
Suggest Treatment For OCD And Depression

I don't know what should I do at this stage, and my tangle of problems what should I address first, out of theses issues I failed my fellowship clinical exam as just night before my husband was arguing and saying hurtful things, I didn't perform with confidence, I never failed anything in terms of exam before as I am a scholar and very good doctor generally. I have to do exam again and I wish to be out of my situation and back to mental good health by next yr when I do it again.
We have decided to take a break from our relationship, but nothing changed in my personal life in terms of happiness or feeling hopeful.
I want to do a lot in life, I have a lot of good abilities that I can explore like painting, singing, writing stuff etc, I think I can do better at least in these aspects, even if I don't have good family life, or have kids which we don't have as we are so distant generally from each other except random occasions that there is no possibility of expanding family,which is probably best for my unborn children yet as they should come in better life situation where we are happy to give them happiness.
My family wants me to do happy things I like and get my confident self back, I tried psychiatric consult before but in my 5 visits it was all messy as my husband kept putting his side of story first and I never got to discuss anything.
I also wonder that occassionally I feel I should get in other relationship and that will be better where I might feel loved, as I can see most people like me, but I at the same time feel, I am not good enough to get anything better. I want fix my current life, but certainly I failed in past 9 yrs.
It's, very complex disclosure, but please guide me with a path I could follow in direction of getting myself better healthier and capable with gaining my self back.
Please see details below.
Detailed Answer:
Hi,
I went through your query in detail and can understand the distress that you must be having currently. Life with so many problems is definitely difficult and it becomes quite stressful in such times.
I look at your problems from two angles. One in which you are having difficulties in your marital life and not being able to get along with your husband. The second one is clinical syndrome of your symptoms.
I know you don't want medications and want do get over all your issues on your own. But lets face it. You have been trying and things aren't improving. At this point, I would suggest that you really consider medications. More so, cause you don't have time to try CBT even.
Of the two problems, I would like to focus on the clinical syndrome first. From what you have mentioned, you seem to be suffering from two major cluster of symptoms: Depressive symptoms and Obsessions of contamination. I believe that if you are able to get rid or decrease the intensity of these symptoms, you can then try to make things better in your life including the marital difficulties.
Anti-depressant medications, from the group selective serotonin reuptake inhibitors (SSRIs) like sertraline or fluoxetine will be helpful in dealing both set of symptoms. The medications are slow to act and you will have to be patient regarding the response but are safe and effective.
Once your depressive symptoms and obsessions have decreased, you will be able to focus better on doing things to improve other aspect of your life. Simultaneously, you should start exercising daily (something like jogging/cycling /swimming would be the best). It will help you feel better and relax.
You cans also start writing diary on a daily basis. It will help you ventilate your emotions which in turn will make you feel better.
After you are better in these two symptoms, I would recommend you to focus on your relationship issues. It would be highly advisable to go in for marital therapy if both of you are ready to give it a chance and see how it turns up. Further decisions can be taken accordingly.
I do hope I was able to help you in some way. Please let me know if you have any further query. I would be glad to help you ahead.
Best wishes,
Dr. Sunil Gupta

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