I've been taking the maximum dose of an SSRI Antidepressant for the past 3 years. Before that I was on the lowest dose of an SSRI for 2 years. This was one of the most excruciating decisions I've ever made, and somehow I managed to make it in the midst of a hurricane of OCD symptoms. That is an act of grace! When my previous therapist suggested the possibility of an SSRI, obsessing went to tidal wave. I already had only a scrap of dry land to stand on in the swirling waters of my mind, which is why the therapist proposed medication. My intense revulsion and fear led her to suggest acupuncture, which was not an object of my OCD anxiety.
It took me a year to choose to take medication. A year of compulsive research, and increasingly time-consuming mental rituals of trying to figure out whether I should take them, which one would work, and battling my fear of making phone calls in order to find a psychiatrist who would be able to prescribe them for me. So let's recap:
1)I have health anxiety, so I was petrified by the possibility of side effects
2)I was prone to existential OCD, and ruminated on whether I would no longer be myself if I took medication. I wanted to know how I would feel without a constant barrage of OCD, but I couldn't actually replicate it in my mind, which totally freaked me out.
3)I I wanted absolute certainty, in advance, that I would get on the right medicine, at the right dose, and that I wasn't crazy to consider taking SSRI's.
4)I had severe OCD issues with making decisions, and the decision points kept branching off infinitely--should I take the med? Who should I get the med from? Which med? Which dose?
5)I felt that my therapist was overwhelmed by my obsessing, and after my initial panic when she suggested meds, she didn't know how to help me make a decision.
Here was the bedrock:
Obsessing about medication was leaving me little time to do anything else with my life.
I had the revelation that it was possible that taking medication would stop the obsessing about medication.
I was full of fury about this. I hated this. I felt trapped. I couldn't go on as I was. I was exhausted. But what if taking medication meant I was unredeemable? That I was wrong? I had intense dread, as if taking medication was the equivalent to choosing to go to hell. I don't mean this in any specific theological way, but rather sheer terror.
It's hard to think back to this time. I found the courage to take a chance on medication, which calmed the constant feedback loop of OCD enough to give me some breathing room, and then later, to do Exposure and Response Prevention Therapy. I'll write more about this experience. It's more than fits in one post. But if you are struggling with a decision about medication, know that my heart goes out to you.
Part 2: Starting Medication While Struggling
Part 3:The Limits of Research in Making a Decision
Part 4: My First Prescription for SSRI's
Part5: Feeling in the Jaw: Side effects
Part 6: Being on Medication & OCD Weeping
Part 7: Wanting to Get off my Medication
Part 7.5: Built on Sinking Sand: OCD and Health Anxiety
Brain-Circuit-Based Therapies for OCD
23 hours ago