OCD Diagnosis

Pretty.Odd.

At the moment I am very concerned about a close family member who is showing signs of OCD. He does not want to go to his own GP but is willing to discuss this and get help - he has admitted that his actions are not normal (after some talking to). Is there anywhere he can go for a diagnosis other than his own GP?

SuperRabbit

A psychiatrist can diagnose this. A psychiatrist is a medical doctor who specializes in mental health, nowadays usually that means diagnosis and discussing whether or not the person wants a prescription or a referral for therapy or both. There are private psychiatrists so s/he woudln't need a referral from the GP.

As I understand it it's often just one consultation and then once you have the diagnosis the therapist or GP can manage the therapy or medication. So because it's not a regular fee I wouldn't be put off by the price, if I remember right the last time I saw a price for a private psychiatrist it was 80 euro for a consultation. If the price is an issue hopefully someone else on the board will know how to do this through the medical card? I assume you would need the referral from the GP in that case

There's also the option to jump straight to a therapist but for OCD if it was me I would like to go to a psychiatrist to start with because there is so much conflicting information around

dar100

diagnosis is unhelpful. We have been moving away from this method of medicalising peoples experiences. A psychologist or good counsellor will use a case conceptualisation framework. For OCD the therapies showing effectiveness are exposure therapy, CBT, CT, if I recall correctly.

A good assessment is the foundation to work from. OP be careful with your approach with your loved one, trying to force therapy or take away a well developed coping mechinism albeit irrational can put said person at risk. All behaviour has meaning, and usually with OCD is is a defence against some sense of something terrible happening if said behaviour is not engaged in. anxiety is a funny thing. We have methods of dealing with it, medication is not needed, it serves no purpose, unless so extreme that any type of resemblance to a life is not possible

see attached stickies for counsellors/ psychologist

EDIT; link to research https://www.ncbi.nlm.nih.gov/m/pubmed/26117062/

SuperRabbit

Diagnosis is not unhelpful. That is a personal opinion and a controversial one, not an accepted fact. You just said it was unhelpful then you listed what would be the most effective treatments for it, surely it is helpful if it allows you to determine what will probably be the most effective treatments?

What if it's not OCD at all but OCPD, then different treatment is needed. What if it's not OCPD or OCD but something else?

A properly trained person, who can explain the options to the person, both medical and talk-therapy wise, is better than going to a counsellor from the IACP or IAHIP list, who has no training in medication, straight out.

( Just a side note, as you said CBT was best for OCD, (if it is ocd) but there are psychotherapists who say they do CBT until you get to them and find out they do not offer CBT at all! Such an odd system, I wonder if you know if the bodies accept complaints of false advertising? )

Medication is still considered helpful for many people with OCD and as we don't know how severe this is for the person I think the person should be allowed to make an informed decision (informed by an expert in all the options) on whether they want medication, medication and therapy, or therapy only.

dar100

a diagnosis represents a label, in the DSM a diagnosis is based within a category framework, i.e 8 out of 10 symptoms, its a medical model for a psychological issue. case conceptualization is what informs treatment and the treatment (theory/technique)in psychotherapy only accounts for a small amount of the treatment outcome variance. diagnosis doesn't help psychotherapy and has no science behind it. Example, diabetes you can go get a test and objectively be diagnosed, you will have the same symptoms as the next person diagnosed. This doesn't and can't happen with emotional or mood or personality issues.
They are pathologizing everyday experiences that we all have in one degree or another.

i agree far to many psychotherapists dont understand, nor know how therapy works, its awful. This is an indictment on training and lack of regulation thus far

medication for very short term use in extreme cases id agree with.

i dont buy into specific therapies for specific "disorders" CBT tried this and failed. Example, anxiety and depression were said to be specific problems with thoughts and cbt specifically deals with this, yet psychodynamic and emotional focused therapies work to?

il come back to this later, im walking two kids to school while typing

Freedive Ireland

I suppose a psychiatrist can subjectively diagnose things but not use any science in that diagnosis. Science could be used to rule some things out. Another psychaitrist could subjectively diagnose something else. You can't start bringing facts into psychiatry tbh and please try and stop calling them disorders.
Worth a read here.
https://www.madinamerica.com/2019/03/mental-health-concerns-not-brain-disorders-say-researchers/

OP this is a separate issue to what is going on for your family member and possibly unhelpful.

