Trying to help a friend

[alsoran]

Hi, the situation is that I have a long standing friend 20+ years, who until recently  (1 year ago) i did not know suffered from OCD. His is the type manifested in thoughts rather than actions. It came to light when he checked himself in to a mental institution. Since childhood he has battled with OCD (now 40), and has had relief from prescription drugs. He describes the diseaseas morphing into something different - outsmarting if you like attempts to defeat it.
Cut to today - he is that the point of giving up and has returned to an institution for his own safety. He is seeing a psychiatrist - the latest in a long line. He is an intellingent and capable guy, but it is that rationality if you like that is forcing him to the point where he can not see a way out other than suicide.
I am hoping that perhaps someone with the disease can shed some light on what kept them going or turned them around in their darkest hours. I don't want to lose my friend.

[alsoran]

Thanks Lola,

It's not easy, I hope you are right as far as him knowing that he can press through this again. It is interesting on the stress side of things - it seemed as though the latest outbreak was following a high stress period. Kind of like getting a cold after the exams. Perhaps the stresses of his job kept his mind occupied and when that went away the demons stepped in. He has been off work for an extended time - and the thought of returning to work was creating a lot of stress, there seems to be an overriding desire to not let anyone down.

[lola099]

Hello.

I am very sorry as well to hear about your friend.

OCD is complicated to understand for those who have it, and even harder for those who do not. I applaud you for learning about the condition and trying to understand it better for your friend. He must be quite special to you.

From personal experience, when OCD gets out of control and you are not on the right meds, it can be a very trying time where you feel like there is no end to the thoughts and worries and compulsions. When you are on medication you are equipped to deal with the fears and thoughts because the medication helps alleviate the anxiety involved. In my case I stopped meds once I had it all under control and similar to you friend forgot I even had it. But it comes back. Usually with stress. Then you are dealing with the stress, the unwanted irrational fears and thoughts and the anxiety that comes along with it. Eating is difficult, sleep next to impossible and now you have a recipe for feeling at the end of your rope.

I am very glad to hear that your friend is in the right place and that he can realize that he needs the help. If he has been through this before, he knows deep down that he can get through this again. OCD is a lot about control and that may be why you feel that he will accept your help only on his own terms.

You should feel good about helping a good friend.

[alsoran]

Yes that is correct and he understands the weening process onto and off various drugs. I think you are right it is ultimately up to the individual - but that is easy for me to say as I don't have OCD. I think he is just over it and yes I have tried to be positive and say well look that used to work something else will work etc. From what he tells me about thoughts - it is a perfect storm in that he has thoughts about what the stress is doing to his body - a self fulfilling prophecy. He wants to deal with this on his own, it was only after a few unreturned calls that I got through to him to find he was again in hospital and he swore me to secrecy, even in the past when I have visited he is so caught up in his head it is almost as though I am not there. I think he prefers my help on his own terms.

[JGF25]

Just so I make sure I'm reading this right...since his medication stopped working they have tried a myriad of other ones only to find that they don't work?  I'm sure the pdocs know what they are doing but just in case, the medication can make the symptoms worse and you just have to persevere through (sometimes with the help of a benzo) until they do start working which is usually 4 to 6 weeks.  When I had to go up in dosage because of a stress-related breakthrough, I felt like I was going to come out of my skin for a good 4 weeks and then a light kind of went off and I was better.  

The bottom line is it is kind of up to us.  Yes we have a chemical imbalance (at least I think so) that medication works to correct but ultimately we need to learn to control our minds rather than the other way around.  He has had past positive experiences (the five years where he forgot about OCD) and sometimes that is what you have to fall back on...I know I always use past positive experiences when I start to have trouble.  

Let me know how he is getting along.

[alsoran]

Thanks for such a detailed reply. The facts as I know them are that yes medication has helped. There was a period of 5 years where he describes "forgetting about" even having OCD. I think work stress pulled him out of that rest period - since then his doctors have been trying whatever drugs they can think of bring some relief. Basically they are out of ideas.
Hes has also tried CBT and acceptance, meditation - and his current psychiatrist who I think is out of ideas is just playing hard ball - it's up to you kind of thing.
So this is I guess the heart of it - his logical brain is saying well we've tried all of these things and I can't continue to live like this, so it really feels like a dead end, there is the possibility of some experimental treatment however this is too far in the future for him. This current storm has been protracted and the worst so far I think.

[JGF25]

Hi there.  I'm sorry that your friend is going through this.  It is a life-long disorder...I'm 48 now and have had it since I was a teenager.  I think though that there are varying degrees of it and triggers are usually different for each person.  I too have the "thought" part of OCD.  The What-ifs, the forward thinking and the catastrophizing.  

I have to say though that I think it is good that he has had the forethought to check himself into the institution rather than do something drastic.  He knows his limits obviously.  

Can I ask, did the prescription drugs stop working for him or did he stop taking them?  There are people out there that medication doesn't seem to work for but sometimes I wonder if they have taken it long enough.  Also,, sometimes people feel so good on the meds that they think the problem is gone and they don't need them anymore only to find out that is not the case.  I've even done that one.  

Since he did find relief at some point, I think that they do work for him to some degree.  What they don't do is take away everything entirely.  I still have panic attacks which I can bring on myself if I over think things.  The medication does not help me with that part of my OCD, but rather the cognitive behavioral therapy does.  I learned how to breath properly, self-coach myself through these types of situations.  Do you know if he learned CBT or if medication was the only thing thrown at him?  

I have had a couple of "darkest hours" and honestly medication is where I needed to go.  When I was pregnant and the OCD was out of control, I did consider institutionalizing myself because at one point I was so sleep deprived that I let go of my steering wheel and didn't care where the car went.  But I yanked it back...kind of like what your friend has done going into the hospital.  He doesn't want to die, he doesn't want to kill himself, he just wants the thoughts to stop.   I went on medication while I was pregnant.   In addition to medication, I have had exposure therapy, learned CBT, and did a type of "exposure" where I would go into a dark room and actually picture myself doing some of the awful things I was thinking.  It helped me to realize that I'm not that person.  

At some point you have to just say "whatever" because honestly the more you fight the thoughts the worse they get and the longer they tend to stay around.  Sometimes they go away, because we are always looking for some sort of closure, and then something new takes its place or something old comes back.  It can be very, very exhausting when in the thick of it.  

Just know that he is where he needs to be and he has gotten this far..not much younger than me and there is every reason to believe that he can continue on with the right help.