Perfectionism and OCD

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Greetings!

I have a couple of questions:

Is perfectionism a manifestation of OCD?

What drugs do you give to a person for OCD? Is Risperidone one of them? and/or can Risperidone cause OCD to become worse?

I want to better manage my son's medication since I don't like his psychiatrist and I'm in the process of finding another one. Unfortunately this is a new area for me and I don't really understand brain chemistry and medication.

Thanks!! !! !

I don't agree with using drugs as an attempted cure to issues pertaining to the autism spectrum. Anti psychotic drugs are absolutely awful and can shorten someone's life span and even cause brain damage over long periods of use. People who absolutely have to take them don't like the side effects of those drugs. You're far better off seeking proper cognitive behavioral therapy that's tailored to children/adolescence on the spectrum. Drugs need to be a last resort. Perfectionism can be related to OCD but in an autistic it might actually be a good trait to have much like a special interest. It could even be the result of underdevelopment in other cognitive areas. Aside from a psychiatrist you also need the proper autism specialist helping you out with your son's over all development, drugs are not going to help him in the long run if there is no support in the areas he needs it most.

Whilst I understand your frustration with the psychiatric profession, it is probably not to be recommended to seek medical advice of this kind on an anonymous Internet forum like this or to second-guess the professional advice of your son's psychiatric or medical doctor.

Regardless, hyper-perfectionism is a diagnostic criterion of obsessive-compulsive personality disorder and not obsessive-compulsive disorder:

My son has been in therapy for several years, and he goes to a private school specifically for kids like him. I have tried everything to help him with his perfectionism and impulse control and other things that he has issues with without medication. It was the recommendation of his therapist that I seek drug intervention. It is NOT at all the road I want to go down, but his therapist does not recommend medication unless it's absolutely necessary, and he feels I have no choice. I love his therapist and trust him totally. His therapist does not recommend medication unless he feels that the child needs that to respond to therapy, and it makes sense because since he started taking it he's gotten so much better. At the time I started the medication he could not interact with another child for 10 minutes without it turning into a conflict. He did not want to hurt people, but he could not control his impulses and it was eating away at his self esteem because he can't control himself and he's is self aware enough to get that. It was breaking my heart. On this med it was wonderful to see his self esteem coming back with his self control and he was doing great, until a few weeks ago.

Risperidone has helped in so many ways, but I feel it's causing him anxiety and depression. Yes, he can control his impulses now but I feel there is a high cost to this self control. I would rather have a child that is aggressive and impulsive than a child that hates himself, is depressed and afraid all the time. I think that the risperidone is causing the significant increase in anxiety and the sadness he says he feels all the time.

The psychiatrist put him on this because he has a diagnosis of autism and he has aggression issues. This is the drug du jour for these kids. I talk to his psychiatrist about things he is experiencing and I feel he isn't listening and I'm having my reservations. With something like this I need to trust the person messing with my son's brain chemistry and I don't. This is a very uncomfortable feeling.

During this process I started thinking about my son and what is really going on right now. I started looking into OCD and OCPD because the OCD things I know he has are starting to become more prominent. Then while reading about this I started to think that maybe the autism diagnosis may not be correct, and all of the issues he has seems to fit OCD. If he does not have autism and this is OCPD instead, along with his language disability then would his doctor have given him this particular drug or would he have started with a different one. I didn't realize that perfectionism is part of OCD. I don't have a problem with perfectionism per say, but when it keeps you from doing something because you are afraid you can't do it perfectly, I'm sorry, that's not healthy. This kid has a lot of potential, but if he quits at everything because he can't do it perfectly the first time he's never going to be able to do anything. The perfectionism is not helping him, it's hurting him.

Last edited by MommyJones on 08 Feb 2012, 8:30 am, edited 1 time in total.

I want to clarify that I am NOT trying to, nor do I want to cure my son. What I don't want is for him to feel like he's a piece of crap because he can't get along with anyone and he doesn't understand why, or what he does understand he can't control and he constantly beats himself up over it. The perfectionism that he has is so bad that he feels like he's a failure at everything, and I'm sure that is the reason for his depression. He works his ass off and feels as though he gets nowhere. He can't appreciate a 98% is a good grade. It's not, he failed because he didn't hit 100%.

