. The right meds can perform a miracle and can bring your life back to normal.

[KatMoonight in reply to Phoenyx]

The thing is I have progressed so much and my life has improved. I have a comorbid with ADHD and GAD, and I can recognize intrusve thoughts and OCD. What I want my psych is to respect my boundary. I’m not a fan of antipsychotics. Especially, when she also admits that i have improved. Before it was horrible. My life is returning back to normal. Why add a med when the other is working?

[Phoenyx in reply to KatMoonight]

When working with therapist you have to establish trust. If you don’t trust him/her it will be hard for you and you will question their decisions for your treatment. I understand your previous therapist was disappointment. Trust me, I’ve been there. Don’t take the antipsychotics if you don’t want to, that’s totally up to you.