How to Manage OCD and Depression

I’ve heard it’s not good to seek reassurance or give it because it lowers your tolerance to uncertainty. But how do I avoid seeking reassurance when my thoughts and doubts are so bad, I genuinely just don’t know anymore if I’m a bad person or if it’s just OCD? I know I’m supposed to sit with the uncertainty, but how can I do that when the uncertainty has me unable to trust my own brain? Especially when the OCD is real event and POCD? How can I not seek reassurance when I feel so alone and so abnormal and just don’t wanna feel that way anymore? In turn, I see so many people on here struggling so bad and my heart breaks for them. How can I give advice to towers without giving them reassurance and hurting them in the long run?

I see a lot of “general” advice on here from people who have conquered their OCD, and i dont often find that advice helpful. How do i identify compulsion when OCD is bad? Its a whirlwind. Nothing makes sense. I’m pretty sure i have something in addition to OCD but modern science is not good enough yet to let me know. At times like this I need medication. I am weening off Zoloft to try Clomipramine or maybe Vyvanse. I’ve been on Zoloft for 6+ years so decreasing is causing quite an uptick in symptoms. I feel very impulsive lately, i say and post things i dont mean to and it causes interpersonal issues and doesn’t represent who i really am. Is it impulsion or compulsion? I’ve asked this before and only got textbook answers, not personal anecdotes (what im looking for). What does ADHD and RSD feel like? I think i have both ADHD and OCD, even though scientific models show these having opposite activity in the same areas of the brain, leading one to wonder: how can someone have both conditions simultaneously? Science contradicts this but also acknowledges a large population of people who have comorbid OCD and ADHD.

Hello, If anyone has experience with codiagnoses of MDD and OCD, how do you differentiate SI from an intrusive thought? How do you know when to engage with the thought (if it’s ocd) bs not (if it’s MDD) I added context of my situation below but no need to read it, you can also drop your experience or recommendations just addressing the question *** I haven’t been active here much since my OCD got significantly better after medical and ERP treatment few years back, but wanted to come on here for more specific help. About a year ago I started experiencing depressive symptoms which cumulated into an aborted attempt in April. Since early this year I’ve had a handful of minor crises (moments where I didn’t do anything but my god I really wanted to) and have been in the severe category for a few months. We’ve been approaching this as a separate entity (MDD as opposed to OCD) because of how different it is, but there are some similarities as well. I ironically years ago had a theme around suicide (except I was afraid that I was going to instead of genuinely wishing for it), so it’s a bit hard for me to tell. Part of the reason why this differentiation is important is because of how I should approach the thoughts. If it’s OCD, I need to expose myself to the idea of suicide, methods, mechanisms, locations, standing on an edge, etc.. If it’s MDD, then I technically shouldn’t engage in suicide related planning or actions because it allows an easy path during a crisis. Similarities: - the SI can appear in an intrusive-like manner of being seemingly out of nowhere - sometimes they are distressing, mainly because it’s annoying while I’m trying to pay attention to class and have a semblance of a good day - I want to do a certain action to make me feel better about said thoughts, which is looking up and establishing methods, planning letters, dates, etc., and resisting the urge to finalize my methods is both difficult and distressing. Differences - It’s MUCH more egosyntonic. And not in a “I’m worried that I want to commit suicide” way, in a literal I’m exhausted and I want out. If there was a bottle of pills that deleted me from existence to where no one would remember me, I’d take them in a heartbeat. I don’t have an inherent will to stay here, I’m only here because of my family and cats. Also ideal methods are kinda hard to access. - Sometimes I find comfort in the thoughts, like it’s always an available emergency way out. When I get distressed from them, it’s usually less because of the thought and more because I don’t have an established plan so I feel trapped to live. - Additional symptoms that appear with MDD and not always OCD (anhedonia, physical slowing, emotional blunting, hopelessness, weight fluctuations, random unexplainable bouts of tears, hypersomnia), like textbook MDD symptoms. - sometimes when the SI is bad it tends to “cancel out” typical blips of ocd I have. For example, I sometimes still have thoughts about contamination and getting in a car accident, except when the thoughts appear they don’t bother me in the slightest, and if anything I avoid compulsions and embrace the possibility of them happening because it’s a good excuse to hit the road. Feels like a bit of a catch 22 because if I engage in suicidal thinking/planning/rehersas, it either 1) could worsen my mental health if it’s from MDD, or 2) could help my mental health if it’s from OCD