i live in a country with no OCD specialist. I have done research, but I need help.

[KatMoonight]

i was diagnosed with OCD this year and well, there are no specialist in my country. My therapist is socialized in trauma and has helped me a lot, but I feel that I need to do ERP and ACT, maybe?

Or a tailored plan. Because my OCD is strange, lol.

I can describe it as mild, to be honest as I don’t perform rituals, compulsions (rarely), and I don’t avoid things. I do fear harm and losing control (but the fear is not that strong anymore, as I started to recognize that it is OCD, so I have decided to not engage) anyways, I used to have panic attacks/fear and dread but it got better when my hemoglobin got better (used to be on 9.9 now it’s on 11.6) and i have started to take vitd3k2. My intrusive thoughts aren’t always there, they come when I’m stressed or when I am on my period but I can manage them now. I am learning my triggers. But here is the thing… I suffer from ADHD and GAD as well, and anxiety can be also be confused to OCD? Idk, because there are timed where I do not relate to OCD when i get anxious.

What type of therapy is best for me? I have done CBT with the aid of my therapist and has helped me a lot. But I read that thought reframing can be harmful? For me, I noticed how dumb the fear is and I don’t do it every time. For example if I do get anxious in a situation, at night I write on my journal and at the end i do reframe of the thought that passed during that time. And that’s it. I don’t dwell on it, nor engage.

Any help?

[deValentin]

I also practice thought reframing. I replace some 'what if' questions by other 'what if' questions. 'What if I don't compulse and I miss a chance to solve my problem? What if don't compulse and the discomfort I feel never leaves me? etc.' becomes 'What if OCD doesn't keep its promises? What if I never get the peace of mind I'm hoping OCD will provide me, and my search for perfection and complete clarity is in vain? '

This weakens somewhat my urge to compulse without raising my anxiety because I don't argue with my OCD thoughts, or try to suppress them. I just open my mind to the possibility I may never get absolute certainties in life. I can't go wrong with that. I'm just facing reality. Then I can practice response prevention (ERP) without too much discomfort. The fact that I'm willing to face reality is good for my self-confidence.

With more self-confidence, I can acknowledge the possibility of the worst-case scenario. But, I can gradually give myself good reasons to be confident in the future and be satisfied with them. It's a slow, difficult at times process, but it's worth it in the end. Few relapses are possible along the way. It's a matter of starting afresh again. Good luck with your recovery.

[Hidden]

It honestly sounds like you are taking the right steps. Exposure that really sets your stress off can be a lot! GAD is pretty common in O.C.D. ADHD too. You're thoughts aren't you, and sometimes saying it out loud, can help. If it makes you anxious or uncomfortable, it's your O.C.D.

[Sallyskins]

Now I'm beginning to understand your reluctance to take antipsychotics. They don't help with OCD except in low doses, as a supplement to an SSRI antidepressant. On their own, they don't help.

It sounds as though your psychiatrists are struggling to find a solution to your problems, and don't really understand it themselves. So they just assume antipsychotics will help.

Not all psychiatrists and psychotherapists really understand OCD. And that is what you need - a team that really understands it.

Perhaps, if you don't mind taking medication, ask if you can try an SSRI antidepressant like sertraline. It does take a few weeks to start working, and it may make you feel worse for those few weeks. But then you start to feel better. But if you don't want medication at all, I get that, and won't urge you to take it.

In fact, it sounds as though you are doing the right things - leaving the intrusive thoughts alone and not engaging with them. And taking care of your physical health.

If it gets worse during your period, then perhaps consider taking a daily dose of vitamin B6 (also called pyridoxine). A lot of women with OCD have found their menstrual cycle has an effect on their OCD (including me). This can help.