OCD Changing & Getting Worse

[Guest guest]

My 17-year-old daughter has a history of the pure obsessional kind of OCD, and

it has been pretty well (though not perfectly) controlled with meds for a while.

Very recently, it's morphed into causing compulsions as well as obsessions.She

told me she " has " to blink her eyes a certain number of times, and do it

perfectly, or she'll have to harm herself or one of our dogs. :-(

I haven't encouraged her to try to overcome the blinking or even talked to her

much about it, because I don't want it to change to something worse. She's had

many kinds of intrusive thoughts throughout her life, and many of them have been

excruciatingly horrible. Also, obviously, I wouldn't want my efforts to backfire

and result in her hurting herself.

We have our first meeting with a CBT/ERP counselor next week. Meanwhile, I've

called the pdoc. He suggested increasing dd's dose of Risperdol from 2.5 mg./day

to 3 mg. But so far dd has decided not to, and I've respected that. I guess she

feels she's hanging in there for now. He'll meet her in person within the week.

Is it common for " pure O " OCD to morph into OCD marked by compulsions, and vice

versa? Do you have any particular advice for someone whose OCD is changing and

taking a turn for the worse?

Thanks, Steph

[Guest guest]

Steph, often times there really are compulsions but we may not know about them

because they may be internal. For my dd, for instance, she would have to count

things to make it through a therapy session at all. She did this in her head,

not so we could hear her. We didn't know she was doing it until she told us.

Another compulsion is avoidance. Your dd may have been doing that one already as

a compulsion to the obsessive, intrusive thoughts. That was a big one for my dd.

My advice would be to hang in there and just make it through until she meets

with the new therapist since that will be soon anyway. An increase in the

Risperdal may be needed eventually but she is so close to starting her therapy

it would make sense to wait. For my dd, an increase though was what was really

necessary to stop the intrusive thoughts. I hope everything goes well and that

she likes the new therapist. Stormy

________________________________

To:

Sent: Sat, July 2, 2011 2:26:44 PM

Subject: OCD Changing & Getting Worse

Is it common for " pure O " OCD to morph into OCD

marked by compulsions, and vice versa? Do you have any particular advice for

someone whose OCD is changing and taking a turn for the worse?

Thanks, Steph

[Guest guest]

Echoing Stormy, with thoughts there may be compulsions that we (or they) aren't

aware of. If there is anything she does (or thinks) when she has a thought,

it's a compulsion following the thought. With , example, praying after a

thought.

But yes, wouldn't be uncommon for something new to pop up with thoughts and now

she has the blinking to do, where before there wasn't such a physical compulsion

response. also used to avoid due to OCD.

Does she have any specifics on " how " she would harm? Exposures can be to give

them the tool they would use. Example, thought of stabbing mom, hand her knife

to hold near mom, later actually move knife toward mom, etc. They have to

realize that no matter what the thought is telling them, making them feel, they

wouldn't actually DO IT. Sometimes just having a knife in the room with mom can

be a start to the exposure. OR telling several stories of stabbing mom, just

how would the events unfold, what would happen during, after....

Quick thoughts. Sorry she's started something new! Let us know how the meeting

goes next week!

>

> My 17-year-old daughter has a history of the pure obsessional kind of OCD, and

it has been pretty well (though not perfectly) controlled with meds for a while.

Very recently, it's morphed into causing compulsions as well as obsessions.She

told me she " has " to blink her eyes a certain number of times, and do it

perfectly, or she'll have to harm herself or one of our dogs. :-(

>

[Guest guest]

Steph, I was thinking about something else too. She is doing DBT right? Talking

about self harm is a big part of the DBT program. I wonder if it introduced

ideas into her head that her OCD ran with? Just a thought. Stormy

________________________________

To:

Sent: Sun, July 3, 2011 11:20:52 AM

Subject: Re: OCD Changing & Getting Worse

Does she have any specifics on " how " she would harm? Exposures can be to give

them the tool they would use. Example, thought of stabbing mom, hand her knife

to hold near mom, later actually move knife toward mom, etc. They have to

realize that no matter what the thought is telling them, making them feel, they

wouldn't actually DO IT. Sometimes just having a knife in the room with mom can

be a start to the exposure. OR telling several stories of stabbing mom, just

how would the events unfold, what would happen during, after....

[Guest guest]

That's a good point, Stormy, and thanks for the sound advice. :-) S.

>

> Steph, often times there really are compulsions but we may not know about them

> because they may be internal. For my dd, for instance, she would have to count

> things to make it through a therapy session at all. She did this in her head,

> not so we could hear her. We didn't know she was doing it until she told us.

> Another compulsion is avoidance. Your dd may have been doing that one already

as

> a compulsion to the obsessive, intrusive thoughts. That was a big one for my

dd.

> My advice would be to hang in there and just make it through until she meets

> with the new therapist since that will be soon anyway. An increase in the

> Risperdal may be needed eventually but she is so close to starting her therapy

> it would make sense to wait. For my dd, an increase though was what was really

> necessary to stop the intrusive thoughts. I hope everything goes well and that

> she likes the new therapist. Stormy

[Guest guest]

Oh OK. Self harm is a common theme with many people with mental health issues

and lots of teens even without them. I wonder if they are really following the

DBT program or if the therapist is just modifying it since she is doing it by

herself. Usually there are very specific guidelines for DBT that are followed in

a specific order. Mindfulness is a topic within many and it is rediscussed every

so many weeks within the typical DBT program. Stormy

________________________________

To:

Sent: Sun, July 3, 2011 1:02:53 PM

Subject: Re: OCD Changing & Getting Worse

I don't think they've talked about that yet in her DBT -- she's doing one-on-one

sessions, and they're having a general discussion of mindfulness. I think

self-harm is just a recurring theme with my dd. :-(

S.

>

> Steph, I was thinking about something else too. She is doing DBT right?

Talking

>

> about self harm is a big part of the DBT program. I wonder if it introduced

> ideas into her head that her OCD ran with? Just a thought. Stormy