OCD Action

StuB
Member

(This will be lengthy, complicated and most likely a bit incoherent. I've posted it on a few forums, partly to get a range of opinions, but also to basically get it off my chest. To anyone who manages to get through it all and makes sense of it - i'm very grateful for your patience!)

Hi everyone,

Firstly a bit of history. I'm a 24 year old male. My OCD first got really bad back when i was 19, initially revolving around handwashing which was itself linked to germ phobia, emetophobia etc. Over the years i've made improvements in this area (the handwashing takes about 5-10 minutes rather than 2 hours now!), but there's still work to be done.

The second main element of my OCD developed about 18 months after that. Commonly known as P-OCD online, it was based around terrifying and very real-seeming intrusive thoughts that i might be a paedophile. At first this brought me to the point of contemplating suicide, but after opening up to my then-psychologist about it, i started to gradually get the thoughts into
perspective. It still flares up from time to time but i feel much more in control of it.

I had taken the beta-blocker propanolol for a brief period back in 2008, but before this year, i'd never really used medication due to my overblown fears of the potential side effects. Three months ago i started taking the tricyclic anti-depressant clomipramine. Due to the concern over side effects as well as my IBS, the doctor recommended that i increase the dosage very gradually - i'm only now up to 60mg per night. I'd perhaps felt a slight improvement in my mood and slight easing of general anxiety, but developemnts from the past few weeks have left me unsure of whether to keep increasing the dosage.

Except for a brief period in my early teens, i've been fairly comfortable with my sexuality - to use totally unscientific figures, about 80% heterosexual and 20% homosexual, basically 'a bit bi'. I'm capable of a homosexual response, but my gut preference has definitely been for girls/women, especially in any romatic/relationship sense.

Over the last few weeks, though, as the clomipramine's started to kick in a bit more, there seems to have been a weird shift in my sexual responses. Basically, my heterosexual response seems to have decreased significantly and my homosexual response seems to have increased somewhat. I'm still capable of a heterosexual response, but it definitely seems to have been reduced. As should be clear, i'm not homophobic (at least not in terms of anyone else's sexuality), but it's REALLY unsettled me for some reason.

The thought patterns emerging from the whole thing do seem very OCD - it's making me miserable, i'm terrified that i'll end up incapable of a heterosexual response and my brain keeps testing me/bombarding me with open-ended questions which leave me feeling very confused and alone. Unlike the P-OCD, my core dislike for what the thoughts are suggesting isn't moral - it simply doesn't feel right for me. The idea of actually being gay rather than slightly bi doesn't seem at all liberating to me - it's just depressing me.

At least in part due to severe social anxiety, i've never been in a sexual relationship or had a girlfriend. I've also been VERY isolated from my peer group in recent years.

Another factor which might have been instrumental in recent weeks relates to a computer CBT course i've been taking. It's proved quite useful and given me a few ideas for controlling general anxiety and depression, as well as getting me out of the house a bit more. The confusion starts when i mention the attractive 20 year old girl who has been assigned to help me with the therapy - i developed a bit of a thing for her pretty much from the beginning, although i've found it surprisingly easy to talk to her given my usual awkwardness around the oppostie sex. I haven't taken the 'crush' too seriously - it's probably got more to do with the fact i've barely encountered any girls of my own age over the past four years. On the other hand, it did get me thinking in more general terms about how i'd eventually like to end up in a relationship once i'd gotten my problems and anxieties under control. I also realised, to my confusion, that my attraction to the girl seemed to be purely on a romantic level - for some reason i found it very hard to think of her in a sexual way. At first i assumed this was to do with anxieties, but then i started to wonder whether my heterosexual instincts were really becoming diminished. I then asked myself "could anyone but me manage to develop a crush on a girl and then convince themselves that they were turning gay all within the same week?" This helped to ease my concerns for a few days, but they now seem to be taking over again and i feel really helpless. Which brings me to typing this message.

The question "is the clomipramine turning me gay?" sounds pretty ridiculous i'll admit, but to frame it another way, could the clomipramine be doing something strange on a hormonal level which might present as a shift in sexual tendencies? On the other hand, working with the idea that this IS H-OCD, might the clomipramine be actively causing the new intrusive thoughts/making them worse and should i think seriously about whether continuing with this medication is going to help or hinder me? Or perhaps might the whole thing be related to anxieties surrounding my attraction to the CBT girl?

I realise that this is a bit of a mess, but the situation is really getting me down, so i'd be very grateful for any advice.

Thanks for reading.

Fri Oct 14 2011 18:28:25 #
Cuthbert ffoliott
Moderator

Hi StuB -

that is a courageous piece of self-analysis. Thank you for being so candid.

