Anxiety-Panic Community

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mitcl: Are obsessions tougher to cure than compulsions? I only have the obsessions and I am curious.

David: And also, please explain what is the difference between obsessions and compulsions?

Dr. Peck: An obsession is a thought and a compulsion is an act.

I think compulsions are easier to work with in therapy. A behavior approach can be useful. The compulsions may be more understandable than the obsessions.

Starfish: Does OCD ever go away?

Dr. Peck: I believe obsessions and compulsions can be diminished, and with medication, in some people, they can almost disappear or at least make life more comfortable.

ksd: Do certain medications cause lack of concentration?

Dr. Peck: I have not heard of medications decreasing concentration. Concentration itself can be obsessional and so, if the drug works, you may not be as intense and thus concentrate less.

tee: What about if you were on medications for a long time and then get off them. Is it possible for the OCD to go away without the medications?

Dr. Peck: I am not sure. If there has been successful therapy to understand the illness and its causes, then it may not return.

David: Have you ever seen cases, Dr. Peck, where there is a "complete recovery;" where none of the OCD symptoms return?

Dr. Peck: In recent years, OCD has been considered a brain chemical problem. I am still of the old school and believe it is a mechanism for the person to hide a deeper feeling such as anger or even rage. Dealing with the anger may dissipate the OCD. I have a patient who yesterday returned with panic and anger about her mother and an abusive brother who is on heroin. The rage is frightening her but no complaint of obsessions--at least not yesterday.

David: So everyone knows, we do have an OCD screening test on our site.

lmoore: I am having sexual side-effects from Paxil and cannot achieve an orgasm. What would you suggest?

Dr. Peck: Paxil has the most sexual side-effects of the SSRI medications. It is a great drug but this is a problem. There have been suggestions of adding other medications to help. Not taking it that day is a possibility or cutting back the dose or taking it after sex. Paxil should not be stopped for too long because there can be a discontinuation syndrome.

mitcl: If you've only had the obsessions a short period of time, can they be easier to control than if I've had them for a long time?

Dr. Peck: I would believe so. Although many people with obsessions probably don't talk about them for a long time.

cargirl: I have a teenager who doesn't believe he has Obsessive-Compulsive Disorder & therefore "forgets" to take his medication. What can I do to help him understand that he needs his OCD medication?

Dr. Peck: Don't let him forget. It is too important. And it will make your life more pleasant.

tee: Can the medicines possibly cause short-term memory loss or forgetfulness?

Dr. Peck: I have not seen this as a problem. Perhaps the obsessions can keep a person preoccupied.

David: I'm getting some questions about the side-effects of various medications. For a more detailed look at the various OCD medications, their effects and side-effects, you can visit our medications chart.

krajo3: Can OCD medications cause other mental health problems such as depression and suicidal thoughts?

Dr. Peck: This is an important question. OCD is caused by some change in brain chemistry--perhaps with serotonin and norepinephrine. Anafranil works on both systems. I believe Serotonin plays a major role here. The SSRI medications affect serotonin so they may possibly increase obsessions. I had a lawyer for a patient who was depressed and placed on Prozac. Songs began to float through his mind, even in the courtroom, to the point that he could not concentrate. This too, is a form of obsessional thoughts. Suicidal thoughts can occur after SSRI introduction, almost itself as an obsessional thought pattern.

Sylvie: Are petite mal seizures or any other brain disorders the cause of OCD? I have this, and also what I call "compulsive creativity" although, after 7 years of nonstop driven creativity, I am better now.

Dr. Peck: I am not certain about Petit mal, but I do believe that brain disorders may be one cause of OCD. OCD in moderation is a part of life. People pick occupations because of it. My best friend in Medical School became a radiologist--a great one. Because of his his Obsessive-Compulsive Disorder qualities, I would want him to read my x-ray.

We B 100: I do some weird things such as when I do my homework, I have to write or type it in 4 different colors and always the same order, red, purple, blue, green. If I do not do this, I become very anxious. Could this be a sign of a type of OCD?

Dr. Peck: I believe so--and you support my contention that anxiety can be the basis of OCD.

David: Is there a genetic link to OCD? Do sufferers have to be concerned with the potential problem of passing OCD onto their offspring?

Dr. Peck: I have trouble with the questions of genetics in mental illness. But who am I to say it is not involved. I DO BELIEVE environment is important in mental illness. A mother with OCD or depression may not even realize she has it and may pass this on to her offspring. A parent may feel their obsessional thought is the way to live, and may encourage their children to follow this belief.