Dear Psychiatrist Sam

/ Jeff Cann

Dear Psychiatrist Sam,

My husband has Tourette syndrome and OCD. Years ago, before he began a twice-daily dose of antipsychotics to reduce his Tourette tics (unwanted movements and vocalizations) intrusive OCD thoughts regularly dragged him out of bed in the small hours of the morning. As a happy side effect of that medication, those intrusive thoughts evaporated. He began sleeping like a hibernating bear, and OCD, while still mildly present in his life, no longer disrupted his daily activities.  

Fast forward eight years. It has become apparent to us that the antipsychotics possibly impact his ability to communicate verbally. He speaks slowly, pauses, and fumbles for words. At times, he bails in the middle of a sentence, or says nothing at all because he is unable to formulate his thoughts while he speaks. His psychiatrist didn’t dispute this concern, and with her help he is weening himself off the antipsychotics to see how it affects his communication skills.

He’s just started this process; he reduced to a half dose four days ago. He already reports feeling a bit sharper in his thoughts, and he seems to be interacting with me more. Last night he woke up at one o’clock worried whether a contractor plowed and shoveled the snow-covered parking lot and walkways at the library where he works—even though this isn’t his responsibility and they have always shown up in the past. He couldn’t get the image out of his head of the Saturday morning crew arriving to find the walks and stairs covered in snow and ice, and frantically trying to clear things up before opening. After a restless hour, he got in his car and drove across town on snowy roads to check.

As you can imagine, I’m worried what the future holds for him. Sleepless nights and heightened tics are a questionable trade-off for better communication skills. Last night was a wake-up call that this might go askew. He also told me that he grunted frequently through his spin class this morning—a Tourette tic he’s been able to curtail in the past.

Tell me, Psychiatrist Sam, how do people choose when faced with two sucky options like this?

Signed: Worried Wife Wondering

Photo by Saidamir Mukhitdinov

21 thoughts on “Dear Psychiatrist Sam”

    • Hi Mark, I wrote this same comment to Georgia: At this point in my life, this dilemma just feels like more of the same crap I usually deal with and doesn’t stand out as an exception problem. I’m certain that I’ll be fine in the end but may need to endure a few sleepless nights as I get my meds right.

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  2. I’m moved beyond measure by the painfulness of the dilemma you describe here. I hope you find a real solution that will allow you to be free of OCD symptoms and to communicate with ease.

    I’m hoping you won’t mind if I ask this. Did you choose to adopt the persona of the wife and the format of a letter in order to gain emotional distance from this difficult subject?

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    • You know, at this point in my life, this dilemma just feels like more of the same crap I usually deal with and doesn’t stand out as an exception problem. It’s interesting that you asked about point of view. Just before I hit publish, I began to wonder why I didn’t write it as myself. The thing I came up with is that I believe (based on the advice columns I read) that a woman is more likely than a man to write in. But really I have no idea why I did that. I just got an idea for a post and this is how it came out.

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  6. Oh Jeff what a thing to go through….and of course I understand. I recently got off my ocd medication (for different reasons) unfortunately for me my ocd went spiraling I ended up going slowly going back on it. I truly hope this doesn’t happen to you and that you find the right solution that fits. There are so many medications out there for us we just have to figure out which one is going to work best. Hang in there Jeff. Wishes you all the best. 😁

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