OCD Action

Change
Member

Hello all,

Am sitting at home on yet another sick day from work, trying to build myself up towards booking a GP appointment for diagnosis. My (self-diagnosed) OCD is contamination, which is making it nearly impossible to leave the house at the moment, let alone sit in a waiting room full of ill people.

Can anyone offer some practical advice on how to overcome this? Is it possible to book a home visit from my GP, and, if so, what would be the best way to go about it?

Any advice would be very much appreciated, as I really am at the end of my tether.

Thanks.

Fri 9 Dec 2011 10:53 #
Cuthbert ffoliott
Moderator

Hiya Change -

it's fine that you already are coming up with the best solution to the problem, IMHO. Now, I am not conversant with the British situation in these matters, but: I think your self-diagnosis is spot on, no worry about that. Therefore your idea about a home visit is the best practical solution at the moment. Most probably you will get an assistant at the phone, and if so: try to express your situation as concisely and urgently as possible. OCD is a life-impairing and potentially threatening disorder, you have every right to act in this way. You may meet some resistance... along the lines of: 'Sir, there are other cases... we'll put you on the waiting list (without any time or date)'. Seeing how much you are stuck in your fears, you really are entitled to put some mild pressure on it all. As far as I can see, you need a quick referral to a specialist.

That's all I can think up for now, wishing you all the best with your efforts,

Cuthbert in Holland.

Fri 9 Dec 2011 11:02 #
Change
Member

Thanks for your advice, Cuthbert. A telephone appointment wasn't something I'd considered, and it definitely seems like the easiest/quickest option for me right now.

Can any of you Brits offer an insight into how easy it is to get a telephone appointment? Am I right in assuming that it would have to be followed up by a face-to-face consultation in order to receive a full diagnosis and/or a prescription?

Fri 9 Dec 2011 11:11 #
Change
Member

Sorry to bump this, but am panicking as my partner is putting me under pressure to book an appointment today.

Just tried calling my surgery to ask for advice on booking a telephone consultation, only to be told there was no one available to take my call, then put on hold to the music from the old "Casualty" theme tune Someone's idea of a joke? Hasn't helped reduce my anxiety, at any rate...

Anyone..?

Fri 9 Dec 2011 12:18 #
Tess
Member

Hi Change
I also have contamination OCD and you do need to take the intial step of contacting your GP who can refer you on for more specialist help if needed. My local surgery which is in Cornwall now only offers telephone consultations and the GP will then decide whether it is necessary for a face to face consultation. I would be surprised if you find any difficulty getting one, it is the way many practices in this country are going because more patients can be fitted in this way.

Fri 9 Dec 2011 12:22 #
Cuthbert ffoliott
Moderator

Hi Change -

(I hope the Brits will jump in here.) What I meant was: make a call to your GP's practice (in my case it's a group practice), and ask for a home visit with due urgency. And don't be afraid to explain your predicament, please.

The 'Casualty' thing: bad taste, lots of bad taste in there.

Wishing you all the best (and perhaps someone from the U.K. with experience in your health care system can give practical advice),

Cuthbert.

Fri 9 Dec 2011 12:25 #
Change
Member

Thanks for your input, Tess.

How likely is it that I'll be able to bypass a face-to-face meeting? I'm worried I'll give in, cancel the appointment and be back at square one again...

Fri 9 Dec 2011 12:27 #
Change
Member

Hi Cuthbert,

Thanks again. The more I think about it, even a home visit seems too much to deal with at the moment..I'm just so tired and stressed out from work as well as the OCD, I don't have the energy to cope with the thoughts and anxiety I'd be experiencing for the rest of the day after the GP visit (Who else had he/she been in contact with already that day? Had he/she just returned to work themselves after a period of illness, with traces of that illness still remaining? It is that time of year, after all....etc, etc, ad nauseum)

*Sigh*

Fri 9 Dec 2011 12:34 #
Tess
Member

Hi Change
I would be surprised if you could bypass a face to face appointment but you might be able to bypass the GP stage and get the face to face appointment with a psychiatrist. Or, if you can afford private treatment then you can dictate rules which you are comfortable with. But you have an entitlement to treatment and if your problems prevent you from physically going into a surgery then alternative arrangements will have to be made for you. I think the most sensible thing you can do is to phone the surgery, ask for a telephone appointment, discuss your problems openly and take it from there. If there are problems you can't cope with then come back and discuss them here. If you fear you will cancel an appointment you can use this forum for support and encouragement to keep your courage up.

Fri 9 Dec 2011 12:40 #
Change
Member

Thanks, Tess. I've booked a telephone consultation for this afternoon.

Should/can I request bypassing the GP stage and going straight for the psych appointment when I speak to her this afternoon?

Worried about what to say, as I've often found that people don't take me seriously when I discuss my anxieties...

