OCD, cannot afford therapy

[Els]

I had known for a while that I had OCD, but I had not really known how much of my psyche was actually caused by it. Recently, I did a lot of research and found out that besides being the reason for about 5 minor things that I do compulsively, it's also the reason I have horrifying thoughts stuck in my head that I feel I have no control over (for hours at a time, sometimes), my insomnia (there are about 20 things I cannot sleep with/without, and I spend a good bit of the first 30 minutes checking and re-checking what I might not have done), and several other things.

 

I took an online assessment from a reliable site. Not as good as a real psychology test, I know, but I ticked off maybe 75% of the boxes. It scares me.

 

The thing is that I'm a foreign student. If I get diagnosed, I may not be renewed for my visa, and it may count against my PR application. No, being sent back to my third world country will NOT help. I hated it there, and they don't have psychologists anyway so it will be a moot point. Your guess is as good as mine whether or not this is true, since there have been no official statements about it, but many people say that first-world govts don't want to subsidize preexisting conditions, so sometimes they turn away people who have them. I don't even care about the subsidy in the long term, but I do really, really care about the PR.

 

I'm not sure what to do. Besides the possibility of a medical diagnosis screwing my app over, a psychologist costs $150 an hour here. There are no disability benefits or subsidies for foreign students and my student insurance does not cover it.

 

I guess I'm weighing whether or not it'd be worth it to get help. Besides drugs, is there really anything a psychologist can do for $150 an hour and the possibility of being sent back to my country, that I can't do with self-help? Can anyone who has successfully managed OCD weigh in?

 

And if I were to do self-help, where would I start besides books and sites?

Edited October 12, 2011 by Elswyth

[january2011]

They will be able to give you some strategies to deal with your condition and guide you in managing the condition. I would say that it's worth going to at least one session.

 

Could you access a psychologist-in-training? In my location, there are clinical psychology students who are qualified but doing the clinical portion of their training. They are also supervised by a trained and qualified psychologist and so aren't just 'let loose' on patients. It might be cheaper or even free.

 

With self-diagnosis and self-help, you don't know that you are heading in the right direction. You also have to be pretty self-aware to navigate the dark waters when you don't have a lighthouse to guide you, so to speak.

 

Other than books and sites for people with OCD, I'm not sure there are other resources out there. You could talk to your support network but it's unlikely that they will understand your condition nor will they be able to give you the specific help that you need in managing the OCD.

 

Regarding the immigration status, I'm not sure how to advise you. I feel that you need to speak to a professional or perhaps even post on a website where people have experience of PR and visas. Though it's no guarantee that they will be able to answer your specific questions, they might be able to give you enough information to get you on the right path.

[whichwayisup]

The Feeling Good Book by Dr. David Burns.

 

Been There, Done That, Try This! By Sam Obitz.

 

Claire Weekes books are also good.

 

Go to your local library or bookstore, all these books should be available, and more. Just google books about OCD, obsessive thoughts, negative thoughts.. Some good titles will come out about those as well.

 

I don't suffer from OCD, but I do suffer from anxiety at times, it's under control now with the help of Cognitive behaviour therapy (google that, maybe it's affordable for you) this therapy is great and it truly does work. Might be less expensive than a shrink.

[Feelin Frisky]

The $150 to a non-prescribing psychologist for OCD is not a good use of money if it's in short supply. OCD need medication (like Luvox) because if you were good at policing yourself, you would already do it. I don't know what the countries are that you're stuck between but real psychiatry is about physiology and not psychology. Go to a doctor and press the issue that you need medication and you don't need a lot of stigma. You may get lucky and find a compassionate physician or one with a colleague who will just medicate you and see you once a month. I can't imagine losing any rights for getting help with OCD but it's a weird world. Best of luck.

[carhill]

IMO, your first stop could be your university psych department. I know the Uni in Auckland is always running psychological research projects and likely has psych services available to students. Your Uni should as well. If nothing else, they could direct you to local real world resources.

Here's a link to the INZ manual

 

My understanding is that they decide the disposition of visa applications where psychological issues are a factor on the basis of the type of issue and potential burden on the NZ health services for treatment.

