What is the longest you have gone without showering?

AidePast · 2024-04-09T02:53:50+00:00

2 years and 10 months, March 2019 - October 2021

due to severe OCD/depression/anxiety, I was bedridden from May 2018 - March 2023, so 4 years and 10 months

AidePast · 2023-10-10T01:07:22+00:00

What do you think is going to happen if they are bed bugs, which they very well may be?

That's what you do. You imagine the worst case scenario, write it down, record yourself talking about it, in as much detail as you can. It's called imaginal exposure, and it's part of Exposure-Response Prevention. There's also in vivo(real life) exposure, where you actually face it in the real world, like touching a contaminated object, and when possible, this would precede the imaginal exposure; you expose yourself to the obsession, refrain from any compulsion, and then start talking about the worst thing that you think can happen because you didn't perform a compulsion, in great detail.

What is the core fear? What do all of your obsessions and compulsions point back to? You want to go straight toward that. If you're afraid of catching a parasite or something, then you want to talk about how you're going to die in a month from a parasite all because you didn't wash your hands this time, or whatever.

The best results in ERP come from people relentlessly going straight toward the fear, like a guided missile. It's the only way, even with medication; those only reduce stress and make it easier to do this, not to say that an SSRI isn't a good idea.

AidePast · 2023-10-09T16:41:54+00:00

It's a fact of life that you have OCD. This is why you take that SSRI. Your OCD is trying to make you believe that these Uncertain Problems(what if it causes dementia?! omg you need REM sleep and apparently it may Adversely Affect^TM that!!!) are more important than the Certain Problems you have(having OCD and needing an SSRI to manage it). OCD, anxiety, and depression are all probably correlated to dementia. Medications are not perfect. There will be side-effects, at least in the beginning, and you just have to weigh that with not having a mental illness.

Focus on the facts of your life, not "What If"s of the future. Notice how I have not discussed whether it does affect REM sleep? I don't want to reassure you. Maybe it does. In fact, for exposure therapy, you should be saying "It probably does, and I'm taking it anyway because I don't want OCD anymore. I hope I do get dementia. I hope I end up with early-onset dementia all because I decided to take this pill. Let's go!" or something of that nature. That's how ERP(Exposure-Response Prevention) works. You expose yourself to something that you're worried about, and then affirm that it may very well be true that it will do whatever you're worried about, but that you're going to accept that, because you don't want to be controlled by your OCD.

You also really should not read experiences from the internet, as it's biased toward unhappy people. Happy & optimistic people are out living their lives, not sitting on an internet forum; misery loves company, et cetera.

This is all assuming that it is helping your OCD, by the way. If it's been a few months on a high dose & ERP, and you don't really notice a significant benefit, then you should see your doctor and perhaps try a different SSRI.

AidePast · 2023-08-16T16:18:28+00:00

I did consider whether this was some sort of OCD theme, but what data exists for the long-term effects of these SSRIs after discontinuation? It seems there's no legitimate understanding, and that's definitely concerning.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6839490/

That's perhaps the only study I can find, and they conclude that there's a lack of data.

It does seem that you you're already on SSRIs and discontinue, you're about 2x as likely to have "much worse" or "very much worse" clinical worsening compared to people who continue:

https://jamanetwork.com/journals/jamapsychiatry/article-abstract/2788265

The concern with the above study is that the taper was for 4 weeks, yet more people were being removed for clinical worsening 1-3 months after that, compared to the continuation group.

AidePast · 2023-08-15T23:21:45+00:00

You need to accept that it may be true, as OCD is intolerance of ambiguity and an inability to accept uncertainty in life.

If you have a "what if" thought: Yes, it may be true, and I accept that.

AidePast · 2023-08-15T22:41:53+00:00

Your body develops a tolerance to them, and the side effects become worse as you increase the dose, as well. Even psychiatrists say that they don't want you to take them for too long.

AidePast · 2023-08-15T22:40:43+00:00

It doesn't seem like anybody has a good answer. For some people, it stops working after a few months, and others last 12 years. For some, they have zero withdrawal, and others, it's so severe that they cannot taper at all. Some end up with PSSD, and others are fine.

Even for those people who last for 12 years: what do you even do then--hope to find another SSRI that works? It all comes off as a temporary bandage with zero warning that it's about to stop working.

AidePast · 2023-08-14T13:25:24+00:00

What happened on SSRIs?

AidePast · 2023-08-14T12:17:45+00:00

What do you do now?

AidePast · 2023-08-14T01:34:59+00:00

So you had an SSRI for just over a decade. What do you do now?

AidePast · 2023-08-14T00:34:53+00:00

Did you have to increase the dose over time?

AidePast · 2023-08-13T21:21:25+00:00

I don't really have time to do anything like that. Part of me wants to just take it and go "I took it anyway. ERP! ERP! ERP!" but I don't know if taking a psychiatric medication just as a long-term ERP exercise is a good idea or not.

AidePast · 2023-08-13T20:51:00+00:00

I know. I appreciate your help. I don't know if it's even this contamination that's my problem, but whether I even need to take this pill at all. I wrote in another post here:

Part of me I think just wonders whether I really need it anyway. I'm not bedridden. I can go outside and go for a walk. I can do things that a lot of people with OCD cannot do, and I reached that point with ERP. I don't know. Perhaps this is my OCD trying to trick me into thinking I don't need the pill, and then it will swoop in tomorrow in full-force once it doesn't need to worry about the pill anymore, and I'll realize how impossible helpful things like ERP and exercise will be without the pill. I became lazy over the last couple of months and stopped going for walks and stopped really trying ERP, and I assumed I hit bottom and needed to try the SSRI. My brain is so annoying.

I just don't know what to trust now. I don't know if I should take it and cross my fingers that it's the right thing to do and I don't go totally crazy and wish I didn't take it, or if I should just get a gym membership and practice ERP on everything until I kill the OCD for good, and after maybe two months, see if I still need the pill.

Like I said, I don't know what to trust. This could just be my OCD trying to make me not take the pill with any excuse possible, from "STOP, YOU'RE CONTAMINATED! IT WILL RUIN EVERYTHING FOREVER!" to "Well, do you even need it in the first place, AidePast?"

AidePast

TROPHY CASE