I’m really horribly struggling with an OCD flare up of an old theme. In the last 6 days, my life has completely spiraled out of control. I am anxious and OCD-ing every waking hour (ruminating, checking, etc). I'm trying not to engage in the compulsions but the obsessive intrusive thoughts are extremely scary and also goes against everything I want and believe in. It seems like absolute cruelty to have to agree with the thoughts.
I’m terrified the thoughts are true, and I’m terrified that engaging in ERP will make the thoughts become true. I really really do not want to do the ERP.
I’m dreading each day. I am on medication but it honestly does not feel like it. I don’t know how to fix this. I feel trapped in my personal hell and I’m starting to lose hope that I can get out.
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ihatemyocd
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The biggest problem is that we are so disgusted by these thoughts that we tend to think about them more, testing and retesting, trying to be sure of everything—even the future. The only way to have some indication of our future actions is to look at our past actions. If you haven't done anything severely wrong until now, it's very likely that you won’t do so in the future.
But can you 100% guarantee that you, me, your neighbor, your cousin, or even the Pope will never do something terrible? No, nobody can, because the future doesn’t even exist yet, and it’s impossible to know anything with absolute certainty.
There is no evidence that OCD leads anyone to act on the thoughts it suggests.
That said, how long have you been on medication, generally? If the dose and medicine are correct for your body, it can take several months to feel a significant difference.
As for ERP, I’ll leave that to colleagues with more experience to comment.
80_Zil_ian thank you for your response. I’m having a hard time sitting in the discomfort and in the doubt. I’m having a hard time with some of the tenants of OCD in general really … mainly that having a thought makes it true & attaching meaning to intrusive thoughts. I feel lucky to have found some relief from the intense anxiety for now. But I suspect it will be back soon.
Regarding medication - in January, I switched from 20mg Lexapro to Zoloft. My therapist at the time recommended the switch because lexapro apparently isn’t on the FDA list of meds that help OCD. So, I switched. Maybe I need a higher dosage. I have an appointment with a psychiatrist this week and look forward to talking with her about what’s going on.
I also take 10mg daily of buspirone to help manage the physiological symptoms of anxiety.
I am on 150 mg of Zoloft which is the suggested dose, I’m sorry you are having such a difficult time. Look up Shannon Shy on Facebook and YouTube. He is a retired marine who suffered terribly from OCD and he tells how he got better. He has also written a few books and is on the board of the OCD Foundation . Along with my therapist he helped me quite a bit. You have a disorder and it is very painful, but I promise there is help and hope.
Lauragbr thanks for your thoughts and suggestions. I have moments of hope and many moments of pain. It's hard to accept that this is just a part of our lives at times.
Yes, in my opinion, one of the roots of OCD is the difficulty in dealing with uncertainty. Throughout these years, I have participated in many support groups like this—mostly virtual, but even an in-person one that was part of a university hospital in my country.
In many cases, people with OCD start to improve (alongside treatment) when they begin to dissociate their identity from the intrusive, ruminative thoughts. Many believe that OCD primarily affects gentle, shy, and kind people by attacking what they care about the most with disturbing thoughts. If this concept helps people by motivating them to improve, I think it’s a positive thing. However, in my opinion (which is just that—an opinion), OCD tends to affect people who struggle with accepting that they are not always in control and can't be 100% certain about most things in life.
We tend to ruminate because we feel the need to constantly test ourselves, like: “I need to feel horrible about this thought to prove to myself that I’m a good person.” In my case, my OCD started to improve when I learned that I don’t need to test myself every time a thought like that arises. It simply comes and goes, and I don't give it any importance.
Regarding medication, I take Zoloft too, and it works for me. I used it from 2010 to 2012, stopped, then had a relapse in 2017 and took it again until 2021. I had another issue this March, so I started taking it again—always at 100 mg. If the medication is suitable for you, maybe you just need to adjust the dose. Adjusting the dose can make a big difference, but of course, this is up to your doctor.
80_Zil_ian thank you again for your insight. I appreciate your perspective, and DEFINITELY identify as someone who really struggles with uncertainty, uncomfortable being out of control, etc.
Lexapro is one of the SSRIs used as a first-line medication for OCD although the dosage needed to treat OCD is usually higher than it is for depression or anxiety disorders. OCD is not an anxiety disorder. A therapist shouldn’t be giving medication advice since it’s out of their scope of practice.
