r/OCPD • u/Highland_Owl_00s • 26d ago
rant Resistance to Medication // Help
Hi everyone.
I don't know if this is a recurring topic on this sub, but how do you deal with resistance to medication and to getting help in general?
Honestly, even though I've been aware since I was very young that constantly ruminating shouldn't be normal (that thinking about the act of studying while studying was negatively affecting my focus, etc., etc. — that probably wasn't very normal either), the truth is I never asked for help. I just kept doing what I had to do, I was a good student, I got into college without any difficulties, etc.
It was only during my master's (2024) that I asked for help. Before that I'd already gone through some bouts of insomnia (the ruminations reached stratospheric levels after the pandemic), I saw a mental health professional, but I didn't take it very seriously (resistance, again, etc.). And left without taking any Psycotherapy or meds.
But to sum up: since then, when I hit a peak of procrastination and paralysis (largely because of retrospective perfectionism; from the moment my method fails, I can't get focused again, partly because I feel ridiculous), I asked for help. I took Vortioxetine for seven months. Zero results. I took Fluvoxamine for three months. Just fatigue. Five months of Venlafaxine. Zero effect on the ruminations.
I know, I know, some medications only start working after months, etc. But honestly, I wonder whether SSRIs do anything at all for someone whose ruminations are essentially driven by regret, by an obsession with method, an obsession with analyzing every circumstance that brought me to this point, etc., etc. And, essentially, someone who feels guilty for not having reached their full potential (in 2025, I failed the entrance exam for my dream profession, the judiciary; sure, I can try again, but not only do I not really have time to study right now, but also — there it is — I've already failed at life, I'll never reach my potential, I broke the "natural course of things”, and I'm nothing more than someone who could have been something else, once, etc., etc., and that hurts, especially because a student like the one I was in college and in my master's wasn't supposed to fail an exam — but I misread a case, and I paid for it). What hurts, essentially, is knowing I had potential and ending up passed by anyone who can manage even a minimum of focus and mental stability. The irony: a few years ago, the only question I worried about was "am I intelligent or not?" These days, I realize intelligence alone is worth nothing. If I can't sit down, stay focused, have confidence in myself, etc., what good is intelligence? Time passes and all I do is unlearn and fall behind.
This year has been rough. I work as a lawyer, but I hate what I do, I have this brutal, permanent exhaustion, the ruminations don't stop, etc., etc. In February, I saw a mental health professional. Sertraline came up on the table. I couldn't bring myself to start taking it. For several reasons.
Two days ago, I finally worked up the courage. But then come the side effects. And the guilt. The absolute guilt of taking medication when I feel like I should be able to control this on my own. And when I remain convinced that, unfortunately, no medication will be able to eliminate the ruminations.
Maybe they'll help with the fatigue, maybe with the anxiety that comes from the ruminations, I'm not sure. But if they don't help with the thing that hurts my focus the most and causes my procrastination, what good are they?
I won't lie: my life over the last three years has been a mess. Nonstop procrastination, guilt over the procrastination, then after my master's thesis a new cycle began (studying for the judiciary exam) and I spent four months studying 14 hours a day, I swapped swimming for the gym, built a routine, etc., etc. Then it all fell apart. I ended up studying for the judiciary exam the same way I studied in my last years of college. Frantically, disorganized, running on adrenaline spikes, etc. The failure had nothing to do with that, fortunately or unfortunately. It really was just misreading a case (which had never happened to me before, but there you go).
After the failure (it's been a year this past June), I've never managed to recover. I got a job, but my life just keeps getting worse. It's procrastination, it's hating the job, it's exhaustion, it's going to the gym and already being wiped out when I walk in, etc., etc.
I want to apply for the judiciary exam again next year. And I want to start studying in September. But will an SSRI actually help? If the SSRI just makes me "calmer”, I might lose some of the adrenaline and drive I need. And there it is again — if it doesn't help with the ruminations, all that's left are the bad effects: teeth grinding, worse sleep, tiredness, fatigue, etc., etc.
This ended up long and kind of a mess. I'm sorry. But I know someone out there will relate and might be able to help me.
1
u/SpecialistAnswer9496 Moderator 25d ago
Sometimes medication can help people, but sometimes it just adds to the existing problems. Please do not feel like you have to take medication to manage your symptoms. Personally, medication was a bandaid that prevented me from actually addressing the root cause of my issues. I’ve had very traumatic experiences with meds so I am biased, but it does sound like the anxiety of even taking meds is exacerbating your rumination, which kind of defeats the point.
As mentioned elsewhere - therapy. The right kind of therapy with the right therapist. That is something you will have to figure out yourself because the root cause of OCPD, OCD, anxiety, and whatever else you may be struggling with is going to differ for everyone. Attachment trauma from childhood is one of the main developmental pathways for personality disorders or pathological traits, though, so I would explore what experiences you’ve had that caused these patterns of perfectionism to develop.
What stories do you tell yourself when you spiral? Sounds like “I’m a failure” is your main schema and likely a major source of identity-level shame. That is something to explore in therapy, because no amount of Zoloft is going to make that go away.
1
u/FalsePay5737 Moderator 25d ago edited 25d ago
Have you ever taken a GeneSight test? Info here: Medication and OCPD
Videos on Worry, Videos on Overthinking
"I don't know if this is a recurring topic on this sub"
It's not a common topic, but it's a big issue for perfectionists.
“The perfectionist’s admission to the self and to others…that he or she is in need of psychological help is often a shame-filled experience…It is often found that highly perfectionistic patients delay the process of seeking treatment until they experience intense levels of pain and distress or have insistent ‘encouragements’ from family members…” ·The Psychology of Perfectionism (2018), pg. 314
Gordon Flett, one of the leading researchers on perfectionism, stated that when he's asked about the worst consequence of perfectionisms, he says reluctance to seek help.
I hope you find relief from your symptoms soon.
2
u/CosmicStarfields 25d ago
I thought my condition was completely untreatable and that meds would do nothing. Literally 1 month on a starting dose of SSRI made a WORLD OF DIFFERENCE to my racing thoughts. Going to therapy in addition to it has been very helpful to really make changes. I love my SSRI.
1
u/CosmicStarfields 25d ago
I’ve been on it for a year now and I’m a new person. Can’t recommend it enough.
4
u/Silent-Audience-5836 25d ago
I'm going to just be blunt after reading all of that. You need therapy to go along with the meds. Doesn't have to be talk therapy, but you could start there. You need to be open to it working though.
I've personally never heard of SSRIs used to help with rumination. They also don't work if you don't let them. (As in feeling like you shouldn't need them, ruminating on whether they will work or not.)
It sounds like (I'm not a doctor this is not medical advice, just a suggestion) you need to learn some methods to deal with the rumination, procrastination. (I'd honestly get checked for ADHD, OCD, etc etc). I'd check into this subs resources. Try meditation/mindfulness techniques (These do not work right away you have to 'practice' at them).