when do you increase meds? when you feel your going backwards and feeling ill again? most things im better with but still get unwanted thiughts and ocd type ritual in head, not sure wether to up dose, im on lowest dose of efexor, been on for 7 months, have helped me but feel like ive stuck at this stage! when shall i come off? wonder if its time to come off instead? so confused! april xx

I think that your ultimate goal would be to come off the meds. You will probably have to do it slowly. When unwanted thoughts pop into your head, say "NO" to them, by thinking about why they are unlikely, impossible, or maybe not well informed. Look for information that could put the lie to the unwanted thought. When the OCD stuff comes up, ask "Why am I doing this?" "What evidence is there that what I am doing may NOT be the best thing?"

To me the bottom line is that we can, for the most part, control our thoughts. The Victor Frankel experience is one example. I know this sounds impossible when you are under the pile, but give it a try, what do you have to lose.