Psychiatrist thinks I have depression & anxiety, not (R)OCD
*Disclaimer: I'm not seeking a diagnosis with this post, just wondering if others have dealt with similar and how I can talk to my psychologist (at the same practice as the psychiatrist) about this. The reason I'm worried about misdiagnosis is because if I do have OCD, I don't want CBT without ERP to make things worse.*
So here's what I'm dealing with and communicated to the psychiatrist at my intake appointment:
- I've been struggling with ROCD-like thoughts (about being in the wrong relationship, whether I'm really in love etc.) for nearly a year now that have been extremely distressing to me given that they came seemingly out of the blue and I had none of these thoughts before (F, 30, in a relationship with a man for the last 4 years).
- Since age ~12, have dealt with bouts of severe health anxiety that led me to spending hours, days seeking reassurance online, panicking about symptoms, specialist visits, etc. As soon as I felt reassured about one thing, something else would come up in another part of my body. I still deal with this occasionally, but not as severely since the ROCD started (and now I wish I had the health anxiety rather than this; grass is always greener I guess).
- From ages ~8-18, had existential intrusive thoughts about death/eternity (raised Catholic) that led me to say long repetitive prayers/sayings every night because if I didn't I thought I'd have these thoughts again.
Those are the main distressing mental compulsions, but I've also noticed these which seemed worth mentioning as well:
- If I notice a thicker or longer hair on my face, I have to pull it out and can't focus on anything else until I do. Not a problem if I'm home/have tweezers, but sometimes I'll spend an hour or more trying to pull it out, and I feel very physically uneasy/not right until I do.
- Often throughout the day, I'm spelling words forwards and backwards in my head and making symmetrical "melodies" (hard to explain).
I'm now in the third year of my PhD, and living abroad (in the country my partner is from but he's not why I originally moved here), and am really struggling to work. Given the lack of structure and short-term deadlines, it's easy to fall into patterns of ruminating, reassurance-seeking, reading online forums without immediate consequences, only now I feel immensely guilty and behind as well.
My psychiatrist thinks that I have "depression and anxiety with obsessive tendencies" but not OCD, because according to her my obsessions are rooted in anxiety and OCD is not (??!). So: I agree I'm depressed and prone to anxiety, and that some of the health & relationship anxiety is rooted in events in my family life, past, and the situation of living abroad and doing a PhD. And I don't care about the label of an OCD diagnosis per se, but I'm concerned that without it, given my "obsessive tendencies," the treatment plan of CBT without ERP might do more harm than good.
So again--NOT seeking a diagnosis--but:
- Does this sound like (R)OCD?
- If yes, how can I broach this with my psychologist to ensure I get the best-tailored treatment?
- If no, has anyone else received this diagnosis of "anxiety with obsessive tendencies?" And what did the treatment look like? Was ERP-informed therapy still an option?
Thank you!