OCD Questions.

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Is it possible for the nature of OCD to change over time?

Because I started out with severe fear of contamination / dirt. Now I still have that, but it has gone to a moderate level. However I have a severe counting obsession, and my ordering / organising / lining up / symmetry compulsions have become severe. Even walking on a pavement is hard for me because I have to walk in prime number / symmetry patterns.

Also, can anyone else here with OCD tell me if medications have helped them? I'm on Sertraline 100mg and this is the first medication I've tried for the OCD. It helps a bit with anxiety, but my OCD is still bad, and I had a near-meltdown in a tutorial at uni today (my support worker had to take me out of it), which is not unusual for me nowadays. I am also on Olanzapine and Amisulpride for schizophrenia, which should theoretically (according to my psychopharmacology knowledge) help with the OCD, but don't really, as my OCD was extremely debilitating before I went on the Sertraline (now it is not extremely debilitating, but it is still affecting my life badly).

Steel, let me be the first to say it's not for everybody, but obsessions, concentration, and mood stabilization are the reasons I'm a tobacco user (nasal snuff), though not a smoker. I can go without the stuff without the "addiction" problems, but when I do, I'm right back where I was when I began using tobacco when I was thirteen. What's more, there is now limited medical research confirming my experiences.

Maybe there is something out there that will work for you too.

My OCD comes and goes with exposure to Intrusive Thought-provoking environment interference. For example, I have contamination fears of parasites. Normally I'm fine, but if I see someone eating fish, It sets me off very badly.

I've found that Lexapro works wonders with OCD. It completely cured me of my germophobia.

With me, the focus of my OCD fears/obsessions may change every so often, but the underlying category of OCD always stays the same. What I mean is that, throughout my entire life, my OCD always has been pure obsessional type, with a focus on scrupulosity. Compulsive confessing has always been my biggest compulsion, but over the years, what I need to confess may change. Also, I used to suffer primarily from sexual, violent, and blasphemous images as my obsessions, but I rarely have those now. I hear short blasphemous phrases now, with no image. As for medication, Anafranil/clomipramine has done wonders for me. Only thing that has ever helped my OCD and my panic attacks. I just wish I had been given it sooner. So many wasted years.

Also, SteelMaiden, Zyprexa and other atypical anti-psychotics wouldn't necessarily help your OCD. The atypicals act partially as serotonin antagonists, and it's hypothesized that there are low serotonin levels in the brains of OCD-ers. There is clearly some link between schizophrenia and OCD, but the details are still fuzzy. Individuals like yourself who have both schizophrenia and OCD often do need to take different meds for each condition. Atypicals usually are only used for OCD-ers who are treatment-resistant and have failed to respond to other more traditional medications. So, if you are seeing an improvement in OCD symptoms on Zoloft and Zyprexa rather than Zyprexa alone, that's very possible.

I don't have any advice for the medications, but I have heard that it's pretty common for OCD rituals/obsessions to change over time. I'm afraid I don't have a source for that, though.