I want to help him deal with the difficulties he has with his brain function, I don't want to cure him. It's heartbreaking when your son sits there, covers his eyes and says "why is my brain doing this to me?" . The kid is FULLY aware of what is going on within him and wants help desperately.

I'm trying to understand OCD better, I'm trying to figure out what I really should be focusing on, and I want to know what medication is right for him, and I want a doctor that I can trust to figure that out. I'm not going to be able to do that if I'm ignorant.

I also want to clarify that I understand the nastyness of antipsychotics and it is my last resort. This is something that I was only going to give him for a year, and if another type of drug can help him without the side effects of Risperidone then I would rather do that. This is a new territory for me and I seek to understand. He does get proper therapy, everywhere he goes. He's with great people. It's not enough.

Agreed. Psychiatrists tend to be overextended and seem hurried to prescribe a magical pill based on a quick clinical impression followed by adjustments to the medication during follow-ups. It does leave the sense that they're playing around with psychotropic cocktails they don't fully understand, especially since the organ they're targeting is the seat of the mind, where we derive our core sense of self.

Especially antipsychotics, including the atypicals, come with real side-effects. They're tranquilizers. Still, you should probably be looking for a psychiatrist you feel is a better fit for you and your son than asking for medication advice here, in my opinion.

I knew a guy who was on Zoloft for his OCD and it seemed to help. That's just an SSRI, not an antipsychotic.

Yes and no. As an Aspie, who is also a perfectionist (with a bit of OCD), I feel there are different types of perfectionism. I know my OCD areas also hold to a strong sense of perfectionism that is strongly linked to order & neatness. But there are other areas of my life I'm a perfectionist with just because I'm a perfectionist overall.

I know other people who are perfectionists, but don't really have any OCD tendencies. While people I know with OCD do seem to also have a perfectionist streak to some degree, but I think a lot has to do with what type of OCD tendencies you have.

Hope this helps.

Please let me clarify. I'm not asking for anyone on here to direct me to the proper medication, I want to feel that I am making the right decision, and if I don't understand anything about medication then I'm trusting someone blindly. I'm not comfortable blindly trusting someone, especially with this.

I want to be educated, I'm not looking for treatment options. The reason I asked about OCD and Risperidone is over the last few weeks his obvious OCD traits seems to be getting worse, and I believe I read somewhere that this drug may possibly help with OCD even though it's not used for that specifically, so why would his OCD be getting worse IF that is true? There are a lot of scientists on here. Someone may be able to explain that. I also started looking into OCD because of this increase and read about perfectionism and OCD. This is where the perfectionism question came from.

This website is one of many resources. Someone on here can say one simple thing that can give me amazing insight just because I never thought of that before.

Thank You!

Sorry I didn't know you were already at that point. There was just too much vagueness in the first post and it came off as potentially being a different kind of situation. I'm glad that there is much more to your story, and I'm also very sorry to hear that your at the point where medication may be necessary. I totally get what your trying to do. Trouble shooting with other people's experiences for potentially better options to discuss with the doctors is still an incredibly wonderful thing to do. As far as drugs go if it ends up being completely necessary I'd also recommend asking about anti depressants "SSRI" rather than an anti psychotic. It's a little less damaging, and has been used for both depression and OCD.

I'd also like to elaborate on my own experiences with OCD and depression. When I was a child I was very depressed, and I realize that to an extent it was because I just wasn't picking up on stuff other kids did. I saw the world very differently than I do now. I thought that everything that happened around me was absolute and that other people didn't make mistakes and I was the only person capable of making a mistake. This was because no one was helping me with my learning disabilities or social understanding. I couldn't read what was going on in my environment around me. I couldn't understand why other kids picked on me or why I was having trouble in school. When I was in high school I started getting better marks because the teachers were a little nicer to me. Now before that I did very poorly and my parents always acted like it was the end of the world that I was constantly failing at things. So what happened when I started getting better marks I started expecting perfection from myself because it was the only thing that made me feel like I wasn't a failure at life in general. I had to be the smartest no matter what. That was bad because I still didn't get social stuff. Even though I had high marks I was getting low scores on group activities and I was emotionally devastated. To an extent I didn't even understand that it was ok to be imperfect at anything in life because no one "showed" me that. I didn't become more relaxed about it until recently. The hugest concern I feel there should be is if there are things your child still may not have the ability to communicate you. OCD can occur with autism but symptoms of autism can manifest like OCD, but have different causes than OCD. He could be distressed about sensory issues he's having, he could have strong special interests that seem overly obsessive, and he could not be properly communicating that he's struggling with certain sensory problems or that he genuinely is not understanding his environment properly. I don't know if this will be any use to you, but I hope that you do find useful information from WP.

