Need a handhold, rubbish Dr appointment and rubbish evening. Rubbish life.

[ElleBelleLou]

I'm just feeling a bit sad and thought writing it down would help - I am feeling fragile (hormonal, tired, genuinely just upset - who knows but I've been in the bedroom in tears) so I think I need a little bit of kindness.

I have OCD and anxiety and have been on fluoxetine for around 18 months, and for the most part I am handling it really well. However, I cannot go in the car with my DP. I am sorry for how long this is, but I wanted to give backstory rather than drip feed;

With my OCD I have crippling emetophobia (fear of vomit / vomiting). I have had that issue since I was a child, but thought it was normal because who wants to be sick or be around sick - nobody. I've managed it pretty well throughout my life, I don't eat out, I wash my hands, I keep my distance from people who are potentially ill, I avoid nightclubs etc. I kind of just lived with it. But 2 years ago I was on the bus home from work when a woman 3 seats away from me projectile vomited everywhere - this caused a mental breakdown. I had a panic attack, was let off the bus and walked 2 miles home with shaky legs, hysterical and sobbing. I got home and my memory is hazy because this is when I was in crisis, but I was doing all sorts of 'routines' and actions that I felt would stop me catching a bug / vomiting myself - taking activated charcoal, washing every part of me, I am ashamed to say I rubbed inside my nose with hand sanitiser and poured myself a cup of diluted bleach to 'clean my insides'. My DP stepped in at this point and I went to bed exhausted. From this point I stopped eating as I was convinced the only reason I wasn't vomiting is because I was empty. I lost 2.5 stone and became severely underweight.

Eventually my DP forced me to the doctors, and this is when I was diagnosed with OCD and an eating disorder. I was put on fluoxetine, given a course of CBT and had to have fortnightly face to face appointments where I'd be weighed and my mental health reviewed to see whether I needed to be admitted anywhere. It was a really tough time in my life and I don't really have a full memory of everything.

During this time, on the way back home from a particularly difficult doctors appointment, my DP gagged in the car. Just one of those things - he'd eaten too much or something. But in my mental state, it took me straight back to the woman on the bus and I had an almighty panic attack - I really thought I was dying.

Following this, I have barely been in the car with him since. It must have been about 18 months now. I am fully aware of how ridiculous that sounds and I wish it wasn't my truth - I'm sat here now crying about it. When I am in a car, I feel claustrophobic and trapped in general, but with him it's like I am on edge waiting for him to gag or vomit and it culminates in a panic attack. It's a huge trigger for me and it's holding me (and realistically, us) back so much - it gets me so incredibly down I can't even really put it into words. We live together, we're trying to plan our wedding and I am so pathetic I cannot get into his car.

I finally went to the Doctors today for an appointment I've had booked for 6 weeks, to chat about this anxiety and the fact I cannot get in the car with him. It was also meant to be a bit of a general review of my OCD and medication but also to see what more I could do to hopefully improve and ultimately go back to normality with my DP. I needed help.

My appointment wasn't with my usual doctor but someone brand new. Someone who had clearly not looked at my medical history or had any knowledge of my diagnosis and medications. I explained my feelings and wondering what more options I have - unfortunately I started crying which I am frustrated about as maybe I couldn't explain myself as clearly as I had intended to.

The doctor just looked at me - whilst I am sat there in tears and asking for help - smirking. Didn't offer me a tissue from the box on his desk. Didn't acknowledge what I was saying. Didn't mention my OCD or my current medication. Just prescribed me sertraline and booked a telephone review in 2 weeks.

I've come out of the appointment feeling lost, and even more pathetic. I don't know what I was expecting, I think at this point I'm looking for a miracle.

I don't even know what I am posting this for or whether any of it makes sense. I just wish I could get in the car with my DP like a normal fucking human. I wish my brain wasn't broken. I wish I didn't have OCD. I wish I could function like a normal human. I am so, so exhausted of living like this every day. I'm so guilty for the impact on my DP, our relationship and our days. I feel pointless, I am a burden to him. I've had CBT therapy and it didn't help me one bit. I feel like I'm all out of options and I'm lost.

So sorry you're going through this OP. Are there no mental health charities in the UK (or eating disorder charities) you can approach?

Just another thought to consider - my DD also has OCD and emetophobia can be closely linked to intrusive thoughts (also a form of OCD).
DD was fairly recently assessed as being autistic. OCD is very common in women with ASD. Undiagnosed ASD often gets treated as depression/anxiety.
CBT can also be less effective if you are autistic as your brain works differently.
Is there any possibility that you are ASD? It would mean you might need a different approach to managing how the OCD/emetophobia makes you feel.

