I am studying at canada. I had been to india for a couple of months recently where I was diagnosed with ocpd. I was prescribed nexito plus initially & after a couple of weeks doctor advised to switch over to nexito 5 mg. Things were more or less in control with the prescribed medicines in india. Now, I am back to canada & still having the medicines. I have increased my physical activity for my improvement but I am finding the panic attack once again returning back. The heart beat also turns rapid at that time. I am unable to understand why it is relapsing once again. I don't have much study pressure right. Can you please tell what might be the underlying cause of the same & what is the remedy.
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Dear lybrate-user, nexito plus contains a benzodiazepine in addition to escitalopram. It was given to you for a couple of weeks so that you get the benefit fast. Escitalopram takes 2 - 3 weeks to act. Now that you don't have benzodiazepine, you feel the fast heartbeat and panic. It is not good to depend on benzodiazepine to relieve your anxiety at this young age. You can learn jacobson's deep muscle relaxation, you can undergo therapy or you can practice yoga and pranayama to manage your anxiety. Having said all these, I would like to remind you that vigorous physical activity increases the heartbeat. You may become panic on catastrophizing it. The remedy is not stopping it. But to wait for heartbeat to normalise after few minutes. It is perfectly normal. Â
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Dear Lybrate user, People with ocpd generally are perfectionists with rigid attitudes and behaviours and also have high conscience in terms of interpersonal relationships and their own life values. These kinds of traits may cause feelings of anxiety/low mood on and off in interactions with others (high expectations from others to comply with). Nothing to worry about your symptoms that you have mentioned. You are in need of psycho education about your condition and there are a handful of treatment techniques from COGNITIVE BEHAVIORAL THERAPY (Relaxation therapies) from which you may benefit to a great extent. You can approach me through Lybrate if you need further help. Â
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The medicine might be working less. You need to consult a psychiatrist either in person or online and escitalopram (nexito) dose may be required to be increased to 10 mg to control the anxiety/ panic attacks. Ocpd/ anxiety have serotonin as the common neurotransmitter implicated. Good luck. Â
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You may have had symptoms at an earlier time in your life. Ocpd is a fear-based disorder and if the fear is not identified and dealt with in therapy, you could continue to suffer. I suggest that you seek the help of a counselor too. The behavior will then become based on magical thinking and certain rituals will become necessary to do normal things making you believe that either the frequency or the ritual is important to its success. This of course is a fallacy but there will come a time that even if told the truth, your belief will defy any logic and you will continue behaving like that even if it cripples you in your daily routines. It only appears as though some other force is behind these behaviors and that you are compelled to act in this fashion. That is obviously not true but no one can convince you of anything different. The obsession is a repeating thought pattern with no meaningful outcome; and the compulsiveness is the need to act on those obsessions also in a repeated behavior pattern as though you just cannot help yourself. This is all driven by fear and when you are frustrated with it, you will escalate anger over it. Doubt, insecurity, uncertainty, and lack of firm memory will all plague you and increase stress. There are certain behavioral techniques to be implemented and if they work you may get out of this condition rather easily. Â
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