 

My advice would be to read up on the relevant guidelines and then approach treatment in a manner which is potentially efficacious but less likely to trigger a review if/when your visa is up for renewal/consideration. There are ways of dealing with bureaucracies which meet their 'hoops' but get the job done.

 

Given what you've described, I think some professional help would be helpful, even if you possess the intellect and control to implement self-help. More tools are better, IMO. Good luck.

[PegNosePete]

I can't really advise what to do in your situation I'm afraid. What I can do is tell you my experience of OCD and what helped. It was not be suffering from it by my ex.

 

The best "cure"is cognitive behavioural therapy. How you would go about geting this in your situation, I don't know. Self help, I don't think would be very effective for OCD. When administering self-help you tend to cover up the symptoms or manage the situation, rather than actually curing it. Therapy such as exposure/response therapy would be extremely difficult to self-administer.

 

Drugs can help but they are not a cure, they just cover up the symptoms. My ex was bounced around from one drug to another, each one would help for a month or so but then become useless so they just changed to a new one. I think she went through the whole alphabet.

 

In the end my ex could not get any CBT due to the appalling state of the mental health system in this country. They just stuck her on drugs and waiting lists endlessly, and kept changing the diagnosis. She just got worse and worse, couldn't work or live properly. She became VERY good at covering it up though, so she could still go out and appear to be having a good time - but inside, she hated it. OCD left unchecked can be debilitating.

[KathyM]

Behavioral Therapy is what is often implemented for people with OCD. Some of the methods used in Behavioral Therapy to treat OCD include aversion therapy whereby visualization is used to make the repeated behavior appear less appealing to you. For example, if you repeatedly washed your hands to an excessive degree, you may try laying down, closing your eyes, relaxing, and visualizing washing your hands over and over again. You would picture washing your hands one time before eating a meal and imagine seeing the germs being washed away, but then picture washing them again right away, and visualizing the skin being washed away. The goal is to get your mind to accept what is normal and develop an aversion to what is not normal (repeated hand washing) through negative visualizations. One other method used is called "Satiation", whereby you purposely repeatedly do that which you are trying to stop doing to the point of satiation. For example, if your OCD causes you to check if the stove is turned off repeatedly, you might try spending an entire day going to the stove to check that it is off over and over again to the point that you are so tired of it, the last thing you want to do is go there. Another method is thought stopping and distraction. If you find that you are having repeated thoughts that you are stuck in and can't seem to get out of your head, then you have a plan that as soon as that thought comes to mind, you will immediately think about or visualize something else that is more positive. Have in mind what you will avert your thoughts to beforehand, and then when you feel the compulsive thoughts coming to mind, you switch to the more desirable thoughts, and switch it up from time to time as to which thoughts you will divert your mind to. Another technique is substitution, whereby you substitute the compulsive action for a more positive activity. For example, when you feel the urge to check if the stove is turned off, you stop yourself and do something more productive or positive in its place, such as to call a friend or go for a walk. Have in mind some positive things you could do instead so that when you feel the urge to do the compulsive activity, your mind will be ready with the substitute activity. OCD can be managed through Behavioral Therapy without the use of drugs, although a lot of people find that medication has been very helpful to combat this disorder. If you are afraid to go to a university mental health counselor for reasons you mentioned, you may want to make just one appointment with an outside counselor and pay out-of-pocket just to see what they have to offer. Maybe they will prescribe the medication right from the start and you won't need additional visits. They are bound to keep everything you tell them and any records you give them confidential.

[Els]

Thanks for all the help, guys! RL got crazy for a bit so had not had the time to post after making this thread.

 

I'm considering everything y'all are saying, and I'll probably get the books and talk to a Uni counselor (they have free counselling services, though the people who do them are definitely not psychiatrists and do not prescribe) once the hectic stuff has dissipated a little.

 

Confidentiality is not a guarantee where medical visa stuff is concerned, you are legally required to tell them about everything you have been medically diagnosed with, and failure to do so is lying on your medical. However, I don't think counselors can diagnose.