Hi MommyJones

I'm taking Fluvoxamine (aka 'Luvox' or 'Faverin'), an SSRI for my OCD.

'Perfection' is usually a part of OCD.

Although, for Asperger's I noticed the OCD is likely to be Ruminations and the 'mental' aspect of it - like thinking through things over and over, instead of the typical/general idea of arranging and sorting things out physically.

My o.c. is of the worrying/rumination sort.

Hope that helped,

Cheers and Blessings
skribble

Thank you Skribble! I do this myself to an extent so I would be willing to bet his OCD is like yours. It seems like it causes him so much anxiety. Since the Risperidone is making my son's prolactin rise they took him off. I spoke to the psychiatrist about possbily taking a different approach, so he is weaned off of the risperidol and they put him on Lexapro. If the anger comes back he said he could give him a little Abilify, but we aren't going there yet. So far so good, but it's really early in the transition.

Wish me luck!

You are most welcome my friend

I read your earlier post about your thoughts and research on OCPD. I had actually researched that too about 2 to 3 years ago, OCPD, when I was trying to understand myself better and was unsure of so many things.

I have to add that it may seem very confusing at first.. Asperger's, OCD and OCPD.

Asperger's is most certainly not OCPD - the main highlight being the 'lack of social skills' or ability to interact well with others in Asperger's. (I'm not a doctor and am not claiming to know everything specifically) but do take note of that, for the different "diagnosis types".

As for Lexapro aka Escitalopram, it made me really sleepy. Too sleepy to function in daily life.
But, as always all medications work differently for everyone. There are people with success stories for Lexapro, although once again, their success stories may be single-handedly suited/crafted to their individual condition - for example, even if they state the same thing "I have asperger's and ocd", it could still vary in degree, which may lead to success for them but not for other people. You get the idea

Fluvoxamine makes me a tiny bit sleepy, but I can live with it if it's going to aid me for my condition.

All in All, medication is not a 'cure all'/panacea.
As supplements to the entire mix, Cognitive Behavioural Therapy (CBT) and Exercise/Physical Energetic Activity are always positive reinforcements


Thanks for your time and for listening. Best of Luck!

- skribble

Thanks Skribble for your support! The medication thing is really not a road that I wanted to go down, but it just got to the point that nothing was working anymore. Social skills and CBT have been difficult for him because even if you suggest a different approach or way of looking at things he takes it that as he's wrong, which ALWAYS translates to bad which causes him to be depressed and angry. I'm very careful to validate his feelings, but offer another way of looking at it as well, but he doesn't always take things that way, and I don't know that until long after the incident is over because he internalizes and dwells before he says something. To him, it's one way or another...black or white...there's no gray, then he can't get past that. It is the opinion of his therapist that he needs medication to help him respond to therapy. My intention is this to be a short term solution until he develops some self esteem and maturity, and gets more CBT under his belt to eventually be able to cope without either, and I believe he will get there. It started with anger control, but I think the anger stems from his constant feeling of failure and that he is a horrible, bad kid. The OCD behavors don't bother me, it's the horrible feelings he has toward himself that does. It got to the point with his speech therapist working on social skills and pragmatic language that it just frustrated him because he knows what to do, he just can't control his reactions to things. This is when I went to a psychologist. My son is wonderful when he's in a good place, he scares me when he is down. He gets so angry and impulsive he'll get himself hurt. I've seen it happen to a small extent, and he would have been more hurt already if it wasn't for me watching him constantly. His therapist says he has a little of this and a little of that and he encourages me not to focus on one thing. It's hard to figure out what is the dominating issue and what is the symptom and what gives him the most trouble and where to focus. I also have changed his therapy to group every other week and one on one every other week. His therapist says he's having good peer experiences so that is encouraging. He also goes to a very small school where he gets a lot of love and attention, and they work with him socially and emotionally. It's a great place but is in danger of closing. I pray every day they stay open because he will never be able to handle public school. It will crush him.

Anyway...thanks for listening!! !!