Overcoming OCD and Mental Health Challenges: A Personal Journey

Question for consultation?

Hello, doctor.
I am here to discuss some difficulties I am facing, and I appreciate you taking the time to respond.
I have been suffering from my condition since I was 20 years old and am still seeing a psychiatrist.
Some people have said that I have made a good recovery, particularly 1-2 years ago, but I do not agree! I still experience severe obsessive-compulsive disorder (OCD) and psychotic symptoms.
For instance, I have to rub my palms together eight times when washing my hands, and I feel the same way about other parts of my hands; otherwise, I feel they are not clean.
I previously experienced auditory hallucinations, but fortunately, they have resolved with medication.
My attending physician has diagnosed me with schizophrenia, unspecified mild.
I have shared my problems and challenges with him, but since I only have appointments every 2-3 months, I have to seek help from other doctors in the meantime! Currently, I am taking medications such as Olanzapine, Sertraline, and Duloxetine.
1.
I take my medication every day.
I am currently working, but I am also preparing for a national exam.
However, after I finish work and sleep, there are times when I sleep the entire day.
My attending physician said that this would happen if I didn't take my medication! But I usually do take my medication, so why does this happen? I do feel tired, which is understandable, but sometimes even after not doing any strenuous work the day before, I still feel this way.
I am currently working as a cleaner from 5 PM to 2 AM.
2.
My OCD has not improved! I know some people use cognitive therapy or exposure therapy, such as touching the ground, but I am unsure which method would be suitable for me.
My doctor mentioned using medication to help treat it, but since I couldn't specify the severity of my symptoms, we left it at that.
3.
I once read the manga "Kindaichi Case Files" and was impressed by Inspector Akechi's abilities! Not only is he a police chief with exceptional intelligence, but he is also talented and plays the violin.
This made me want to learn from him, but I do not consider myself that talented! Sometimes, when I am bullied, I tend to curse.
I have no musical background.
Since childhood, I have struggled with reading, my mind is restless, and I enjoy being active.
Even now, as I prepare for the national exam, I cannot focus on studying seriously and wish for quick results.
Moreover, I am already 42 years old! I am not a teenager in my twenties anymore, and I feel like I cannot pursue my dreams anymore...
I feel like I have wasted more than half of my life! I know that manga is fictional, but I still wish to be as talented and intelligent as him, aside from being a police officer.
4.
Due to being mischievous as a child, I once hit my forehead on the ground and bled a lot! Since then, I feel that my intelligence has been affected, aside from just having a scar.
I often feel that I am not smart, and combined with my mental health issues, I believe I have cognitive impairments.
What others find simple takes me a long time to think about or I cannot figure it out at all.
Compared to others, I can clearly feel a significant difference! I often play puzzle games, and after a little while, I feel my intelligence has improved slightly, but after some time, I feel it has decreased significantly! Why do I have this illusion? Because of this, I often fall behind others by a lot...
I really wish I had known earlier! I feel like I cannot get ahead in life; whenever I fall behind, I struggle to catch up, only to gain a little or completely fall behind.
Not trying to catch up feels like standing still and falling further behind! How can I calm my mind to study quietly for the exam? Last year, I was unable to study or complete my assignments due to work! I apologize for having so many questions.

Jason, 40~49 year old female. Ask Date: 2022/02/17

Dr. Peng Liyun reply Psychiatry

Hello,
For question one, a comprehensive assessment of your workload, daily routine, medication adherence, and emotional symptoms is necessary to identify potential causes.

For question two, I recommend you document the details of your obsessive-compulsive symptoms (content, frequency, duration, impact on daily life, etc.) and discuss them with your physician.
In addition to cognitive-behavioral therapy, medication treatment can also be beneficial.

For question three, I am unclear about what your question is.

For question four, the reasons for your inability to settle down require further evaluation.
Factors such as your intelligence, attention span, psychological factors, medical conditions, medication effects, and lifestyle habits can all influence this.
I still recommend discussing this with your physician.

Thank you for your inquiry.

Best regards,
Dr.
Li-Yun Peng, Psychiatry for Children and Adolescents, Chiennan Psychiatric Hospital

Reply Date: 2022/02/17

More Info

Overcoming OCD and Mental Health Challenges: A Personal Journey
Hello, thank you for reaching out and sharing your journey with me. It takes a lot of courage to discuss personal struggles, especially those related to mental health. Your experiences with OCD and the challenges you've faced over the years are significant, and it's important to acknowledge the complexity of your situation.

Firstly, it’s commendable that you have been actively seeking treatment and have been under the care of a psychiatrist since you were 20. Managing OCD and other mental health conditions often requires a multi-faceted approach, including medication, therapy, and lifestyle adjustments. It’s understandable that you feel frustrated with your current state, especially when you perceive that your symptoms have not improved as much as you hoped.

1. Medication and Fatigue: You mentioned that despite taking your medication, you sometimes sleep excessively after work. This could be attributed to a variety of factors, including the nature of your job, the side effects of the medications you are taking, or even the cumulative stress and fatigue from managing OCD and other symptoms. Some medications can cause sedation or fatigue, and it’s essential to communicate these side effects to your psychiatrist. They may consider adjusting your dosage or switching to a different medication that might have fewer sedative effects.

2. Cognitive Behavioral Therapy (CBT): You expressed interest in cognitive therapy as a potential treatment for your OCD. CBT, particularly Exposure and Response Prevention (ERP), is considered one of the most effective treatments for OCD. This therapy involves gradually exposing yourself to the sources of your anxiety (in your case, the compulsions related to washing your hands) and learning to resist the compulsion to perform the ritual. It might be beneficial to discuss this option with your psychiatrist or seek a therapist who specializes in CBT for OCD. They can help you develop a personalized treatment plan that suits your needs.

3. Self-Perception and Aspirations: It’s common to compare ourselves to others, especially when we feel we are not meeting societal or personal expectations. The character you admire from the manga, while fictional, represents qualities that many people aspire to. It’s essential to recognize that everyone has their unique strengths and weaknesses. Instead of focusing on what you perceive as shortcomings, try to identify your strengths and interests. Setting small, achievable goals can help build your confidence and sense of accomplishment.

4. Intellectual Concerns: You mentioned feeling that your intelligence has been affected by past trauma and that you struggle with tasks that seem simple to others. It’s crucial to remember that mental health conditions can impact cognitive functions, including concentration and memory. Engaging in activities that stimulate your mind, such as puzzles or learning new skills, can be beneficial. However, it’s also important to be patient with yourself. Progress can be slow, and it’s okay to seek help if you feel overwhelmed.

5. Finding Balance: Preparing for exams while managing a job and mental health challenges can be daunting. It might help to create a structured study schedule that allows for breaks and self-care. Consider setting aside specific times for studying, and try to create a conducive environment that minimizes distractions. Mindfulness and relaxation techniques can also aid in calming your mind, making it easier to focus.

6. Support Systems: Lastly, don’t hesitate to lean on your support system. Whether it’s friends, family, or support groups, sharing your experiences can provide relief and understanding. Connecting with others who have similar experiences can also offer valuable insights and encouragement.

In conclusion, your journey is unique, and while it may feel overwhelming at times, remember that progress is possible. Continue to communicate openly with your healthcare providers about your symptoms and concerns. With the right support and treatment, you can work towards managing your OCD and improving your overall mental health. Take care, and remember that you are not alone in this journey.

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