Can you have ocd and just intrusive thoughts? no stuff you have to do just thoughts? well i do twitch when i think of the thoughts is that a compulsion? would anafiranil wwork for me?

today i just got moved up from my 30 mgs of celexa to 60 mgs? should that help the obsessions??

Hi Yushima1,

Yes, it is possible to just have obsessions - the intrusive, persistent, unwanted thoughts with OCD. While many people engage in compulsive behaviors in attempt to reduce the anxiety they are feeling, not everyone does this.

As for "twitching" when you have those thoughts - that sounds more like a reflex action rather than a compulsion. It would classify as a compulsion if you did it voluntarily - on purpose - in an attempt to reduce your anxiety. If it just happens whether you want it to or not (i.e. it's involuntary), then it isn't a compulsion (I hope that makes sense).

Regarding your medication - an increase in the Celexa may help your obsessions - but there is no guarantee. Medication is a tricky thing because everyone is different. What works for one person may not work at all for someone else. Often, finding the right medication and the right dose involves some trial and error. If the increase in dosage doesn't help, your doctor may decide to increase it again (I don't know the dose limits of Celexa right off hand), or he or she may decide to try another medication instead.

Thank you doctor, 60 is the highest dosage for celexa he said so that's where I am at right now. Right now my obsessive thoughts are focusing on ending my perfect relationship so that i end up in a mental hospital and live out my life in a institution... :( the thoughts suck!! :( i am trying to get into CBT aswell. is there any CBT stuff you can sugguest to maybe help me a little?

Also the twitching may be voluntary due to the fact that when i do it, it relieves some of the anxiety i feel and i feel ok for a second because its like a reminder that the thought is a bad thought.

Well, I can certainly imagine the anxiety you are feeling if you think you are going to live out your life in an institution. But, if it helps, I have never seen someone institutionalized (or even admitted to a psychiatric hospital) for OCD alone. That doesn't mean it never happens, but it's pretty unlikely. So, I encourage you to challenge that thought (as unrealistic) when it comes into your mind.

Which brings me to cognitive behavioral therapy (CBT). CBT is pretty involved, and it's a process. But, essentially CBT is based on challenging irrational thoughts and beliefs, and replacing them with more rational thoughts over time.

As you identify the irrational thoughts (such as spending your life in a mental institution) and challenge them, they begin to lose their power.

Your thought about ending up in a mental institution may be considered "catastrophizing" - you're jumping to the worst possible outcome of having OCD (and really not a very realistic one).

Whenever you have a thought that makes you feel anxious, challenge it. (I realize this is easier said than done, and it takes work.) Ask yourself, how true is this thought really? You took a huge (and illogical) leap from ending a relationship to living out your life in a mental institution. Why would one automatically lead to the other?

An example would be someone who says to himself - "I'm a complete failure" or "I never do anything right". Really? Challenge it by listing all the things you did right, all the times you didn't fail. Sometimes you have to start with small things you did right. Again, it's a process.

Here is a good article that talks about different types of irrational thoughts. http://psychcentral.com/lib/2007/identifying-irrational-thoughts/

You may be able to identify with some of them. When you do, start questioning how true the thoughts are. (This is just a first step until you get into CBT - which I think you will find very helpful if you do the work involved.)

I hope this helps a little!