I’m curious what my readers think about medication. Do you believe that medicine is usually necessary to treat OCD? I ask because ever since finding out I have OCD, I think my obsessional fears have a lot less power over me — like just knowing where they come from has helped me become free from them — without medicine. That’s not all of it, of course, and I certainly still struggle with obsessional fears every day. However, they don’t control my life like they used to — the only problem is when a new one appears, I sometimes have trouble identifying whether it is a legitimate concern, or an obsessive-compulsive problem. People with OCD get accused of being upset over “little things” but they never feel little to us at the time! If they did, we wouldn’t be upset. If I had seen a therapist as a child, it’s possible medicine also might’ve been more necessary then, and would’ve helped me deal with my hand-washing problem before it damaged my skin too badly. As children we don’t know ourselves as well and our reasoning abilities are still developing to a great degree. But it’s hard to say in retrospect. I think most of the work really is cognitive-behavioral therapy, and I feel like relying on medicine too much is like continuing to use a crutch once your leg has healed — maybe for both children, and adults.
For Tourette’s (and other disorders) it’s different; there is no amount of cognitive therapy I can imagine taking my breathing tic away, so on days that it is really bad, I do wonder if I would be better off taking medicine. But I can’t only take it on bad days; I would have to take it every day, and that’s what worries me. Most days, it doesn’t interfere with my life that much. But I don’t envy people who have tics which do severely interfere with their lives on a regular basis, because I can very easily imagine what that is like, and I would not make the same “crutch” comparison because Tourette’s and OCD are very different in that way. OCD is a mental disorder, so to some extent many people can think their way out of it — but Tourette’s is about physical urges, and you can’t really think your way out of that. Imagine trying to think your way out of blinking or breathing when you felt like you needed to! It would be hard, and sometimes you blink or breathe without thinking. That’s the interesting thing about tic disorders — they’re a manifestation of a very normal body process that probably had a great evolutionary purpose. It’s pretty darn convenient that most of the time, we breathe without thinking about it. It’s just that people with tics do OTHER things without thinking about it, too.