It is indeed a long letter, so what I will do is write down some first impressions, and then read it again later and add a couple of further comments.

Is clomipramine turning you gay? Well, I read a lot of scientific articles on antidepressants and, by definition, anti-OCD medication (which most often is an increased dose of antidepressants). But I never encountered a case history that described a person becoming homosexual (or: for the most part homosexual) after starting clomipramine.

I would think this: you are very young; and obviously you have a lot of discoveries before you. Social and intimate experiences will eventually reveal to you what your persona, your character is, in terms of finding a partner, of entering an enduring relationship. I'd almost say: that is an enviable position to be in...

Furthermore, I guess that the clomipramine has freed you from some mental shackles. It is no wonder then, that you are somewhat confused about your sexual identity, and analysing yourself regarding this. Feeling uncomfortable is very common in such a life phase. The results from your analysing may shift on a weekly, or even daily basis. My advice would be: you are worrying about normal (and potentially wonderful) things, try not to 'meta-worry', i.e. worry about your worrying. No need for that.

It's great that you developed a crush for that CBT girl - and I wish all such things would go the way you are feeling it right now: romance, and not overtly sexual from the word 'go'. Here's hoping that this may continue.

Finally: I am absolutely not belittling your OCD problems, and your social anxieties in the above. The hand-washing and the P-OCD you describe are very serious, and indeed need be handled with professional help. Luckily, the washing has, as you tell it, decreased to an acceptable level. I can well imagine that the troubles you had with very real OCD spilled over, in disguise as it were, to your self-discovery regarding your sexual identity. Which means: lots of ruminating, worrying, self-questioning, and so on. I sincerely hope that you eventually will be able to separate the two (again), and will find the relationship that satisfies both you and your future partner.

Well, that's it for now, cheers,

Cuthbert in Holland.

Sat Oct 15 2011 8:30:05 #
Beth
Member

From reading your post, I have had very similar OCD thoughts to you. In my experience It is the OCD part of your brain that is questioning you. If you are like me, your OCD picks out the worst thing that you can think of, and tortures you with it, hence the POCD. As one OCD obsession finishes, another one pops up to take it's place. Perhaps ERP could help you. If you know that you are not gay, then you are not, it's just your OCD messing with you.
Everyone has these thoughts anyway, it;s normal. Keep telling yourself it's just a thought, nothing more, nothing less. Nothing is black and white, everybody is a mixture. Just let the thoughts come and go, keep practicing and that is just what they will become, just thoughts. Mindful meditation or meditation helps me. You are not on your own. I wish you all the best.

Sun Oct 16 2011 13:13:05 #
StuB
Member

Thanks for the replies - sorry i was a bit late reading them.

Cuthbert-
The thing that's most unsettling about this whole mess is that until very recently i'd felt very much secure in my sexuality - admittedly despite my lack of experience. The elements of bisexuality took some getting used to in my early teens, but since then i've never found them to be a source of distress. I've always been predominantly inclined towards girls/women and have always imagined myself in the future falling in love with and settling down with a woman. Any homosexual inclinations/curiosities have always felt very superficial - i have no memory of ever thinking of a guy in a romantic way, just occasionally feeling some physical attraction.

Deep down i think i KNOW this is OCD. It IS capable of something as tangible as significantly diminishing my heterosexual response. In clearer terms, if i see a good-looking girl/woman, i'm getting anxious that i WON'T be physically attracted and the anxiety is potent enough to suppress any response which i would usually expect. Conversely, if i see a good-looking guy (and i mean that in pretty much an objective sense!), i'm getting anxious that i WILL be physically attracted and the anxiety exaggerates my normal response!!!

Reading this back, it makes me sound like i'm someone who wanders around public places staring lasciviously at the general public! The problem is that the H-OCD is on my mind pretty much all the time so yeah, these thoughts are going through my head but it's torture trying to shut them up.

As should hopefully have been evident, i'm in no way homophobic in terms of other people, but for some reason the idea of me becoming gay (if such a thing were possible) just FEELS wrong. I could never imagine myself being in a homosexual relationship - i can't see how i'd personally find it rewarding or fulfilling. Now it feels like i'm typing this purely to reassure myself!

Emily-
I completely agree about the OCD latching onto your worst nightmare - the P-OCD was horrendous when it first emerged (frankly what could be worse than thinking you might be a paedophile?!?).

Tellingly, as you suggested, that came about at a time when my handwashing issues were becoming more manageable - perhaps the anxiety was simply transferred over because i hadn't properly addressed it, merely gotten the behaviour under control? Even MORE tellingly, the P-OCD, which still quite frequently pops up when i'm at my most stressed, has been suspiciously quiet over the last few weeks - maybe it's a case of the underlying anxiety jumping over once again to another part of my brain (so to speak) and build up this H-OCD complex?

