Things again took a turn for the worst. He was into all his magical thinking. He knows the answer. It is the receptors. He screams in panic as the stories flood in. He craves his Propecia tablet as though that is a saviour. But it is what traps him into thinking he is control of hair. When will he ever realise he isn't and it doesn't matter. He is blind to what is important in life. His mind has been hijacked into a world see sawing between a need for absolute control and a life of chaos. The foundations of a life were there but what he is building is a delusional bubble. I am the one enabling this to continue growing even bigger. But what would happen if I stopped being there for him.

The meds are causing more anxiety at this stage. I have upped the Lyrica to three a day as his breakthrough anxiety was obviously related to the dose of Lyrica being so short acting. We can take up to 300mg but don't want to be doing that until we have raised the Prozac. Prozac is at 30mg so this is still considered sub-therapeutic for OCD/BDD. Just can't raise this as my son is just too unwell to tolerate it. I can't tolerate him is probably more the point.

It is almost midday and he hasn't gotten up. He actually mentioned being fearful of the kitchen. I will give this a couple more days and consider requesting a hospitalising.

On a positive note. He is not touching much. Most likely too sick to care anymore.

I hid the knives as unfortunately that is the stage we are at. Mercifully we don't live in a gun culture.

If anyone ever thinks BDD is about being ugly physically, then they haven't read enough of our story to understand the brain's perception faults. You can't fix this level of brain impairment with a simple aesthetic fix through a transplant or hair meds or toppik. My son's internal biology is faulty in a fairly big way. He lives in a magical world of his thoughts. But the fantasy is not of the milk and honey variety, more the black, bitter and ominously cruel.... Where dread lives and hides from the light of truth.

Only time will tell if we can get anywhere to fixing it. That is the fix we are after. That is the fix all of you with BDD need. Hope we find it. Marg

This is an overview of our new psychatrist Professor C.

*mod edit- details removed*

I have added these credentials so you are able to recognize what a leap up the scale this guy is from your average psych who hardly sees anyone with OCD or BDD at all. I wouldn't be at all surprised if he wasn't compulsive himself. His notes were impeccable and ordered so well he could find a cold case of ten years in seconds and they were hard copies nothing digital.

So the med regime of Lyrica and Prozac was a triumph yesterday. He had periods of the day when he was able to focus on his life and talk about plans. This hasn't happened in weeks if not months. He was happily connecting to his real life. He had plans to get a blood test. He talked about making a list of chores. He looked on RSVP. Things were looking brighter for the day.

But suddenly he got a thought that he was too ugly to date again. His wife was not the one for him and he would have trouble finding a woman to accept him. So the fear entered. Fear likes company. All his BDD logic flooded in and his resolve to live well was swept away in the tsunami of fear BDD brings. The storytelling overwhelmed us both. His testosterone, DHT, hairiness, hairloss devastation stories fill his mind. Bed to the rescue.

He was still calmer than usual through this downturn and got up later. He took the Lyrica early at about 4pm as he was having break through distress. We were able to watch an episode of My Kitchen Rules to finish off the night.

This morning he is back to being psychotic with disorganized speech. " The silence going forwards...Its just pestinance????" He is making up words.. One would expect the Lyrica has worn off and a panic has happened. Although he claims he has not had any panic and has not been touching. Still he got up at 4 am to take a Propecia tablet. That tells what was on his mind even if he tries to cover it up.

The doc also asked him to take blood tests for testosterone and DHT to find out the facts but the test paperwork still lies on the table after a week. The stories are not in anyway problem solving facts. You can't solve a problem anyway, that exists in the past. The stories are just an explanation for the panic. Without them there is no reason to panic. That is too confounding to consider.

So although the morning hasn't been stellar so far he isn't calling out in distress to the same degree. I haven't given him the Prozac yet as he is still a bit too loopy. Letting the Lyrica start working first. No idea what the day will bring. We are no longer completely out of control but not really on top of this BDD either.

