Do I Have OCD, HOCD, Depression, Anxiety?

Reader’s Question

I believe I have OCD. I’m just a regular guy, I go out, I watch movies, have girlfriends, friends, etc. I never exercise, and when I say never, I mean it. I never sleep, because I like to be doing something else. So I sleep about 5 hours daily, I don’t take naps during day, never. I felt tired all the time and sleepy, so I used to take vitamins to feel better.

One day during school we were taken out of the classroom because we were given the Measles vaccine. About one hour later I was fine but then suddenly, out of the blue a lot of strange images, strange thinkings came to my mind, regarding disturbing homosexual stuff. My heart started to beat so fast and so strong that it literally moved my body; also I felt in general terms bad, really bad. I got really scared so I went home. That day I went with my girl and I couldn’t feel anything, it was like all my feelings were gone! Love, happiness, I couldn’t enjoy anything. Two days after that I suffered something like a panic atack, again those disturbing homosexual images. First there were images, then anything related to “gay” or “homosexual” would trigger my anxiety, even seeing guys. That anxiety was because of the fear of becoming homosexual; I’m straight, I don’t hate gays, I’m very open minded. Then, the only thing I could do to avoid this anxiety was leave situations that would have made me feel anxious.

Then I went to the psychiatrist. I talked to her and she told me some things about my life (stress, exercise, rest, school) that could have triggered that situation. I felt relief, but it lasted only a few days. Then I went to another psychiatrist; he got the information from my previous psychiatrist and also he asked me a lot of simple questions. He diagnosed “depressive reaction with anxiety and anguish (distress)”, and gave me Paxil and alprazolam.

It’s been 3 weeks since that day and I feel a lot better, I no longer feel the need to leave from somewhere, but I do feel the need all the time to be touching something, tapping, moving my fingers, hands or feet. When I realize that I’m not moving anything, I notice that my shoulders are very tense.

You should know that I have always been a perfectionist, I love symmetry and order, things well done. Also when I was about 16 I had a situation in which I had to wash my hands many times to feel clean, otherwise I wouldn’t leave the bathroom. That lasted about 1 or 2 months and caused no anxiety, but it was strange.

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Now my sexual desire has diminished, something I believe is caused by both paroxetine and alprazolam, only sexual desire, because I can’t keep my eyes off of a pretty girl. I wasn’t able to sleep well, but .5mg of alprazolam daily seemed to help me, also daily exercise (swiming and gym).

I almost feel no anxiety now, but I can’t keep my fingers, feet or hands from moving, I only feel good when I’m with my family, I don’t feel like going out with my friends, maybe because of my condition.

I’ve read tons of OCD websites and my condition matches HOCD 100%. Do I have HOCD? Why did my psychiatrist gave me Paxil, if Paxil is for treating OCD but I wasn’t diagnosed with it, and I am not depressed? Does the fact that Paxil is making me feel better support the idea that I have some kind of OCD? Did my previous physical condition (sedentary with no rest) and the vaccine have something to do with this?

I read somewhere that OCD may be caused when something interacts with the inmune system, in this case the vaccine and/or the excess of vitamins, that’s the reason I asked the last question.

I would greatly appreciate feedback, because I have been through this for 46 days.

Psychologist’s Reply

Let me say from the beginning that your psychiatrist is on the right track, and you need to continue treatment and medication. That being said, I’ll tell you why:

  • Your long-term symptoms are clearly associated with Obsessive-Compulsive Disorder (OCD). Being a perfectionist, hand washing, etc. are classic symptoms.
  • In OCD, the brain often develops obsessive thoughts about situations we encounter in our life. If we feel ill following a vaccine or become emotionally or physically upset following anything (exposure to smells, a dog bite, a medication, an uncomfortable thought, etc.) — the OCD brain “locks on” to that topic and becomes obsessed. I’ve worked with patients who have become totally obsessed with radiation exposure, CO2 exposure, rabies (his pet pig bit him), and electricity. The target/topic of the obsession is almost always something uncomfortable or offensive to the individual — in your case homosexuality. While people have used the label of “HOCD” as OCD associated with homosexual fears and concerns, from the brain’s standpoint it’s just OCD with that specific obsession. We don’t use Radiation OCD, Hand-Washing OCD, etc. as clinical descriptions. In short, the problem is OCD and not issues associated with homosexuality. Your brain has selected issues related to homosexuality as an obsession. Your brain chose germs when you were 16 and may select another obsession in the future if not treated.
  • Both depression and OCD are associated with low levels of the neurotransmitter Serotonin. In fact, many depressed individuals finds themselves counting and obsessing when their depression becomes severe. On the good side, Paxil and other antidepressants improve both depression and OCD. You might want to read my article on Chemical Imbalance on my website at www.drjoecarver.com. You are on the right medication and receiving treatment in the right direction.
  • The restlessness may be associated with your antidepressant. Ask your psychiatrist about those symptoms. A medication adjustment may be necessary.
  • Based on your questions, I can tell that your thinking speed is accelerated. You’re thinking too much and too fast. Mention that to your psychiatrist as well.

Your situation is very common. You may have always had some OCD features which, under routine life stress, become exaggerated. As the OCD features increased, so did your obsessions. You were correct to seek treatment and it sounds like your psychiatrist has correctly identified the issues. Stay in treatment and the obsessions will disappear. Try not to take herbal remedies unless you discuss them with your physician/psychiatrist. Those products can interact with and complicate your current medication treatment program. Your vitamins and other over-the-counter products may also be producing your restlessness and poor sleep.

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