@Jk987 Next time I'll go with my DP and some notes - and if it's my normal GP he will take the time and have the patience to listen and guide me so it will be a completely different appointment hopefully.
I do work, full time in a good career, plus then a weekend job in the local pub (for a bit of extra pocket money / socialising) and my day to day is completely normal apart from this car issue. Which you're right I should be kinder to myself, but also I think makes it easier for me to avoid fixing this issue because everything else is so 'normal'.

We used to go out for lovely meals, days out to the beach, weekends away, full days walking out in the most beautiful places and I miss that. I hate that it's my fault we don't do that anymore - I am desperate for us to get away to Whitby and that's what's going to be my goal.

@PinkDaffodil2 yes, I take 40mg fluoxetine daily and now he's prescribed sertraline (and propranolol) on top - no instructions as to when or how much and I don't actually have the prescriptions yet. I've always thought it was one or the other, so won't be taking anything aside from my usual fluoxetine until I've spoken with my regular GP.

@Mrsttcno1 Thank you - I am feeling so much better with the posts and support I've had, honestly. I will look at private options and see if we can make it work financially, I know my DP will be happy for us to do whatever helps so I need to see what my options are - you're right.

Sorry to hear about your experience, I agree with others I think the GP's reaction may be out of embarrassment for their own lack of pre-apt reading. I work in the NHS and recently had an awful GP appointment which I actually complained about as it was that bad, so it happens to us all so don't worry that you might have wasted GP's time. You haven't. It is a good reminder to always book in with GP's we know are good!

It does sound like you would benefit from further therapy, again worth discussing with GP to see if they will refer. Exposure therapy would work well along with the CBT you have already had.

Sometimes OCD/Anxiety/Mental health issues in general stem from something deeper rooted, if that is the case then it is worth reengaging with therapies.

Wishing you all the best. OCD is difficult to manage but it sounds like you have a good understanding and support from your partner

@YelramBob that's something I've not thought about, any charities. I'll add that to something to look into this weekend to see if they can suggest any support options.

@Beamur that's really interesting, thank you for sharing that. If I am honest, I have always thought or wondered whether I am autistic or may have ADHD, but I put it down to the OCD. I get very hyperfixated on certain things like hobbies and will dedicate everything to them, then drop them - gym, then knitting, then resin, then drawing, etc. I struggle in certain social situations and interactions as well. But then all of that could just be my OCD. It's certainly something I will explore with my regular GP though, especially knowing the link now with CBT. Thank you so much for that!

@mrstrickland Thank you - I am sorry you had such an awful appointment too, it's such a shame but then I know the doctor I saw was probably back to back trying to fit everyone in and it must be hard to keep up with - it's just so frustrating for all involved I think.

Thank you so much for your post. I really do have the best partner and I want to get better for him.

We recommend BEAT for eating disorders, but not sure if there will be much to help your particular situation. Might be worth a look and they do have a helpline though.

Honestly, the best thing might be for you to actually be sick and realise that while it's horrible ( I'll do almost anything to avoid being sick)it's not life threatening and it's over quite quickly.

@tripleginandtonic this is the thing, I have been sick since - and I am okay. I know it's inevitable sometimes and I actually had a bug earlier this year, plus was sick with covid last year. It doesn't really make sense to me but once it's done it's done and I survived, but maybe it's the anticipation and build up that causes the anxiety, I really don't know. If I am sick I just lock myself away, but I cannot cannot cannot be around others who are sick.

Look into the Thrive Programme.

Please don't feel you are alone with this, I have worked with a few women who have looked for help in managing Emetophobia, so its not just you.

I really like this website: https://www.cci.health.wa.gov.au/resources/looking-after-yourself, there isn't anything specific to OCD but there might be some useful information in health anxiety modules.

Im amazed that someone would think this or not understand that gagging is a really common physical reaction to lots of things and sometimes your throat just does it. If Ive been in a long meeting where I have been doing most of the talking I can get it.

You do need to check with the other GP as it is definitely not recommended to take fluoxetine and sertraline together. Also, if the intention was to switch from fluoxetine to sertraline, you need advice on how to do a controlled switchover.
It sounds like the GP was out of his/her depth

You’ve been given different medication, have a review in 2 weeks and have been referred to the mental health team. The GP has taken you seriously and completed three action points. There’s no quick fix to this and everything that could be done at this time was done.
I realise this is all extremely difficult for you to deal with and you have my full sympathy. There is a process to treating conditions which is what the GP is following.