 

I thought they did not prescribe drugs until CBT is attempted and fails, btw?

Edited October 16, 2011 by Elswyth

[Kamille]

When do you plan on applying for the visa?

 

I struggle with anxiety and some obsessive behaviors (but do not register as OCD), and, as far as I know, whether you want to start with therapy, or a combination of drugs and therapy is really up to the preference of the patient. After all, in psychology, the patient making autonomous decisions about their well-being is an important part of treatment. What you decide is probably what you're comfortable with and therefore what is best for you.

 

I do hope no doctor prescribes drugs alone, without therapy. That would not make sense to me at all as a way to treat anxiety related disorders (as OCD tends to be).

[Els]

In a few years' time, K. They do turn down people with high medical costs, quite routinely. I'm pretty sure OCD doesn't have high medical costs, but it's not something I want to risk...

[Els]

For example, when you feel the urge to check if the stove is turned off, you stop yourself and do something more productive or positive in its place, such as to call a friend or go for a walk.

 

See, that's the problem. How do you know when it's just OCD thoughts and when it's just being careful? Where's the line? I COULD make myself not check but there have been a few occasions where I checked and actually DID leave the stove on. Those would have been calamitous had I not checked. In fact, there was one time I left the stove on, did not check, and only found out the next DAY. I'm still thanking my lucky stars nothing happened.

 

I guess a good boundary could be if I had already checked once, I resist the urge to check again 'just in case I saw wrongly'.

 

IMO, your first stop could be your university psych department. I know the Uni in Auckland is always running psychological research projects and likely has psych services available to students. Your Uni should as well. If nothing else, they could direct you to local real world resources.

Here's a link to the INZ manual

 

My understanding is that they decide the disposition of visa applications where psychological issues are a factor on the basis of the type of issue and potential burden on the NZ health services for treatment.

 

My advice would be to read up on the relevant guidelines and then approach treatment in a manner which is potentially efficacious but less likely to trigger a review if/when your visa is up for renewal/consideration. There are ways of dealing with bureaucracies which meet their 'hoops' but get the job done.

 

Given what you've described, I think some professional help would be helpful, even if you possess the intellect and control to implement self-help. More tools are better, IMO. Good luck.

 

Thanks, carhill, that really helped! I have read the manual, but it is not terribly specific, and I also did not want to refer to it or my plans in great detail here. Perhaps when I have a better idea and more time to deal with the issue, I could send you a PM, if you don't mind?

 

The $150 to a non-prescribing psychologist for OCD is not a good use of money if it's in short supply. OCD need medication (like Luvox) because if you were good at policing yourself, you would already do it. I don't know what the countries are that you're stuck between but real psychiatry is about physiology and not psychology. Go to a doctor and press the issue that you need medication and you don't need a lot of stigma. You may get lucky and find a compassionate physician or one with a colleague who will just medicate you and see you once a month. I can't imagine losing any rights for getting help with OCD but it's a weird world. Best of luck.

 

I read that CBT is the first-line therapy for OCD. The bf thinks exactly the same way you do, however - he's a freshly-graduated doc and insists that I don't have OCD because I'm not like the patients he sees in the psych wards who are on huge cocktails of anti-anxiety meds. I think he does not realize that the ones in psychiatric wards are very, very extreme cases, and that many OCDs get by with just a psychologist or therapist.

Edited October 16, 2011 by Elswyth

[Feelin Frisky]

...

 

I thought they did not prescribe drugs until CBT is attempted and fails, btw?

 

Not necessarily so. Start with a physician and stay with the idea of a physiological approach. Ask your doctor for help and either he may prescribe or refer you to a psychiatrist. It's up to the psychiatrist as to whether he or she thinks you need therapy as well. If you start off on a psychological footing, you'll likely run into a lot more stalling and "talk therapy purism". OCD is physiological and driven by a chemistry loop that needs medication to resolve--not months of trying to out-think it. IMO, mediation is no big whoop and there is nothing to be lost by trying it first and then trying to figure out how to behave differently through therapy.

