Reader’s Question

I am a 27-year-old female with OCD. My biggest problem is fear of anything to do with death: cemeteries, funeral homes, etc. It has gotten to the point where I get stressed out leaving the house and I won’t go to people’s homes for fear of them having an urn. I moved last year to a very small town and my symptoms have gotten worse. I am on Celexa which has made me feel happier but has not helped with my OCD. Any suggestions?

Our Clinical Psychologist’s Reply

Your fear appears to be a combination of Obsessive-Compulsive and Phobia symptoms. As you describe, under stress these symptoms become worse. As we often find in clinical practice, the fear of funerals/death “generalizes” to become a fear of going to people’s homes, public places, businesses, etc. From that standpoint, it becomes more than a phobia.

Celexa is a medication in the right direction, although I suspect you need a more aggressive treatment program. When we remember that most antidepressants are prescribed by nonpsychiatric physicians (mostly family MDs and OB/GYN), you may need a higher dose or another medication. If you’re not already seeing a psychiatrist for these symptoms, I would recommend consulting the physician with the highest training in these symptoms — a psychiatrist.

You would also benefit from psychotherapy/counseling treatment. Medications are great for stabilizing the physical and biological symptoms of depression and OCD — but don’t address the cognitive and thinking issues associated with those symptoms. The best treatment approach to any mental health issue is a combination of efficient medications with psychotherapy.