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I am a RN and my OCD went very very bad after my son was born. Still unable to work. I was on Luvox 300mg and a 75 daily. I have been very inconsistent with the meds because they make me so tired. I just started Prozac 20mg today….any suggestions? I have been seeing a CBT therapist but nothing works for me. I’m struggling with Germaphobia which focuses on blood and hit and run OCD. I do not need to be normal but it would be nice to be able to drive my kids to the park without circling for hours….

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You report that you have OCD, Obsessive Compulsive Disorder. What this means is that you feel compelled to repeat certain behaviors that are time consuming, meaningless and very frustrating. In addition, you suffer from “germaphobia” or a fear of germs. That is a real irony for some who is a nurse. You have to deal with germs all day long. Basic to OCD and Phobias is anxiety. After your son was born your symptoms worsened. That is no surprise since birth and infant care are both stressful and anxiety producing.

While is is understandable that you have been prescribed medications for your OCD, they are not helping to any great degree. In addition, you have started Cognitive Behavioral Therapy, CBT. However, nothing helps.

It is common to expect immediate improvements when taking a medication. While this may be a realistic expectation in the medical sciences, when dealing with human behavior it is different. The medications you list, as well as all medications in that category, take two weeks to a month before they work. After that there are no guarantees when dealing with OCD because it is a very stubborn illness.

As Americans we want immediate results when it comes to medication and to therapy. The expectations we have of medication we also have of therapy. Many people incorrectly expect the same immediate results from CBT. In point of fact all psychotherapies for all psychological problems take a long time to set right. I suspect it is taking longer to get results from your therapy than you wanted. You need to do all the homework assignments, work hard and be patient in dealing with your ocd.

Cogniton in CBT refers to “knowledge.” The more you know about OCD the more you can help yourself. I urge you to buy “Brain Lock,” written by psychiatrist Jeffrey M. Schwartz. In addition to giving a clear explanation of OCD, he also describes how to overcome it. In combination with your present therapy I think this could be very helpful. As the book explains, your symptoms are the result of your brain being locked in a pattern that is probably connected with the brain cells or neurons. When you feel yourself becoming compulsive you need to remind yourself that it is because of a brian problem. In addition, follow the steps recommended by the book and you should be able to break that block, especially with your CBT.

Repeatedly remind yourself that the compulsive behaviors are your brain misfiring and that the compulsions are unrealistic.

Best of Luck

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