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Do I have OCD?

answered 09:50 PM EST, Sun November 13, 2011
I’ve always been a bit of a double checker of things, but it’s gotten to the point now that I have a lot of trouble leaving the house. I have these crazy worries that I left the stove on or the iron is plugged in or the electrical wire is dangling out of the socket. Before I leave the house and before I got to bed I have to check and recheck everything like 5 times – and I’ll usually end up getting out of bed or unlocking the door after leaving to go back and check things a few more times before I can reluctantly leave it alone.

I used to really like to smoke marijuana but I had to give it up because it just drove my anxieties about this kind of stuff into super overdrive and I’d literally stay up for hours into night just so I could monitor the house so it wouldn’t burn down.

If I use the stove at any point near when I have to go I have to check that it’s off and cooled down an insane number of times.

I’ve told a few friends about what I go through and they laugh it off and say they do the same thing…but I don’t think they could to the same level, because I really have a hard time even leaving the house anymore. Oddly enough, if I am with someone else and they do the checking, I don’t worry at all and can leave without distress. I also brought it up with my doctor at a recent check-up but he said that people with OCD are much more affected and that my behavior remains within the normal range. He recommended relaxation exercises as a way to overcome compulsive feelings.

Based on what I have described, do you think I have OCD? If so, will medication help me?

Dr. Steven Brodsky Says...

Dr. Steven  Brodsky S. Brodsky
Psy.D.

This advice does not constitute treatment and I wouldn't want to diagnose someone by email. However, the symptoms you describe(checking, difficulty leaving, etc.) are typical among the OCD sufferers I treat in my practice. OCD can take literally thousands of different forms as unique as the individual, not just the ones you read about. OCD is an anxiety condition in which the sufferer has unwanted thoughts or worries and feels compelled to get rid of the thought by either an action, avoiding certain situations, or by mentally reassuring themselves (or asking others to reassure them) that their worry is irrational. None of these measures works and, in fact, only make the worry worse in the long run. OCD does not mean you are going crazy, it is simply an anxiety condition and nothing more. About 6 million people suffer from OCD in the U.S. alone.

The good news is that OCD is very treatable, and medication might not be needed indefinitely, if at all. Hundreds of studies support that the most effective treatment for OCD is "exposure response prevention" (ERP), which is a special type of behavior therapy designed specifically for OCD. ERP is the only treatment endorsed by the Obsessive Compulsive Foundation. ERP enables sufferers to very gradually overcome their fears and let go of their compulsions at a pace with which they feel comfortable, so they are never overwhelmed. Results are achieved in a matter of months not years. ERP is more effective than medication, therapy and medication combined, or any other kind of therapy. Medication provides only temporary or partial relief and has side effects; symptoms just come back when you end the medication. ERP provides permanent relief, essentially eliminating OCD forever.

Most of my clients benefit from ERP alone with no medication. If someone is on medication already, however, I recommend staying on it until therapy is complete and then gradually reduce and eliminate medication while continuing the therapy for another several weeks or months to assure that symptoms don't return.

There are about a dozen medications used for OCD. The most popular are Luvox, Zoloft, Lexepro, Celexa, Prozac, Zoloft, Effexor, and Anafranil, which is an older medication, and many other medications.

One very helpful book on OCD is written by my former client, Linda Maran, and is called "Confronting the Bully Of OCD," which describes her therapy with me. It's a wonderful success story written from the perspective of a former OCD sufferer who overcame it. Two helpful books written by professionals are "Stop Obsessing" by Edna Foa and "When Once Is Not Enough" by Gail Steketee. The movie "As Good As It Gets" with Jack Nicholson is a depiction of an OCD sufferer, although aspects of it are inaccurate.

I don’t know where you live. I practice in mid-town Manhattan (34th St. trust me it's worth the trip. If they don't have someone in your area, ask them if they know of a similar organization in your region that could make a referral to you. Such organizations would have words such as "OCD," "Cognitive Therapy," or "Behavior Therapy" in their titles. For those with limited funds, the most affordable option is some large prestigious hospitals associated with a medical schools have clinics with low fees that accept insurance and Medicaid/Medicare with words such as "Anxiety," "Depression," "Fear and Phobia," or the above terms in it's title. Usually the therapists in these hospital clinics are junior therapists-in-training--such as psychology graduate students or medical students--but they are supervised by very experienced licensed professionals. Once you get names of therapists, you have to call and interview the therapists by phone.

If you are considering another therapist, there are TWO "TEST QUESTIONS" you must ask them before you make an appointment: (1) Is ERP the main technique they use? If they don't, forget about using them. And (2) How many people have they SUCCESSFULLY treated FOR OCD? They should have treated at least a dozen people (a few dozen in metropolitan areas), the people should not longer have obsessions or compulsions or should not be taking medication any more. They should NOT say they just helped people "live with" their OCD better.

Even better news is that OCD TREATMENT IS MORE AFFORDABLE THAN EVER BEFORE due to a new law, called Timothy's law, that went into effect in 2007. Although I am out of network, as are all private specialists competent to treat OCD, the new law mandates all insurance companies to cover treatment for OCD (which they term a "biological condition") at a higher rate and, sometimes, for more or unlimited sessions. So whether or not the therapist is in-network doesn't make as big a difference as it used to. In fact, even with HMOs, if you can't find and ERP specialist within network they are required to cover them out of network.

If you can't find anyone in your area, I offer phone sessions for those outside of the New York Metropolitan area. It's not ideal, but it's a lot better than going to someone who is not an expert on OCD. I can be reached at 212-726-2390.

By the way, would you mind emailing me back to tell me how you found my website? Was it through a link off another website or through a keyword search, and, if so, which keywords and on which search engine? Your feedback will help me make this information more accessible to other people. If you found this information helpful and would like others to benefit from it, please consider providing a very brief rating of my services at Health Grades (about 10 seconds) at HealthGrades.com. Or consider providing a brief review to AngiesList.com or call in a review at 888-888-5478 (one word is sufficient).

I hope this information has been helpful. Good luck and tell me how it works out. I only want to ensure you get the right kind of treatment, regardless of whether that is from me or someone else.

 

Sincerely,

Dr. Brodsky

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