I'm extremely eager to get started on some proper CBT and ERP with a therapist, but this whole new H-OCD thing is still very draining emotionally. Perhaps something a bit more sedate like meditation would be a good additional avenue to explore - to help me get into the right mindset for progress? Good idea, thanks!

Sun Oct 16 2011 21:49:41 #
StuB
Member

Thanks for the replies - sorry i was a bit late reading them.

Cuthbert-
The thing that's most unsettling about this whole mess is that until very recently i'd felt very much secure in my sexuality - admittedly despite my lack of experience. The elements of bisexuality took some getting used to in my early teens, but since then i've never found them to be a source of distress. I've always been predominantly inclined towards girls/women and have always imagined myself in the future falling in love with and settling down with a woman. Any homosexual inclinations/curiosities have always felt very superficial - i have no memory of ever thinking of a guy in a romantic way, just occasionally feeling some physical attraction.

Deep down i think i KNOW this is OCD. It IS capable of something as tangible as significantly diminishing my heterosexual response. In clearer terms, if i see a good-looking girl/woman, i'm getting anxious that i WON'T be physically attracted and the anxiety is potent enough to suppress any response which i would usually expect. Conversely, if i see a good-looking guy (and i mean that in pretty much an objective sense!), i'm getting anxious that i WILL be physically attracted and the anxiety exaggerates my normal response!!! I'd be fine with the idea of the clomipramine diminishing my libido (hopefully temporarily) - it's just that it's teaming up with the OCD to do it selectively and freak me out!

Reading this back, it makes me sound like i'm someone who wanders around public places staring lasciviously at the general public! The problem is that the H-OCD is on my mind pretty much all the time so yeah, these thoughts are going through my head but it's torture trying to shut them up.

As should hopefully have been evident, i'm in no way homophobic in terms of other people, but for some reason the idea of me becoming gay (if such a thing were possible) just FEELS wrong. I could never imagine myself being in a homosexual relationship - i can't see how i'd personally find it rewarding or fulfilling. Now it feels like i'm typing this purely to reassure myself!

Emily-
I completely agree that OCD frequently latches onto your worst nightmare - the P-OCD was horrendous when it first emerged (frankly what could be worse than thinking you might be a paedophile?!?). Weirdly, though, the H-OCD feels even more distressing than the P-OCD, partly because the idea of me being a paedophile just seems ridiculous and is easier to dismiss once i've got the thoughts under control. I'm still trying to find a way of getting these H-OCD under control, never mind dismissing them!

Tellingly, as you suggested, the P-OCD came about at a time when my handwashing issues were becoming more manageable - perhaps the anxiety was simply transferred over because i hadn't properly addressed it, merely gotten the behaviour under control? Even MORE tellingly, the P-OCD, which still quite frequently pops up when i'm at my most stressed, has been suspiciously quiet over the last few weeks - maybe it's a case of the underlying anxiety jumping over once again to another part of my brain (so to speak) and building up this H-OCD complex?

I'm extremely eager to get started on some proper CBT and ERP with a therapist, but this whole new H-OCD thing is still very draining emotionally. Perhaps something a bit more sedate like meditation would be a good additional avenue to explore - to help me get into the right mindset for progress? Good idea, thanks!

Sun Oct 16 2011 21:59:10 #
StuB
Member

Oops, sorry, i appear to have posted that twice, though the second one has been edited slightly. Read that one!

Sun Oct 16 2011 22:00:05 #
Cuthbert ffoliott
Moderator

Hiya StuB -

that's a great post. You do have a way with words, and rest assured: whenever I happen to be walking in public spaces, I don't really feel your probing eyes looking at me...

From this message, I gather that it's indeed your OCD that seeks to trouble your feelings of romantic/sexual happiness. It sneaks into your sensuality when you see an attractive woman, and it also does so whenever you see a (handsome) man. Somehow it 'bends' what you really would want to feel in all its entirety, into something unwanted, something that has fear and/or guilt attached to it. Please correct me if I am wrong in my understanding.

Indeed: CBT/ERP (tailored to your individual needs) would be a good avenue to explore, IMHO.

And as you're still such a young guy... let me put it this way: your youth has the advantage of offering you many opportunities to change, of trying out different approaches, and setbacks won't be as discouraging as they would be much later in life - and with taking action, you can make sure that you won't waste time unnecessarily on that ugly thing called OCD.

Wishing you all the best in the world,

Cuthbert in Holland.

Mon Oct 17 2011 9:01:43 #