OCD, Anxiety, and Depression: A Teen's Struggle

Obsessive-Compulsive Disorder (OCD)? Anxiety? Depression?

Hello, doctor.
Although this issue has only been troubling me for about six months, I sincerely feel distressed and hope you can offer some guidance.
I used to consider myself quite brave—someone who, despite being introverted, interacted with others without any burdens, and wouldn't easily cry when reprimanded.
However, I've noticed that as I've grown older, this bravery has diminished.
I seem to have closed myself off, becoming increasingly timid, like a flower in a greenhouse that can't withstand the wind and rain.
I am 18 years old and currently preparing for the university entrance exam.
When I entered my senior year, I began intensive review for the exam.
Unlike during middle school, I didn't join a comprehensive class, thinking that with weekends to rest, the pressure wouldn't be as overwhelming.
However, reality has proven me wrong.
Due to my naturally sensitive personality, the pressure has exacerbated my tendencies to overthink, leading me to dwell on negative thoughts.
The situation peaked last October and November, when I often experienced difficulty breathing, dizziness, nausea, and a racing heart whenever I started to overthink.
Additionally, I have a sensitive stomach that causes me pain, and I felt inexplicably fearful.
I could hardly stay alone in a room, and I was even afraid to sleep with the lights off at night, plagued by nightmares.
Eventually, I developed a fear of sleeping altogether.
Going out became challenging as well; passing certain places would trigger my overthinking, and I would occasionally have harmful thoughts (such as self-harm or harming others, curses, and other negative thoughts).
One day, while watching a medical program with my mom, I learned about panic disorder, and the symptoms seemed to match my experiences.
I self-diagnosed with panic disorder, but later, after seeking help from my school's counseling office, I saw a psychiatrist who diagnosed me with obsessive-compulsive disorder (OCD).
This was around the end of the year, and the doctor did not prescribe medication.
However, since my family had some tranquilizers at home and were concerned about leaving a record at the clinic, they opted for the tranquilizers to manage my symptoms temporarily.

By December, my symptoms of difficulty breathing, dizziness, and nausea had improved, but my issues with intrusive thoughts, nightmares, and sensitivity to certain topics and places remained unresolved.
I initially thought these symptoms would gradually disappear after the entrance exam, but that hasn't been the case; they still accompany me to this day.
I often feel depressed—sometimes due to my mood, other times for no apparent reason, and sometimes I experience irritability.
Additionally, whenever I start to overthink, I engage in self-harm (such as hitting my head or legs).
My family has noticed and intervened, but this only addresses the symptoms temporarily, and I still resort to shaking my head vigorously as a coping mechanism.

Today, I am sending this consultation form mainly to ask you, doctor, if there are any other mental health issues beyond the diagnosed OCD? Are these problems contributing to my feelings of weakness? I feel like my emotional threshold has lowered, and I often reflect on my past behavior without understanding why I acted that way.
By the way, when I selected the label for my symptoms, I clicked on "eye bulging," which I am not entirely sure about, but I remember that during the peak of my distress, I sometimes felt like my eyes were out of control, as if some force was pulling my eyeballs upward.
These issues have significantly impacted my life, leading to persistent nightmares and overthinking due to my sensitive nature, as well as a decline in my memory (which used to be very good), making it difficult for me to retain information during my studies.
I would like to know if all these symptoms can be attributed solely to OCD, and if there are any methods to alleviate them.
I apologize for the lengthy message, and I appreciate your help, doctor.