On the positive side he is willing to discuss, what does he think will help him best? He may be open to exploring different options to find the one that suits him best. That may be medication or may be talk therapy.
If it's medication check it out on hpra.ie and look through all the effects of the medication, download the pdf. See if it's worth going for or not. Above all, make it about informed choices as opposed to what someone thinks is best for him. This equates to better outcomes across all healthcare.

SuperRabbit

Do not trust people without any qualification in medicine or psychiatry to tell you what to do in terms of meds or diagnosis, simple as. Their opinion is just that, an opinion.

On the positive side he is willing to discuss, what does he think will help him best? He may be open to exploring different options to find the one that suits him best. That may be medication or may be talk therapy.
If it's medication check it out on hpra.ie and look through all the effects of the medication, download the pdf. See if it's worth going for or not. Above all, make it about informed choices as opposed to what someone thinks is best for him. This equates to better outcomes across all healthcare.

Great advice

dar100

the myth of the depression gene has been debunked. substantial research, see link. They are working from a model with absolutely no evidence to support it. We would not accept this from other disciplines, nor should we with psychiatry.

The DSM et al medicalize mainly social experiences based on some arbitrary symptom based category, where people can have markedly different symptoms or lack thereof, and be given the same "diagnosis"

Further, see below article smashing the neurobiology myth. No evidence has been established to support it


https://www.madinamerica.com/2019/03/mental-health-concerns-not-brain-disorders-say-researchers/?fbclid=IwAR0k1fejoLkV8m6lu9I-6VxlMaB7EvR9t19ZC5rOe97m5e7j4q3TsNXxJ2I


https://ajp.psychiatryonline.org/doi/10.1176/appi.ajp.2018.18070881

JuliusCaesar

I think you'll find that OCD is different to other general anxiety and depression diagnosis; it's one of the few diagnoses that is actual, specific, and usually helpful as the treatment path is clear.

See OCDIreland, OCDUK, OCD Action, OCDFoundation etc etc etc

The diagnosis is usually helpful to sufferers because they're often afraid of being the only person with this, that they are 'going mad', and because there's a clear treatment path.

OCD effects about 1.5% of people in any population worldwide. That's about 1 in 75 people. So it's a pretty common disorder - but kept very hidden as the sufferers KNOW there's something wrong but feel ashamed and don't tend to seek treatment.

And the stickies about Finding a Therapist/Counsellor will give the reputable professional accrediting bodies for CBT. Do not engage a counsellor who once did a weekend course in it. Accreditation give a baseline of education, qualifications, experience, but still can't guarantee quality.

caitb1

Hi I just saw this post, i have severe OCD and have bn off work for almost 3years now with it, it's really hard to go for treatment because u no that the thoughts are irrational and talking to people about them is really hard,even if the other person is understanding u still feel stupid as u talk about the thoughts that comeinto ur head and OCD can make u paranoid so u feel like ur bn watched which makes u more anxious,so talkin to their own gp cud b hard for these reasons, if ur relative has vhi I'd look in to going to one of the deen clinics from St Patrick's hospital the only thing is there could b a long wait, when I got very sick I was goin to have a long wait to c someone and the lady in the clinic suggested goin in to St Patrick's hospital as an inpatient to see a doctor, something I fought against but eventually I rang and said I'd go in,I needed a letter from a gp but as far as I can remember it wasn't my own gp that wrote it. I no someone else who walked into a&e and said they needed to be assessed and the got treatment straight away, lately iv started goin to bio energy healing and find that helps, anyway, I hope ur family member has got the help they need, I know how hard it is to go for help as it's like ur admitting u can't cope and that's not easy,I also no how frustrating it is when someone needs help but won't do anything about it,mental illness is horrible and everyone is different and take different lengths to recover,