Fri 9 Dec 2011 12:50 #
Tess
Member

Hi Change
Got to go out now but well done on booking the consultation. Yes, you can request by passing the GP stage but you will need to explain why you will find it difficult to attend the surgery. Rather than making a request I think it would be better if you explained your problems and if you are not happy with what she suggests then explain why. There may be a protocol whereby she has to see you first but if she knows you are virtually housebound due to the OCD she will be able to take that into account. You will no doubt be worrying about the phone call so the best thing is to think of the things you need to tell her and write them down, have some tissues handy because you may find you get upset, this is absolutely normal, it is very hard to make this first step of getting help but be open and honest about the intensity of your feelings and don't put the phone down until you are satisfied with the next step. Good luck, let us know how you get on.

Fri 9 Dec 2011 13:59 #
Unregistered

Hi Change,

Take a look at the Information Packs on the OCD Action website. (Click on "Resources" at the top right corner of the page, or use the link below.)

There's a document there called "Accessing Treatment -- Your Rights". This info pack includes the following information: "The department of health has introduced a scheme to make psychological therapies more widely available and this includes CBT. This programme is called ‘Improving access to psychological therapies’ (IAPT). To see if the scheme is active in your area, please access http://www.iapt.nhs.uk . You can ask your GP to refer you to your local IAPT service and you can self refer to an IAPT centre and only need to go through your GP if medication is being considered for you."

There's a GP Card, to take to the GP, and you can access lots of other really good info packs at this address:

http://www.ocdaction.org.uk/support-info/resources/

Take care.

Fri 9 Dec 2011 17:11 #
wannabefree
Member

Hi Everyone, Hi Change, how did your appointment go?
wannabe

Fri 9 Dec 2011 22:32 #
Change
Member

Thank you, Londoner, I've made a note of those links for future reference.

(Hi wannabe) Phone consultation went as well as I could've hoped, thanks. Looks as though I won't be able to get out of seeing the GP altogether since she's recommended I go on a course of medication, but I've been given an early morning appointment next week before official opening hours, so hope that'll be easier to cope with.

Just wanted to say thanks again, Cuthbert, for your suggestion (even if it was a misunderstanding - for the best, it turns out!). Don't think I could've dealt with seeing anyone face-to-face today, and I'd still be at square one now if I hadn't made the call. Thanks also to Tess for the practical advice, it paid off and I think I'm being taken seriously for a change

Bed time now, exhausted! G'night all.

Sat 10 Dec 2011 0:38 #
Cuthbert ffoliott
Moderator

Hi Change -

you're doing right by your nickname, and that is a cause for celebration. I am so glad I could help you a bit. I think that early appointment, before others will be there, is an excellent idea - it's the best compromise I can think of, given your form of OCD. It might still be hurdle for you, but you will be able to concentrate much better, compared to a visit during usual hours.

Do keep us updated, will you?

My compliments, Cuthbert.

Sat 10 Dec 2011 10:33 #
Unregistered

Hi Change,

that's fantastic -- well done!!!

I think that, although GP's sometimes aren't as up to speed about OCD as they should be, they are still one of our biggest weapons against our biggest enemy -- OCD!

I have personally found medication (in my case, Fluoxetine) to be a life-saver. The NICE Guidelines also tell you all about the benefits of SSRI's (anti-depressants) when used to treat OCD.

Here's a couple of links, for particularly useful infomation about medication for OCD:

NICE Guidelines for Treating OCD (version for the public):

http://www.ocdaction.org.uk/files/2009/09/nice-cg031-publicinfo.pdf

“Accessing Treatments – Your Rights”:

http://www.ocdaction.org.uk/files/2011/10/Number-3-Treatment-your-rights2011d2.pdf

“Medication for OCD”:

http://www.ocdaction.org.uk/files/2011/02/Medication-for-OCD.pdf

As you pointed out, you need to see the GP to discuss medication, as a therapist cannot prescribe medication. (A psychiatrist can, but most of us see therapists or psychotherapists, not psychiatrists, so we still have to go to our doctor (GP) in relation to any medication we want to try.)

You've done so well, Change. I have 100% confidence in you, and 100% confidence in your ability to face up to your fears. You're stronger than you might think. And most of all, you DESERVE to get better.

OCD is a treatable illness. The treatment is out there, and it's all laid out in the NICE Guidelines and the other links I've attached.

Take that, OCD!!!

Sat 10 Dec 2011 13:41 #
wannabefree
Member

Hi change, same from me too... Be good to yourself and be patient with yourself at the GP's it will all work to the positive...
wannabe

Sat 10 Dec 2011 21:14 #
Change
Member

Back from the GP, feeling flat.

Have been prescribed Sertraline, despite requesting Paroxetine (which I've taken for anxiety before, and found it effective with few/no side effects). Why might she have been reluctant to prescribe Paroxetine again? Is Sertraline proven more effective against OCD?

Also been referred for CBT, but the waiting times are beyond ridiculous..don't think I can cope that much longer. My mind's spinning, and I need a break from this now.

