My story

Here's my situation and how I see it.

I have had body image issues for many years. I look at myself and see a disgusting looking person. As a result, I feel self-conscious and worthless when I go out. I isolate myself because of this and find it very difficult to interact with other people due to the anxiety. I'm not agorophobic because I have a job but don't have any friends so rarely leave the house, except for solitary walks and occasional outings with my immediate family. I constantly think about changing my face and body with surgical intervention. I also write down a lot of things such as what I've eaten on a daily basis, how many calories are in each food, how much I've lost and gained in weight and I also write endless lists about what I'd like to achieve with my life in the short-term and long-term. I'm depressed and have had CBT as well as Prozac and citalopram.

Here's how I breakdown my situation

Body image >> Anxiety >> Obsessive-compulsive tendencies >> Depression >> Occasional suicidal ideation

Does my analysis sound correct?

I want to back on antidepressants but I've noticed that the antidepressants I've tried have had sexual side-effects such as an inability to orgasm and dry skin (which obviously contributes to self-consciousness).

Feel free to elaborate your thoughts.

Hi,

I don't actually agree with your 'analysis', but I don't want to focus on it too much. In fact, I think that your 'analysis' need only focus on one thing - i.e. OCD. If yuo put OCD at the center of a page, every problem that you've listed could be a branch away from it. What I'm saying is: I see OCD as the core of your problems. i'd add in another thing though: Obsessive Compulsie Personality Disorder (OCPD).

The lack of libido/inability to orgasm are indeed due to the medication (citalopram), but these are recognised side effects and they do disappear once the medication is stopped.

Moving forward ... it would be very beneficial that you didn't write out what you eat, nor that you counted your calories. Doing such things is entirely negative and is just part of your OCD. Plan a day that you don't do these things, and then see how you feel at the end of it. You just have to mentally 'let go' of the behaviour and see how it feels. Your brain naturally wants to stick to habits, but you already know that your habits are destructive and are not making you happy.

There is still ample time in your life to change things. Im' doubting that you are truly a 'disgustign looking' person. No-one out there is actually disgusting to look at.

Kevin

Hello CJ,
Have you talked to your doctor about wellbutrin? It has less sexual side affects than the ssri's or the snri's. Body dysmorphic disorder is treatable, as well as all the symptoms you described. Since you mentioned you have thoughts of harming yourself, you may want to try any antidepressant that works regardless of the sexual side affects until the depression is under control. mental illness really sucks, but give treatment another chance. Your not alone my friend.
ms. el