Hidden but Not Silent

Posted on January 18, 2006 in OCD

Visited my psychiatrist in the afternoon. Moods are stable. I didn’t babble garrulously and I didn’t try to bury myself beneath the pillows of the couch. OK, we agreed. The bipolar disorder was under control for the time being. The matter of the OCD took center stage as I picked my callouses and related a few other events that fit the spectrum.

From an article in the November 2005 issue of Psychiatry, I learned that OCD is the fourth most common mental disorder after substance abuse, specific phobias, and depression. Typically, they have found using drugs that raise the serotonin levels in the brain help alleviate the picking, chewing, pulling, scratching, scrubbing, blurting out, washing, obsessive thinking, and ritualizing that characterize the disorder. (Where bipolars often relate similar stories, every OCD sufferer feels unique.) The SSRIs don’t work so well for me and I’ve had to cut back on my Effexor because it launches me into mania. So I am having to seek other therapies.

I’ve spoken before of the compulsive skin picking. Showing people my calloused fingers almost serves as a badge of authenticity. “Yep, Joel has got it bad.” I shelter most of my acquaintances from another apparent compulsion: blurting out. This usually happens when I am alone or with my wife or talking on the phone. If there is a lapse in our conversation in a restaurant, I say things entirely unrelated to the moment or the previous line of conversation. (If you’ve ever heard me do this, I trust you very much.) It feels as if I am nervous about the empty air time and must shove words between the lapses. Any words. Usually they are not obscene.

Memory of what went before often disappears. I don’t know if I forget and then blurt or if I blurt and in mid-blurt forget. I believe it varies.

We’re not sure what to make of this, whether it is a psychotic symptom or the product of a neurological disorder. I think I do it to cope. If it is OCD, then it should respond to the new drug regimen I begin later today — a low dose of Risperdol.

If not, either I must work on it through therapy or submit to that dreaded CAT scan.