Why I feel I might not get better

[MattMVS7]

I have these obsessive thoughts that are there all day everyday.  They cause panic and depression.  When I first had these thoughts (which were thoughts of feeling trapped and can't escape--that the brain is trapped inside your head and can't escape), I felt trapped and this caused me to experience one panic attack immediately after another, adding up to many panic attacks per day.  On a scale of 1-10, it was at a 10 and I had to be put in the hospital because I lost all control and no positive thing I thought or did had any effect in calming this thought down.  I experienced one panic attack immediately after another and nothing could get this under control.  I know for a fact that they are panic attacks because the difference between panic and anxiety is that with anxiety, you just have a feeling of nervousness.  But with panic, it is a completely different emotion from anxiety and is something much worse and causes a racing heart.

Most people who have panic disorder only experience one or two panic attacks a day.  But mine were constant due to this constant obsessive thought.

After a few days of the worst experience of my life, I managed to get rid of the thought completely by convincing myself that the words "trapped" and "can't escape" do not apply to the brain being inside your head because of the fact that your brain is not trapped inside your head--it is contained.

Therefore, since that got rid of those words since they no longer apply, that got rid of the thought.  But now I have a new thought that I cannot get rid of no matter what I tell myself and although it is not causing any panic and on a scale of 1-10 it is a 4, I fear that if this thought gets to a 10 like with my previous one, that it will remain at that level and that there will be no hope for getting better and getting it under control.

This thought is that my nose is always there up close in my vision and there is no escape from that situation since I cannot remove my nose from my vision.  Although I know that the phrase "can't escape" does not apply in this situation and that I shouldn't feel that way, I feel this way anyway for some reason.

Absolutely nothing I tell myself or doing anything else relieves the thought.  The only thing though that is keeping it under control is knowing the fact that I can put something over my nose and have it remain there and that this is something I can remove from my view anytime.  My nose is something I can't remove from my view and there is no escape in that situation.  But I can remove something I put over my nose and there is an escape in that situation.

Knowing that there is a possible escape is the only thing that is keeping this thought under control.  But in the event that this possible escape no longer has any effect on this thought and this thought gets to a 10 like with my previous thought, I feel that it is likely that there is no hope in getting better or getting it under control and that I will have to live at the hospital the rest of my life getting shot up.

The reason I feel this way is because up to 25-40% of people with OCD are treatment resistant in that no medication or psychotherapy works at all.  That percentage is reasonably high.  Therefore, it is likely that I am someone who is treatment resistant.  If that is the case, then if this thought ever gets to a 10 and causes me constant panic, I will have to go to the hospital and live there due to the fact that if I am treatment resistant, then it will never get better and I can never get it under control.

In this link, at the bottom of the page, it explains:

http://ocd.about.com/od/treatment/a/when_nothing_works.htm

All of us, when we have a disorder such as panic or depression that is out of control, look forward to and live by the hopeful message that this is something that will get better and that you can get it under control.  Without that, there is no hope and no living with it in such a way that you are able to accept it and live with it.  You may be able to try with all your will and be able to do the things you want to do in life, but there is no hope and no coping and living with it.

Because I feel that it is likely for me to be someone who is treatment resistant not only because of the percentage of people who are, but also because that this thought has remained at a 4 and hasn't gotten better despite medication and therapy, this is the reason why I feel there may be no hope.  Knowing the likely possibility that there is no hope is causing me severe depression all day everyday.

[JGF25]

Any coping mechanism is a form of treatment in my book therefore I don't think you are treatment resistant.  I think obviously you have got it in your mind that only one form of self-coaching in "trapped does not apply"  is your only recourse.  I think with work, you would find that other self-coaching statements would work as well.  

For instance, I sometimes panic in the car.  It messes with my vision, etc.  What I have started to do is say to myself "bring it on" becuase the reality is that panic is just a few moments of being uncomfortable.  I don't wreck the car, I don't pass out.  So what's to be afraid of?  So I take the fear out of the thought and next thing you know I'm not having panic anymore when I drive.  

As for your medication, are you still on it?  And if you don't mind me asking what med and what dose?  

[MattMVS7]

Now I would like to add something which is that I can't be so sure at all if the fact that I was able to reduce these thoughts determines if I'm treatment resistant or not.

If someone, for example, has agorophobia, no matter how severe it is, this person can rid of the fear he/she is currently experiencing by a means of escape--such as staying home.  In other words, even though you can rid of your fears by a means of escape, that does not mean you aren't treatment resistant.

Just because a means of escape is something that worked and got rid of the fear does not mean that medication and therapy will also work against the fear.  Having a means of escape to rid the fear is not any form of therapy or any method of therapy--it is just simply a means of escape.  There is no lessening of the actual fear itself in terms of combating it--only in terms of escaping it.

In my situation, I feel that I have not gotten rid of those thoughts of feeling trapped in terms of combating those thoughts.  I feel that I have instead gotten rid of them by a means of escape.  By convincing myself that the word "trapped" does not apply to those thoughts which got rid of those thoughts, I feel that I have gotten rid of those thoughts only in terms of escape.  By ridding of the word "trapped," that has given me a permanent escape which has permanently gotten rid of those thoughts.  As a result, that got rid of this feeling of being trapped that was causing me constant panic.

However, the method of combating those thoughts would be with statements such as "I know that I'm trapped, but I don't have to worry about it and can just focus on the things I want to do."  This has absolutely no effect.  No matter what other positive thoughts I thought to myself such as this and many others and no matter how much I focused into the things I like to do, that had absolutely no effect on these thoughts.  The only way I got rid of them was, again, what I think is a means of escape and not combating at all by, again, convincing myself that the word "trapped" does not apply.

Since therapy is all about combating your thoughts, this is why I feel I might be treatment resistant.  Or was my method an actual means of combating those thoughts and I don't realize it?  If so, does that prove right there that I am not treatment resistant in terms of therapy?

Finally, as for this thought about my nose, the reason why this thought was reduced to a 4 and has stayed at that level is not because of the therapy and meds.  I managed to keep it at that level before any therapy and I don't notice any improvement with the medication.

[JGF25]

Why do you think you are treatment resistent?  You spent time in the hospital and obviously came out having learned how to let the thought go.  You now have another though not too unlike the first one.  Well no shocker there I tell you.  That is what we do when we have OCD.  We bounce around like little rabbits from one thought to the next.  That is why you need to get a good handle on CBT.  Did they put you on medication?  

And I agree with rls27.  Having OCD and getting it under control is work.  You learn how to help yourself and sometimes you take medication to help as well.  I happen to use both and I have my OCD under contrtol.  What kind of follow-up treatment did you do when you left the hospital?  

[rls27]

A word about treatment. It is only as effective as what you put into it. It's not enough to sit in a therapists office for an hour and listen to sound guidance. It's not enough to read a self help book but not put in the work. Treatment only starts in the therapists office, you have to do the rest. You need to take an active approach and not only read something that makes you feel good for an hour, but actually do and live what is being shared.

Do you spend a lot of time alone? Do you have a lot of idle time to think? Do you stay in the same routine each day? These are all things that feed your anxiety and panic. They are triggers and enablers, you need to push yourself. We don't always feel like doing things like going to the gym, taking a walk, taking classes, going out to socialize, etc, but the time to do those things is when you really don't feel like doing them. If you keep repeating the same course of action, you get the same result. It's a vicious cycle that needs to be broken.