Linjin Bengkuai de Gaozhongsheng, 10~19 year old female. Ask Date: 2021/02/22

Dr. Lin Mianzhang reply Psychiatry

Hi there! After hearing about all the uncomfortable experiences you've been through, I truly empathize with you.
It must be really tough to endure so much discomfort while also preparing for this year's major exams.
I believe the doctor diagnosed you with obsessive-compulsive disorder (OCD) based on your involuntary thoughts of harming yourself or others, as well as curses.
However, from your description, it seems you may also be experiencing symptoms of panic disorder and depression.
I strongly recommend that you seek psychiatric care as soon as possible, especially since you have engaged in self-harming behaviors.
It's crucial to get an evaluation from a physician to prevent further harm.
Whether it's OCD, panic disorder, or depression, with proper treatment, significant improvements can be achieved.
This includes enhancements in mood, memory, concentration, and sleep, which will also help you prepare for your exams.
So, please make sure to seek medical attention promptly! Wishing you a speedy recovery and good luck on your exams!

Reply Date: 2021/02/22

More Info

It sounds like you are going through a very challenging time, and I want to acknowledge the courage it takes to share your experiences. Based on what you've described, it seems you are dealing with a complex interplay of anxiety, obsessive-compulsive disorder (OCD), and possibly depressive symptoms. Let's break down some of the key issues you're facing and explore potential avenues for support and coping strategies.

Understanding Your Symptoms
1. Anxiety and Panic Attacks: You mentioned experiencing symptoms such as difficulty breathing, dizziness, and a racing heart. These are common signs of anxiety and panic attacks. It's not unusual for individuals under significant stress, such as preparing for exams, to experience heightened anxiety levels. The fact that you feel fearful of being alone or sleeping in the dark indicates a significant level of anxiety that may require attention.

2. Obsessive-Compulsive Disorder (OCD): Your diagnosis of OCD suggests that you may have intrusive thoughts that lead to compulsive behaviors. The thoughts of harming yourself or others, as well as the compulsive need to engage in self-harm, are concerning and indicate that your OCD may be manifesting in distressing ways. It's important to recognize that these thoughts do not define you; they are symptoms of a condition that can be treated.

3. Depressive Symptoms: Feelings of sadness, irritability, and a decrease in motivation or enjoyment in activities can be signs of depression. The fact that you feel your emotional resilience is diminishing and that you cry more easily could indicate that you are experiencing depressive symptoms alongside your anxiety and OCD.

4. Sensory and Perceptual Disturbances: You mentioned feeling as though your eyes are being pulled in a certain direction and experiencing nightmares. These could be manifestations of anxiety or stress, but they warrant further exploration with a mental health professional.

Seeking Help
Given the complexity of your symptoms, it is crucial to seek professional help. Here are some steps you can take:
- Therapy: Cognitive-behavioral therapy (CBT) is particularly effective for both OCD and anxiety disorders. A therapist can help you identify and challenge negative thought patterns and develop coping strategies. Exposure and response prevention (ERP), a specific type of CBT, is often used to treat OCD.

- Medication: While you mentioned using a calming medication, it’s important to consult with a psychiatrist about your symptoms. They can evaluate whether medication, such as selective serotonin reuptake inhibitors (SSRIs), might be beneficial for managing your OCD and anxiety.

- Support Groups: Connecting with others who have similar experiences can provide a sense of community and understanding. Look for local or online support groups for individuals with OCD or anxiety.

Coping Strategies
In addition to professional help, consider incorporating the following strategies into your daily routine:
1. Mindfulness and Relaxation Techniques: Practices such as meditation, deep breathing exercises, or yoga can help reduce anxiety and improve emotional regulation.

2. Journaling: Writing down your thoughts and feelings can provide an outlet for your emotions and help you process your experiences.

3. Establish a Routine: Creating a structured daily routine can provide a sense of stability and predictability, which may help reduce anxiety.

4. Physical Activity: Regular exercise is known to improve mood and reduce anxiety. Aim for at least 30 minutes of physical activity most days of the week.

5. Limit Stimulants: Reducing caffeine and sugar intake can help manage anxiety levels.

Conclusion
Your experiences are valid, and it’s important to remember that you are not alone in this struggle. Many people face similar challenges, and with the right support and treatment, it is possible to find relief and regain a sense of control over your life. Please consider reaching out to a mental health professional who can provide you with the guidance and support you need. You deserve to feel better and to live a fulfilling life.

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