Are you able to go out for short walks- ideally amongst nature eg a park?

Have you ever tried simple breathing techniques to help you calm down? Perhaps this is something you could try. It’s a helpful life skill for many people.
And/or can you focus on a small task to get through the next couple weeks until your review and go from there?

Hope you get the answers you need ❤️

Hi
i have OCD (alongside bipolar) and whilst my OCD isn’t around being sick I know how hard the anxiety and rituals are. Two things that have really helped me is finding a private psychiatrist and taking anti psychotic medication (in my case olanzapine). I was very reluctant to take the medication initially - the term anti psychotics was really scary to me - but it has honestly changed my life. My OCD is now under control and I can do the things I enjoy without being consumed by anxiety. You can also take anti psychotic medication alongside fluoxetine so it might be worth speaking with your GP about your options.

I think you need to look at EMDR therapy. It helped me lots.

One of my children has severe OCD and CBT didn't work but found exposure response prevention therapy really helpful. It was quite a slow process but worth it in the long run. Might be worth asked your regular GP/therapist about it. We found the OCD UK website helpful and I think they might have support groups as well although we never looked into that.

Thank you everyone for your responses, I don't know what I was expecting but I thought I'd be told how pathetic my problem is - so thank you for your kindness and sharing your experiences I really do feel lighter.

I'll have a look at Thrive - I think with work we used to use / recommend a Thrive app to patients, I wonder if it's the same thing.

@QueenOfHiraeth I definitely will check that, I don't want to come off fluoxetine and switch to sertraline if it's not needed either because I remember the hell that was settling onto fluoxetine and I wouldn't want to go through that again if it's not needed. I didn't get any information about whether to switch or take together so I'll hold off for definite until I have that confirmed.

@Studyunder Thank you for your post - it helped give me perspective that the appointment wasn't a lost cause. I think I just felt frustration with it not being my GP and not what I expected, but things have happened and I can appreciate that. I get out quite often on my bike in nature which helps, I have good coping strategies for most of my OCD symptoms and triggers luckily.

@CleverQuacks I've never known much about anti-psychotic medication, I'll do some research and see if it's something I can bring up at my next appointment. It's worth a discussion at least - and if it helps, even better.

@LemonBeagle @Witsend101 when I was referred to the CBT the other year there was some discussion of EMDR but ultimately the CBT seemed a better option - then didn't really help. I'll look into it, I can't remember why we didn't go with it but I will try anything.

OP, I wonder if this is something EMDR could help with. It's a tough treatment, but works like magic for somethings.

@Aknifewith16blades I'm going to find out whether that's an option for me - I think it looks like a really good potential the more I read about it.

Thank you for your posts everyone. I feel like I can make a start to get past this. I've just self-referred back to the place I previously did CBT to discuss EMDR as a potential (hopeful) option.

In the meantime, I will keep on with my usual medication. I'll wait and see what the referral to the mental health team does as well.

My first step and my goal is to just have a short drive with my wonderful DP. I hope I can come back here and say I've done that.

Hi @ElleBelleLou , I have no advise sorry but your OP shocked me because my dc2 is exactly like this. They are 10 and are being tested for ASD.

They are fearful of vomiting/getting sick, stopped eating outside the house, will only eat limited 'safe' foods, and have ocd washing hands, needing clothes sparyed with disinfectant.

Im going to look into EMDR for dc also after the recomendations on this thread.

Can you ask to be referred to a specialist OCD centre there’s an NHS one in London CADAT. I think you need intensive help. You could also ask to try anti psychotic medication.

@Shitstix I am so sorry your poor poor DC is the same. My DM was less than understanding when I was younger, telling me to get a grip and stop being ridiculous. Even back when I was in Year 4 I stopped eating for weeks following a sickness bug that went round the class, until I actually started vomiting myself from not eating somehow? I was so poorly and even then my DM was just angry.

You sound so supportive, and it will hopefully make the world of difference having you behind them and getting them help whilst young. Well done ❤

As someone who ended up in hospital due to my MH, your GP is not qualified to support you. You need secondary services to assist you. Ask for a referral to the community mental health team.

The condition I had was only 3 hours of the training for GPs, one recommended a hot chocolate, another recommended a "book for dummies". They don't have the training (or even the time in a 10 minute appointment).

There are other therapies besides CBT but you'll usually need to go via the CMHT to access them.