Edited October 16, 2011 by Feelin Frisky

[carhill]

Since BF is a medical professional and works with disordered patients, I would tend to give his opinion traction. One aspect supporting it is that, unless he's an extremely altruistic individual, a hallmark of OCD is the inability to form healthy intimate relationships, as preoccupation with the disease factors preclude healthy attachments with 'normal' people. It's entirely possible that you have perfectionistic tendencies (checking 'minor' things and insomnia can indicate that) and associated anxiety which trends to OCPD, even if not precisely meeting the clinical description, but still can control them and form healthy emotional attachments.

 

IMO, as a non-professional, the fact that you can initiate, progress and sustain a long-term relationship with someone most people would likely consider to be 'normal' says that, if anything, your symptoms, while apparently distressing to you, aren't the specter of the OCD most clinicians would describe and obviously not what your BF is dealing with day to day in his work.

 

Can you see how trying to describe this and connect the dots to the disease can be anxiety-producing in and of itself? If this is interfering with normal life functions, whether the actual symptoms or your 'thinking' about them, I'd suggest re-prioritizing and getting it looked after. The process is a matter of reorganizing choices. Each day is full of them. Personal health is job #1. Good luck.

[KathyM]

Thanks for all the help, guys! RL got crazy for a bit so had not had the time to post after making this thread.

 

I'm considering everything y'all are saying, and I'll probably get the books and talk to a Uni counselor (they have free counselling services, though the people who do them are definitely not psychiatrists and do not prescribe) once the hectic stuff has dissipated a little.

 

Confidentiality is not a guarantee where medical visa stuff is concerned, you are legally required to tell them about everything you have been medically diagnosed with, and failure to do so is lying on your medical. However, I don't think counselors can diagnose.

 

I thought they did not prescribe drugs until CBT is attempted and fails, btw?

From what I understand of it, in America there are strict confidentiality rules outlined by the APA that govern all counselors and that require them to keep everything, and I mean everything you tell them and give them confidential unless it involves you being at risk of hurting yourself or hurting someone else. You are required to give all your medical information to them, but they are not allowed to give that out to anybody unless they have to bill your insurance company, and then it would be only limited information that they give. Maybe you can circumvent that by paying out-of-pocket for the services you get, and go to an outside counselor. A University counselor may have to disclose some information about students, but I would question how much they really are able to disclose also. They have to abide by APA rules also. So I guess I would suggest going to an outside counselor and paying out-of-pocket if you are concerned about this. And you are right that the therapist would have to be a psychiatrist in order to prescribe medication. Psychologists and counselors cannot prescribe medication, but they can provided CBT, and they can refer you to a psychiatrist if you both decide that medication is the route that you should go. I can't imagine they would terminate your visa if you went to a University counselor to get CBT for OCD. That doesn't sound right, but if you think there's any chance of that, you should see an outside counselor for your OCD. Some counselors provide services on a sliding fee scale based on ability to pay. I don't know if that is accurate that they only resort to medication if CBT fails. I think some are willing to go the medication route pretty early on.

[denise_xo]

From what I understand of it, in America there are strict confidentiality rules outlined by the APA that govern all counselors and that require them to keep everything, and I mean everything you tell them and give them confidential unless it involves you being at risk of hurting yourself or hurting someone else. You are required to give all your medical information to them, but they are not allowed to give that out to anybody unless they have to bill your insurance company, and then it would be only limited information that they give. Maybe you can circumvent that by paying out-of-pocket for the services you get, and go to an outside counselor. A University counselor may have to disclose some information about students, but I would question how much they really are able to disclose also. They have to abide by APA rules also. So I guess I would suggest going to an outside counselor and paying out-of-pocket if you are concerned about this. And you are right that the therapist would have to be a psychiatrist in order to prescribe medication. Psychologists and counselors cannot prescribe medication, but they can provided CBT, and they can refer you to a psychiatrist if you both decide that medication is the route that you should go. I can't imagine they would terminate your visa if you went to a University counselor to get CBT for OCD. That doesn't sound right, but if you think there's any chance of that, you should see an outside counselor for your OCD. Some counselors provide services on a sliding fee scale based on ability to pay. I don't know if that is accurate that they only resort to medication if CBT fails. I think some are willing to go the medication route pretty early on.

