I have had OCD since I was young, about 10-12 years old I can remember. I have an obsession regarding counting objects/people/anything in my line of sight basically in multiples of three. It has always been inside of my head, never aloud, the only behavior that was visible in combination with this counting is foot tapping and/or finger tapping and grinding my teeth. I usually do this in response to feeling anxious, having a fear that I have said/done something wrong and also just general anxiety. I have always been able to manage this and have considered it as a mild annoyance most times. But recently, about the last 9-12 months or so, I have developed a new compulsion that has been scaring me. Every morning I brush my teeth, I gag myself 9 times. I'm not trying to make myself vomit at all, I just feel the urge to gag myself and have been doing it every morning and don't feel like I can stop it or have a choice. I can't imagine that it is good for my stomach and I also carry a lot of shame and disgust with it. It's also not in regards to feeling afraid that something bad will happen if I don't do it, but after speaking with my therapist a bit, figured out it seems to stem from a feeling like I deserve to be punished because I am "bad" or "not good enough" and it also provides a very brief sense of relief after the ritual is over. Has anyone experienced this? I feel like I am alone in this behavior and am struggling to decide if I need to consider medication as I feel like it is also fueling my depression.