Natureloverpeace yeah in retrospect, I wish I would have conferred with a psychiatrist before switching. I am on an adjusted Zoloft dose with supplementary buspirone daily. I am going to give it one more month - if nothing improves, I'm going back to the psychiatrist for reassessment.
I understand your experience. I know the feeling of being compelled to do things that cost you a lot in terms of quality of life.
The other day, I was playing a board game with a highly educated person who used to repeat out aloud the number she wished to get before throwing the dice. A part of her mind knew that what she was doing had no bearing whatsoever on reality (although it's an useless habit, in that case, it was also harmless), but she couldn't help herself. Her desire to win (or her fear to lose) was too great.
Isn't it the same with OCD? Our desire for a good outcome (or our fear of a bad outcome) is so great, that we feel compelled to do things (checking or ruminating) that the logical part of us knows don't help allay our fears in the long-term. ERP would, but you said that you're terrified that engaging in ERP will make the unwanted intrusive thoughts come true.
You may fear to become a person you don't want to be, or to do or have done something against your moral values. You may also fear that ERP will make you used to that fear, and if you stop fearing a possible bad outcome, you may become complacent and increase its chances to happen. It's like me driving on the highway and thinking about the possibility of steering my car towards incoming traffic. It's a scary thought indeed, but do I have to dwell on it to be reasonably sure I won't drive into oncoming traffic? Not at all. Actually, keeping on trying to get absolute certainties in that regard may incite me to do "foolish" acts out of sheer desperation. I only have to keep driving as usual, and with good experiences, I realize I can reasonably trust myself.
Same thing with checking or ruminating. Accept you can't control everything in life, don't give too much importance to your intrusive thoughts, tend to invest time in sensible activities in a timely manner, and you'll see that, with good experiences, you'll gradually rebuild your self-confidence.
You're welcome. I'm still practicing ERP on a regular basis because, in my opinion, OCD is a bit like a substance use disorder. There are some personal predispositions (genetics and nurture), and, if one doesn't set limits to one's behavior, one can fall into an OCD spiral again, even after a period of remission.
ERP is difficult at times, but very effective. By learning not to count on a perfect order or clarity to feel at ease, I deprive myself of a source of short-term comfort. However, the reward is great. I regain a normal freedom of choice, which is priceless. I don't have to return to my home to check whether the faucet is turned off (as long as I made sure everything was okay when I left). I could, but I don't have to. I reasonably trust my senses and memory. That's the difference. I don't have to endlessly wonder whether I married the right person, etc. Now, when I make a mistake, I lose something, I'm not certain, I don't "freak out". I'm more able to deal with problems in a manner that an independent observer would approve, thanks to ERP. I'm not perfect, and that's okay.
Recovery is a bumpy road. It took several weeks to see positive results. It depends on the severity of your condition and motivation. Motivation is key to recovery. I wasn't always motivated to do ERP. Let me explain why.
If I was left alone and didn't see any adverse immediate consequences to my ruminations (I could keep it a secret), I didn't see a problem in putting everything else on hold to try to solve the problem that was disturbing me at the time. However, when problems started to accumulate (falling behind in my professional work, neglecting house repairs, inability to focus on matters other than what I was obsessing about, etc.), I was motivated to change, but I couldn't change. I was too dependent on the short-term relief from anxiety that giving in to compulsions provide.
It's no good to be motivated just when you're on the brink of despair because when the crisis is over, the motivation weakens. You need to be motivated when everything goes well. You realize that relying on a certain order to put things in, on absolute certainty you won't do any harm to a loved one, etc. is a dead end. It robs you of your quality of life in the end. Then you start to rely on relationships, sensible activities, and healthy lifestyle to feel good. This is a gradual process. It doesn't happen overnight. But when you realize the difference it makes in your life, the freedom and psychological flexibility it gives you, you don't want to go back to your old ways.
deValentin thank you for your insight here. I am hoping to start ERP soon with my OCD specialist therapist. I feel so fortunate to have someone who will work with me who knows how to treat this disorder. I am afraid of how difficult it will feel, but I am motivated to get my life back.
Good luck with your ERP therapy! I know it's not always easy, but you know your limits, you know how far you can be pushed. Personally, I'll never require from an OCD sufferer more than what an OCD-free person would do in the same circumstances.
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First time here, could you help me, please???
I'm having a really hard time figuring out how to apply ERP to my specific OCD theme.
Accepting OCD 
Is this really OCD?
This is too hard...