Hopefully if this BDD is a purely biological disorder we will be able to signpost a way out. Dr C seems to think it is. We are doing all we can to follow what he suggests. Hopefully you guys will be helped too.. Marg

The latest doc appointment was just a checkin to see how we are faring with the meds after 5 days. As there was a lot of break out behaviours and storytelling, the Lyrica is to be doubled and the Prozac upped to 40mg. The doc talked up Prozac and mentioned doses as high as 100mg. This comment was met with some dread by my son and I too felt extremely hesitant. It just sounds so much. The doc is firmly of the opinion that the studies are where science lies and gives us the best chance of full recovery. He mentioned that he did have cases of full recovery so that gave my son hope. The aim is for my son to gain insight that he has a brain disorder that sends unwanted thoughts and urges. At the moment that insight is missing and only understood at a conceptual level rather than something that needs to be operating in his day to day conversation with himself.

My son didn't have a good night and there was some slurred speech in the morning that can be attributed to the Lyrica side effect. This effect is supposed to resolve with habituation. The Lyrica is to counter the worst aspects of the Prozac side effects. This morning it seemed to be working. He wasn't so easily upset by little things and he was overall more balanced. He still believes all his BDD thoughts are real and he needs to see a hair doc so there has been no change there. He still can call himself ugly and his body hair can start to annoy him but there is something more calm about his disposition.

The NBA playoffs are proving a godsend. A lot of game watching can chew through most of the day. The distraction has reduced the time for storytelling and touching. So we actually haven't had a panic since early morning. He tells me Boston is losing so maybe the antidepressants should be increased now!

So my son needs to develop the skill of analyzing his thoughts to know whether they are BDD thoughts or not. The goal is to control responses to the thoughts and urges by really knowing they are not real and don't actually tell you anything you should do. Trying to make these thoughts and urges go away in seconds or minutes will cause only frustration, demoralization, and stress. It will, probably tend to make the urges worse. The idea is to acknowledge the thought, expect the thought but know it is only triggered from your BDD brain. You have this disorder that sends you unwanted thoughts. Disconnecting the thought from the panic response is where I see the hiccup in the theory. We will see what works in time.
The doc is also sending us an outreach worker. This is to help with my son's lack of routine. We no longer feel alone in the battle with this disorder. That is so important to monitor how we are going and give us hope. Marg

He has been so bad that I haven't had a moment to post anything. Most of the day he spends in bed or watching NBA. When bed ridden he calls out every 5 minutes. He comes after me when I dont respond. I leave the house multiple times a day. The police have been called once as he prevented me from leaving and held my arms so tightly that we ended up in a physical fight. I was trying to kick him away with my feet. He got my handbag and started slamming me with it. It was over in seconds but I needed to acknowledge how bad it was. The police have been here before with an overdose attempt so they were aware of how he is. It is insanity but to him it is hair. The young officer attending was shaved to a number one so I can't imagine what he must make of it. He was surprised he hadn't been hospitalized in all the 16 months we have been managing this exacerbation.
The medication has obviously had an effect of energizing my son but not in any good way at the moment. By 4pm each day the basketball is starting to finish. The stories start coming in to fill the void. He should have been on Fin since 19 and he wouldnt have lost hair. His testosterone levels must be through the roof. He has so much DHT he can feel body hair grow. He should never have touched Dute. He is sterile now. He needs his wife back. He needs the transplant doctor. He hears an ad for Rogaine and tells me it is rubbish. He rattles off his extensive study of the topic. Then it is back to Dute and the idea that Fin is now useless as it is too weak after being on Dute. Then he asks, "Should I go back on Dute to save my hair?"
By 6pm he is usually looking for the sedatives.
The mornings aren't good either. The calling out today was unbearable. I decided to make a finger splint from a skinny sponge and wrap it around his finger, tied with a hair elastic. I thought the touching might have been triggering the thought attacks which have been likened to Tourettes in the way he responds to them. This morning he was so anxious that he was delirious. Sink holes were mentioned???? He told me he felt like he wanted to throw knives at the wall. So it wasn't so surprising that moments later an almost empty berry smoothie smashed into the bedroom door. He tells me he will replace the door.. Maybe after the front door he did over at Christmas???
But he will still tell you this is all over hair and if it was just like what it was 18 months ago he would be fine. Why don't I understand this??
We have another appointment with the doc this afternoon. It has only been 5 days since starting Lyrica and upping Prozac to 30mg. He is trying to do what has been asked even though he feels so bad on the meds at the moment.
Living in chaos is exhausting. He still doesn't realise it is what he is telling himself and not what his hair is doing. All people have to live with a body that lets them down somewhere. We cant live obsessing about what we don't like. Negatives are so powerful. They make us feel hopeless and helpless to overcome them.
Hope for better times ahead as tough times don't last forever. Marg