 

The way I understand it, the OP isn't concerned about confidentiality in the medical profession, but her obligation to be truthful to the immigration authorities. I've worked with immigration in my own country and they can be a real bit_h if they find out you've hidden information or lied, so from that POV I understand Elswyth's concern. If I were Elwyth, I would try to make friends with a law student/ lawyer and see if she can get a clearer answer to what the repercussions are, if any, of disclosing such a diagnosis when she applies for PR.

[carhill]

My understanding so far, from reading the manual and government 'opinion', is that, where she is, as an alien residing on a student visa, there are certain requirements for renewal and evidently potential burden on the public health system is one of them, with psychological disorders being an area which is apparently scrutinized.

 

I don't see an indication that she would be 'kicked out' if she sought treatment today, but she could be 'denied' when time for renewal came and this denial could interfere/disrupt her educational process, as well as impel her to return to her home country when she wishes to stay with her boyfriend where he is practicing.

 

That part is bureaucratic and there's probably a way around it; it's just a matter of figuring the right path.

 

The other part is finding efficacious treatment, if clinical treatment is indicated, and finding it in an affordable package.

[FitChick]

Do you believe:

 

I'm not important

I'm not good enough

Mistakes and failure are bad

 

OCD is a coping strategy for anxiety and feeling out of control. You can eliminate any or all of the above beliefs and see a quick improvement in your symptoms by using this free interactive website for The Lefkoe Method.

 

I've tried nearly every type of conventional therapy over decades, spent thousands of dollars, and at best only got temporary relief. You have nothing to lose by trying this.

[Anela]

http://www.lowselfhelpsystems.org/index.asp

 

Although I haven't been able to get to their in-person meetings, I've sat in on a few phone meetings, and they have had online support groups for about a year now.

[laurahill]

Thank for giving information about OCD..I am looking more detail information about OCD therapy.

[spiderowl]

Has your university/college got a free student counselling service? If they have, that would be a good place to start. The counsellor would listen to you and may be able to provide some helpful strategies or at least help you work out what to do next. They may also have contacts and know of low-cost therapists.

 

Look online for all the tips you can get too.

 

I don't know if a tip I discovered recently for myself might help with OCD or not. I do not have OCD but I find myself worrying and worrying and feeling very stressed about all the things I have to remember to do. I realised that the thoughts were in my head constantly because I was anxious (yes, obvious) and also because I thought I would forget them. Now, I've found a little notebook and I write everything down in there so I won't forget it. It gets the thoughts OUT of my head so they have no excuse to keep rumbling away in there.

 

I realise that with OCD you are constantly going back to things that you feel are not completed or might have not completed, so it's not the same issue, but I'm working on the theory that the brain has a compulsion to see something through and this is why it keeps prodding us with 'reminders' in the form of thoughts and anxieties. Maybe if you write each individual compulsive thought down it will dissipate the energy involved and let you relax and leave things more. Might be worth trying, I don't know, see what you think.

[Els]

The bf and I have decided that I am not going to see anyone about it. I really don't want to talk about that part of it further in this thread due to potential litigation issues, so let's focus on what I can do for myself. If anyone would like to talk about the former issue further, my PM is open. Thanks, Anela and Fitchick, I'll look those links up ASAP.

 

I don't know if a tip I discovered recently for myself might help with OCD or not. I do not have OCD but I find myself worrying and worrying and feeling very stressed about all the things I have to remember to do. I realised that the thoughts were in my head constantly because I was anxious (yes, obvious) and also because I thought I would forget them. Now, I've found a little notebook and I write everything down in there so I won't forget it. It gets the thoughts OUT of my head so they have no excuse to keep rumbling away in there.

 

Oh, I do that! But one of the symptoms of OCD is excessive list-making, so even if my lists help.. I'm not sure if they're actually just aiding and abetting the compulsion. I feel anxious about what I need to do, so I compulsively make lots of lists, and just write and write til I feel the anxiety dissipate. This could be a coping strategy.. but I guess it could be a compulsion too. How do I know?