Home Anxiety What should I do about therapy?

What should I do about therapy?

by Dr. Marie Hartwell-Walker

Q: Currently my life is completely unmanageable. Im not in therapy at the moment, but do see a pdoc once in awhile for meds. I am on Luvox for OCD and my dose was just doubled. Im an alcoholic and currently not allowed to leave my house because my parents are attempting to control my drinking. Im also working on not drinking but not having too much success. I started drinking because I was depressed and wanted a way out. Now I drink a lot to try and help me function (even though it helps with some things, it makes others worse). I find that if I drink enough the night before, I can actually shower and get ready in the morning, otherwise, I cant handle it, I get panic attacks and usually just spend a few hours showering and then go to sleep because im so exhausted from just trying to get ready.

My OCD is currently completely running my life. Partially because of the OCD, other life problems, and the whole alcohol situation, im very depressed. I was drunk the other day and tried to overdose, but my mom caught me, and I ended up just puking a lot and being okay. I also have been cutting for 4 years and have now lost control over it. Once I start I cant just stop until usually im bleeding badly from my wrists or legs. Im covered in cuts.

Due to all this I am thinking that maybe I should be in regular therapy. Im not sure though. Some part of me worries that maybe I don’t need therapy and that I should just try to tough it out and hope it gets better. I feel like a worthless wimp. Do you think that this would be a good idea?

Another reason im hesitant about therapy and worried about getting the point across to my pdoc is that when im talking, I cant talk about serious things. I just go straight to really shallow, dumb talk. Like joking and being sarcastic. Its like I don’t realize that I did it until after the appointment and nothing has been accomplished at all. Then I beat myself up for days. Do you have any suggestions as to how I can keep myself from diverting everything away from myself and really open up? Like maybe something so I can slow down and really say whats on my mind? It’s like I freeze up and go brain dead. I need to do something as I feel that I am dying. I think about killing myself all the time, I just can’t take it. I plan to hold on though because it would kill my family. I love them very much and couldn’t do that to them. But i’m still worried about it nonetheless because i have little control over the cutting, try to kill myself when drunk, and feel as though I am just losing general control of myself. Please any advice would be appreciated.

I read your letter with great concern. You are right. Your life is out of control and you need more help than your current doctor can give you. You needn’t feel like a wimp for being unable to manage all of this. It’s hard for me to imagine anyone who could handle this on his own.

My best advice is to follow your own advice. You definitely should find yourself a therapist. You need to find someone who is experienced with both addictive behaviors and OCD. In your case, the two are probably related. An addictions therapist who isn’t also conversant with anxiety disorders probably wouldn’t be helpful to you. Interview several therapists on the phone before you settle on someone. If you think you’ll have trouble with those conversations, ask your mother to help you.

As for your self-defeating behavior when you see your doctor: You have already taken the first important step toward a solution. You write articulately and with considerable insight. Take the letter you wrote to me to your next appointment and ask the doctor to read it before you start talking. It will give him or her the information he or she needs to even begin to help you. Also share the letter with your therapist to give him or her a reasonable chance to be helpful. Consider keeping a daily journal of your thoughts and feelings to bring to your therapy appointments as a way to stay on track.

Your problems are big but not unsolvable. Experienced therapists have seen these kinds of things before and will be able to help you if you give it a chance.

I wish you well.
Dr. Marie

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