Dr. Punya Mulky
Psychiatry
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Patient's Query
Hello doctor,
I am looking for an appointment with you firstly for reassurance I suppose and then CBT rather than waiting for the NHS. I have had OCD since I was a teen (intrusive thoughts and having to touch wood, say prayers, etc.). This seemed to subside until I had my daughter but then flared up again after and I was misdiagnosed with postnatal and placed on Citalopram. After a couple of years, I came off the tablets and was extremely stressed. Then suffered what I now see as an OCD relapse. I was petrified. I was losing my mind. Researched schizophrenia and almost gave myself all symptoms, suffered depersonalization on the commute home from work and spiraled into an anxious mess. I took myself to a doctor and was adamant I was psychotic. I was screened and told that I had bad anxiety and OCD. From here, I was put on Fluoxetine and things got a lot better. Five years later, I am going through a lot of stress and I stupidly did not take the tablets every day for a period of time. I am now again riddled with OCD thoughts and feelings around schizophrenia. I am my own worst enemy as I know if I had schizophrenia I would not query it. I would believe irrational things. So in turn, my OCD tried to confuse me and I do believe the thoughts. I do not want to carry on like this please help. I am a working mother.
Hi,
Welcome to icliniq.com.
I understand you must be going through a tough time. First of all, please do not stress yourself so much with whether it is OCD or schizophrenia or what not. You are much more than a diagnosis. It is important you are at peace and have some relief from the distress. Coming to your symptoms, you have said you have intrusive thoughts but what kind of intrusive thoughts do you have? And apart from saying prayers and touching wood is there anything else that you do? From your history, it does seem that you are having severe OCD which is causing a lot of anxiety. If Prozac has helped you in the past, you can reconsider the same medication but you will have to take it for longer duration like two years or more and at a higher dose like 60 mg. Consider tablet Clomipramine 20 mg along with Prozac for an augmentation effect. For acute anxiety, you can consider tablet Etizolam on SOS basis. As for psychotherapy, rather than CBT, exposure and response prevention seems to be a more helpful option for you but we can explore more on that only when we know the exact nature of your intrusive thoughts. Please look up progressive muscle relaxation techniques. These will help you gain some control over your anxiety symptoms.
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