Body dysmorphia: Mindfulness and Passivity. Where is your mind going?
The Doc appointment was a mixed event. Still very much a positive but a glimmer of doubts came too. He offers no magic bullet. The TMS will take a minimum of 6 weeks to organize. He doesn’t offer it privately as it is purely experimental. We are to increase Prozac to 30mg and commence Lyrica. Lyrica is for the agitation and apathy. A mood stabilizer working on norepinephrine, a stress hormone. This is likely to calm the amygdala panic response which is a primary feature of my son’s manifestation of BDD. The drug seems to be helpful for those who found the alcohol outlet from illness. The effect the drug has is similar to having had a couple of drinks. A bit light headed and fuzzy.
He had his first dose of Lyrica last night. He was able to sleep till 4am. He was able to overcome two panic sessions where the thought arrived and was processed to the feeling of palpitations but then subsided. He has had a few more panics over the Testosterone story in the last couple of hours but they haven’t ripped up the scale and taken the roof off. He is looking forward to an NBA game so there is a distraction.
It is important to recognize how the storytelling in BDD is so significant in maintaining the potency of the illness. The testosterone story has no real point to it. Whatever happened in the past should be left in the past.
He tells me he knows his story is true.
But I ask, “If it is true, why doesn’t it solve your concerns?”
He then replies that he doesn’t know if it is true.
Of course, I reply that this thought then is only a hypothesis and can’t be proven at all. So why does it frighten you?
And then he replies,” Because it is true.”
A circle of ‘what if’ thoughts, with no end or beginning. Sub-logical, originating at the level of a survival fear.
The doc wants me to stick with a consistent message that the story can’t be a hook for me. I am to answer, “No answer.” It still isn’t helping at present. I am to leave if he keeps up with the requests for reassurance. Got to prepare how to do this consistently.
We also have made agreements on the use of the mobile phone. No phone in bed for online browsing and a ban on hair sites. It is up to him to start some self-regulation and become accountable for what he does that continues the compulsions.
We commenced some logic work as well. One IQ question each day. There are plenty of online sites with questions and answers. Crosswords and any other form of mind game using logic is also to be encouraged. His brain needs to be exercised and respected for what it can do. This might be the step closer to mindfulness that we seem to be missing.
Knowing you are in control of your mind though mindfulness is an important skill he has yet to really start working on. Being aware of what you are thinking in this moment now sort of takes the mind off free flowing automatic pilot and makes you accountable for your own mental paper trail. This will take some training and a much needed routine established. Hopefully the bed warmer will get a new zest for life.
I suppose there is the point. He is just too passive. He has given into his wife over many years. His wants were not important. He stopped caring himself to even be able to express them. He still often apologizes for things without needing to as though he is always wrong. He doesn’t complain when he should about how he has been treated. He lets others make the decision for him even when they don’t work for him. He tells his wife only what he thinks she wants to hear. I suppose it all adds up to a people pleaser who just thought others would treat him well because they thought like him. But everyone is not the same. You have to know what is right for you and be assertive about it. His mind has not been directed to concentrate on what is important. It has been hijacked for a long time. Maybe my part in that is that I have enabled it to happen without realising it. But no...

[ Continued ]