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Therapist Isn't Listening To Med Concerns...


i’m wondering what alternatives are there to medications to help with OCD symptoms? i’ve been in therapy for 10 years and was initially diagnosed with BPD (borderline), but then after my one therapist retired and i got a new one, she switched the diagnosis to OCD and said that the behaviours resembling BPD are simply caused by the OCD. so needless to say, they’ve tried me on practically every medication available over the years and finally gave up because they were so bad. the issue is that i have severe food allergies and digestive problems which mean that i’m either allergic to components in the medications or don’t tolerate them well… yet she insists on focusing soley on the OCD – doing CBT exercises (and ignoring my other problems) and keeps putting me on medication after medication saying we just haven’t found the right one yet even though i’ve been on many before with dire results. meanwhile, i’ve been very physically sick as she keeps experimenting – even when i’ve been on as little as 1/8th of the lowest dose!!! i don’t know what to do as she basically ignores my concerns about it. i’d really like to be able to say to her "can we try "this" instead?". any ideas?

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  • Dr. Schwartz responds to questions about psychotherapy and mental health problems, from the perspective of his training in clinical psychology.
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  • Always consult with your psychotherapist, physician, or psychiatrist first before changing any aspect of your treatment regimen. Do not stop your medication or change the dose of your medication without first consulting with your physician.

First, it is really important that any patient who sees a doctor for medical or psychiatric reasons be able to say what they need to say or ask any questions that need to be asked. If your doctor is not able to tolerate your asking the question, "Can we try this," then you should find another doctor. Besides its being your legal right as a patient to ask questions or make comments, it is also within your right to expect and even demand the type of doctors who show sensitivity to your needs.

Second, there is the world of difference between the diagnostic categories of Obsessive Compulsive Disorder and Borderline Personality Disorder. BPD is the result of a combination of things but many of them have to do with learning and having been abused as a child (mostly but not always). Of course, there is always the role of genetics and inheritance, as well. Generally, medications do not help BPD except to relieve anxiety and depression. The destructive behaviors associated with BPD require intensive Dialectical Behavior Therapy, both group and individual and many years of treatment. Obsessive Compulsive Disorder results from extreme anxiety and using unsuccessful strategies to relieve that anxiety. Such OCD strategies may include performing rituals and thoughts repeatedly. People who experience OCD are aware of it and do not like it. People with BPD may feel extremely depressed and anxious and angry but have no clear idea why they have these feelings. In addition, they are mostly unaware of how their behaviors get them into trouble.

I have no idea which of the two disorders you suffer from except that something is not happening that should be happening and that is that you are not getting better.

Yes, you need to speak to your doctor about other options that may be available and/or you may need a consultation. By the way, you have the right to discuss a consultation with your present doctor. After all, after all of these years you really should expect to feel a lot better.

Best of Luck

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