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Proscrastination Or Something Else?

Question:

I procrastinate about many, many things and it’s practically destroyed my life. I’m 53, moved in with my widowed Mom 17 years ago, make only a marginal income, have no spouse or offspring or friends. I’m too embarassed and ashamed to pursue new friendships or even to allow the few good old friends I used to have stay in contact with me. And, I’m actually fairly personable –believe it or not! But heres the thing — and I wonder if there’s any connection to procrastination for me. I shake my hands vigorously, almost always unconciously, whenever I feel like I’ve accomplished something, or even if I think about or anticipate (exited?) accomplishing something. It looks and feels very weird when I do it (my face even contorts somewhat) and I’ve always been afraid of being caught doing it. I guess the only way I can stop it completely is to kind of not do much and to not think (fantasize) about doing much or to get too excited as a spectator of something, say for instance a sporting event on TV. Iv’e had this unconcious physical compulsion since I was a little boy. Could you provide any insight or direction for me? I don’t want to see a professional or even describe –in person– what I just described to you (let alone give a demonstration!) unless I have at least some idea what the hell this is, going in. I don’t have much time left to try to build some sort of a, not so isolated, not so hopeless, not so useless life.

Thank you for your website offerings and thank you for your time. Sincerely, Mike C.

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Answer:

Dear Mike,

It is clear that you have been tortured by these symptoms for many years and that they are the source of great embarrassment for you. There are two possible disorders that come to mind that could be the source of the hand movements you describe:

1) Obsessive-Compulsive Disorder: OCD is an anxiety disorder characterized by either repeated thoughts, or by repeated movements like you describe or by a combination of repeated thoughts and movements. The person with OCD is aware of the symptoms, yet, cannot stop them and feels just the way you feel about them. Your description of excitement or over stimulation leading to the hand movements does make is seem a lot like you could have an OCD type of disorder. Treatment usually includes a combination of anti depressant medications and behavioral psychotherapy.

2) Tourette’s Disorder is characterized by multiple tics and one or more vocal tics. A tic is a sudden rapid, recurrent, nonrhythmic motor movement or vocalization, according to the DSM IV. The motor movements can be twitches, blinking, jumping or the type of hand movement you describe. The vocal tics are similar but are “noisy” and come in the form of either sounds, such as clearing the throat, or of words, often times obscene in nature. It is possible that Tourette’s is related to Attention Deficit Hyperactivity Disorder. Treatment for this condition is medication, such as Haldol, which is a major tranquilizer. Because Tourette’s must include at least one vocalization along with the motor tics it seems unlikely that this is what you have. Instead you could have a variation of this:

3) Chronic Motor Tic Disorder is similar to Tourette’s but without the vocalizations. Treatment is usually behavioral therapy.

Whatever the diagnosis you owe it to yourself to speak to your Medical Doctor and, assuming nothing physical is wrong, be referred to a psychiatrist who can do a formal evaluation, diagnosis and, if necessary, begin medication treatment to relieve the symptoms. In addition, the psychiatrist can refer you to a psychologist so that you can begin behavioral therapy to further help you stop these symptoms that are so annoying to you.

I understand that you feel embarrassed by your symptoms but you are not “crazy” and help is available. Your life has been interrupted enough by this disorder, regardless of its actual name and you deserve the opportunity to get it under control and live a life free of this thing. In other words, I am urging you and appealing to you to go for help.

Best of Luck and thank you for your inquiry.

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