Can Depression, Anxiety, and OCD Be Fully Treated? A Patient's Journey

Obsessive-Compulsive Disorder (OCD)

Hello Doctor: I am a patient with severe depression, and my anxiety test results were also close to severe.
When I feel agitated, I tend to pick at my scalp, which has been a habit for several years.
The doctor advised me not to pick, but I do it every day, sometimes causing bleeding.
After washing my hair, the wounds scab over, and I pick at them again.
The doctor mentioned that this is a form of obsessive-compulsive behavior.
I am currently taking Venlafaxine and Sertraline.
Previously, the doctor prescribed an effervescent expectorant tablet, which was originally for coughing, to see if it would help with my scalp picking, but after taking it for a few days, I still continue to pick.
Regarding work, I often feel incapable of performing my duties, which leads me to resign the next day, causing further distress.
Doctor, can depression, anxiety, and obsessive-compulsive disorder be fully cured? I have been on medication for over 20 years! I would greatly appreciate your insights.
Thank you.

Wang, 40~49 year old female. Ask Date: 2021/09/11

Dr. Zhang Gengjia reply Psychiatry

Dear Sir/Madam,
From your letter, it is evident that you are experiencing discomfort and distress due to the pressures of severe depression and obsessive-compulsive disorder (OCD).

1.
Facing an uncertain future, severe depression and anxiety disorders are common conditions in modern society.
These are chronic illnesses that require long-term treatment for recovery.
2.
Depression is a chronic condition characterized by episodes of exacerbation, remission, recovery, and relapse.
More than half of patients may experience a recurrence even after remission.
Due to individual differences in physiology, it may take time to identify the most suitable medication, so please be patient and cooperate with your physician.
3.
Regarding pharmacological treatment, each primary medication requires 4 to 6 weeks to assess its efficacy.
I recommend that if you experience any discomfort, you should note the duration and frequency of these symptoms.
4.
In addition to medication and psychotherapy, repetitive transcranial magnetic stimulation (rTMS) is a non-invasive, anesthesia-free, highly safe treatment method that does not require hospitalization.
It can improve anxiety and depressive symptoms.
For patients with treatment-resistant depression or poor response to medication, rTMS has shown significant improvement in depressive symptoms after treatment.

Please discuss any psychosomatic issues thoroughly with your physician during your follow-up appointment, as some symptoms may be related to the original condition, while others may be side effects of the medication.
Our clinic is open for consultations from Monday to Friday, both in the morning and afternoon.
I recommend considering a visit to allow your physician to personally assess your symptoms and collaboratively determine the best course of action for you.
Wishing you mental and physical well-being.
Sincerely,
Dr.
Chang Geng-Jia
Department of Psychiatry

Reply Date: 2021/09/11

More Info

The journey through mental health challenges such as depression, anxiety, and obsessive-compulsive disorder (OCD) can be incredibly complex and deeply personal. Your experiences reflect a common struggle faced by many individuals dealing with these conditions. The question of whether these disorders can be fully treated is nuanced and varies from person to person.

Firstly, it is essential to understand that depression, anxiety, and OCD are recognized mental health disorders that can significantly impact daily functioning and quality of life. Treatment typically involves a combination of medication, psychotherapy, and lifestyle changes. The medications you mentioned, such as fluoxetine (Prozac) and paroxetine (Paxil), are selective serotonin reuptake inhibitors (SSRIs) commonly prescribed for these conditions. While they can be effective for many, they do not work the same way for everyone, and finding the right medication can sometimes take time and patience.

In your case, you have been on medication for over 20 years, which indicates a long-term struggle with these disorders. It is not uncommon for individuals to experience fluctuations in their symptoms, even while on medication. This can be due to various factors, including stress, changes in life circumstances, or even the natural course of the disorders themselves. It is crucial to maintain open communication with your healthcare provider about your symptoms and any side effects you may experience from medications. Adjustments to your treatment plan may be necessary to find the most effective approach for you.

Cognitive-behavioral therapy (CBT) is often recommended for OCD and anxiety disorders. This form of therapy focuses on identifying and changing negative thought patterns and behaviors. For OCD, exposure and response prevention (ERP) is a specific type of CBT that has shown effectiveness in reducing compulsive behaviors, such as skin picking. Engaging in therapy with a qualified mental health professional can provide you with tools to manage your symptoms more effectively.

Your mention of compulsively picking at your scalp to the point of bleeding is concerning and suggests that the OCD component of your condition may need more targeted intervention. It is essential to address these behaviors not only to prevent physical harm but also to reduce the anxiety associated with them. Discussing this specific issue with your therapist or psychiatrist can lead to more tailored strategies to help you cope.

Regarding your question about whether these conditions can be fully treated, it is important to note that many individuals experience significant improvement in their symptoms and can lead fulfilling lives. However, "full recovery" can mean different things for different people. Some may find that their symptoms are manageable with ongoing treatment, while others may experience periods of remission. The goal of treatment is often to reduce symptoms to a level where they do not interfere significantly with daily life.

Support from family and friends can also play a crucial role in your recovery journey. Encouragement and understanding from loved ones can help you feel less isolated and more motivated to engage in treatment. Additionally, support groups, whether in-person or online, can provide a sense of community and shared experience, which can be incredibly beneficial.

In conclusion, while depression, anxiety, and OCD can be challenging to manage, they are treatable conditions. With the right combination of medication, therapy, and support, many individuals find relief from their symptoms. It is essential to remain hopeful and proactive in your treatment journey. Regular follow-ups with your healthcare provider, open discussions about your treatment plan, and exploring various therapeutic options can lead to improved outcomes. Remember, recovery is a process, and it is okay to seek help and make adjustments along the way.

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