Tue 13 Dec 2011 11:24 #
wannabefree
Member

Hi change, it could be that sertraline will be good... Are you on any other medications that may react with your other choice of Paroxetine?
I do wonder how doctors decide on what is best for us... See how it goes... I know of people on Sertraline who say it is really good...
I understand about the waiting times for CBT, they are so long, and it is scary waiting... At these times it helps to pick up a book on OCD, that is written in CBT type principles... Overcoming OCD, by David Veale and Rob Willson is a good book to read, I've found it helpful... I think I'll pick it up again this morning, cos I'm going through a difficult time this morning...
wannabe

Tue 13 Dec 2011 11:33 #
Truddles
Member

Wow, that was a major achievement for you going to the doctor, you need to give yourself credit for that.

Tue 13 Dec 2011 11:38 #
Change
Member

Hi wannabe,

Sorry this morning's being hard on you. If you're anything like me, it'll get better as the day goes on.

Am not on any other medication, no. I asked her why she wouldn't prescribe it again, but she just said she was "reluctant". The last thing I need is to contend with any side effects over the Christmas period, which should be a time to relax... Worried about even managing to get the pills inside me at the moment. Will mean having to put my hands to my mouth every morning, which seems almost impossible.

Did I read that you're on a waiting list for CBT, or have been recently? How long was/is the wait for you?

Have considered asking for some OCD reading material for Christmas, but it seems a bit sad Not to mention the fact that my partner probably already has all of my presents sorted by now! Brain Lock and Overcoming OCD are definitely on my wishlist, but they'll have to wait until I have the time to breathe again, let alone read.

Thanks for the support, Truddles. Wish I could feel more positive about it.

Tue 13 Dec 2011 11:50 #
Cuthbert ffoliott
Moderator

Hiya Change -

great to hear about the visit, despite you yourself feeling not that wonderful... that step is a practical move in real life that deserves applause. Often (in my case), feelings are 'lagging' a bit compared to the events that actually were brought about by yours truly. So it can take days before I say to myself: hey, Cuthbert, what you did was pretty good, wasn't it? I guess that it has something to do with the dreaded 'catastrophic thinking' inherent in OCD: I tend to first go through things that I potentially might have done wrongly (complete with possible consequences of those wrong actions, that did not happen in the first place!) - and only later my mind is free to see that it was, in fact, right what I did.

Now: the matter of paroxetine vs. sertraline. At a first glance, I could not find significant differences between the two, both serve the same goal, namely to increase the levels of freely available serotonin (a messenger molecule) in your brain. I will delve again into the matter shortly, when I'll have the time. Well, there have been stories about the initial effects of paroxetine in children - these suggested that they became more depressed after having taken their first doses, up to the point where they felt so bad that they thought about dying. But IMHO these were not that well substantiated, and referred only to single cases. Could be that your GP is a bit wary about prescribing paroxetine on these grounds, that is her good right. But on the other hand: had paroxetine really such grave initial effects, then it would never have been put on the market in the first place. I myself use it and never had bad effects.

Taken together, I guess sertraline is as good as any other SSRI type of medication, including paroxetine (SSRI: specific serotonin reuptake inhibitor). So if I were you, I would not worry overmuch about this issue.

And I am sorry for you that CBT comes with a long waiting list. Governments could do worse than eliminating these obstacles altogether. But they aren't generally known to be fair in distributing money, in a way so that human needs are met where it's really urgent.

Best, Cuthbert.

Tue 13 Dec 2011 13:23 #
Change
Member

Cuthbert, you made me smile with this:

So it can take days before I say to myself: hey, Cuthbert, what you did was pretty good, wasn't it?

Thank you

Just managed to finish all of my (admittedly small) lunch without "contaminating" it, for the first time in I can't remember how long, so feeling a bit better now.

I've been reading up on meds a bit more, and it seems as though 2 separate courses of the same meds can sometimes produce a completely different set of side effects in the same person. I think that's made me feel a bit better about not having been prescribed the Paroxetine, too - odd, though...

In any case, thanks again for your input, I enjoy your posts!

Tue 13 Dec 2011 14:11 #
Cuthbert ffoliott
Moderator

Hiya Change -

thanks for the compliment, it really makes me happy! And do check your private messages, I could find a description of the actions of paroxetine and sertraline, written just this very year. It is very reliable, hope you will find something of interest in there. I sent it privately because I don't want to violate copyrights, by the way.

Cheers, Cuthbert.

Tue 13 Dec 2011 14:16 #
wannabefree
Member

Hi Change, Hi Cuthbert, that sounds good about the meds, so it should be okay... Stick with it, I will stick with my meds too... Anything is better than nothing in these situations... I'm just off to get something to eat, hopefully without washing my hands too much! More later...
wannabe

Tue 13 Dec 2011 14:20 #
Change
Member

Thanks, Cuthbert, your PM has helped clarify a few things and made me feel a bit more at ease with the prescription.

wannabe, how are you feeling now that the day is in full swing? Good luck with lunch, don't wash your cutlery 4 times like I did!

Tue 13 Dec 2011 14:32 #