Seeking Guidance on Medication Effects for OCD and Anxiety - Psychiatry

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Hello,
Thank you for reaching out with your concerns regarding your current medication regimen for OCD (Obsessive-Compulsive Disorder) and anxiety. It’s understandable to feel uncertain about the effects of medication, especially when you are experiencing changes in your mood and behavior.

From your description, it seems you are currently taking a daily dose of an SSRI (Selective Serotonin Reuptake Inhibitor) known as "百憂解" (likely referring to fluoxetine or a similar medication). SSRIs are commonly prescribed for both OCD and anxiety disorders, as they help to increase serotonin levels in the brain, which can improve mood and reduce anxiety.

However, it’s important to recognize that while SSRIs can be effective, they can also lead to side effects that may impact your daily life. Common side effects include fatigue, changes in sleep patterns, and a feeling of emotional blunting or detachment. The symptoms you describe—such as sleeping in until noon, feeling less motivated to study, and experiencing a sense of guilt or anxiety about not being productive—could indeed be related to the medication. It’s not uncommon for individuals to feel a shift in their motivation or energy levels when starting an SSRI.

Your concerns about whether you are truly ill or if the medication is causing you to feel "off" are valid. It’s crucial to differentiate between the effects of the medication and your underlying mental health conditions. Sometimes, medications can alter our perception of what is "normal" for us, leading to confusion about our baseline functioning.
It’s also worth considering that anxiety can sometimes drive productivity. If you have relied on anxiety to motivate you in the past, the reduction of anxiety symptoms through medication might lead to a feeling of being less driven or focused. This doesn’t mean you are not capable of achieving your goals; it may simply be a shift in how you approach tasks without the pressure of anxiety.

Regarding your thoughts on reducing your medication dosage or stopping it altogether, this is a conversation best had with your prescribing physician. Abruptly stopping medication can lead to withdrawal symptoms and a potential return of OCD or anxiety symptoms. If you feel that the current dosage is too high or that the side effects are impacting your quality of life, your doctor may suggest a gradual reduction or an alternative treatment plan.

Additionally, it’s important to remember that medication is often most effective when combined with therapy. Cognitive Behavioral Therapy (CBT) is particularly effective for OCD and anxiety disorders. It can provide you with tools to manage your symptoms and improve your coping strategies, which may help alleviate some of the guilt and anxiety you are experiencing.

In summary, it’s essential to communicate openly with your healthcare provider about your experiences with the medication. They can help you assess whether the benefits outweigh the side effects and guide you in making informed decisions about your treatment plan. Remember, you are not alone in this journey, and seeking help is a positive step toward managing your mental health.

Take care, and I wish you the best in your recovery and studies.