Hello dear I think it is probably due to side-effects of ocd medication which causes Bleeding Diarrhea Vomiting Weakness Dizziness Pain Clotting Iam suggesting some tests for confirmation. Please share the result with gynaecologist in person for better clarity and for safety please donot take any medication without consulting the concerned physician Serum ferritin Serum tsh Serum prolactin Serum progesterone Rft Lft CBC Urine analysis Pelvic USG Serum estrogen Serum progesterone Hopefully you recover soon Regards
Experiencing fear and anxiety around people you perceive as more intelligent might relate to social anxiety, but it may also reflect issues like a residual self-esteem concern or performance anxiety which sometimes tag along after OCD treatment. Social anxiety disorder could be possible if your fear stems primarily from concern over being judged or embarrased in these situations. Interestingly, Clomipramine and Fluoxetine, both of which are used to treat OCD, can also be helpful for social anxiety disorder. However, medication alone might not fully address the situation. Cognitive-behavioral therapy (CBT), often including techniques focusing on social skills training and exposure strategies, can be effective. It might be worthwhile discussing this with your therapist or psychiatrist to adapt therapy sessions to target these specific social triggers. Moreover, consider introducing structured activities gradually involving small groups of people until you become more comfortable over time. If your current medications are effective at managing your prior OCD symptoms without significant side effects, you should continue them but monitor any new or worsening symptoms. In the event your anxiety impacts your daily functioning to a notable degree or if you experience thoughts like avoidance becoming predominant, it’s important to return to your healthcare provider promptly for reassessment.
your OCD has improved substantially with ERP therapy and treatment with clomipramine and fluoxetine, which is an encouraging sign. The newer pattern of intense fear and anxiety around people you perceive as more intelligent, along with avoidance of most social situations and persistence of symptoms for more than six months, may be consistent with social anxiety disorder, although it could also represent residual OCD-related self-doubt or another anxiety-related condition. A comprehensive assessment by your treating psychiatrist or psychologist is needed to clarify the diagnosis, as the distinction will guide treatment. The medications you are currently taking (clomipramine and fluoxetine) are commonly used to treat both OCD and social anxiety disorder, so they may also help these symptoms, although dose adjustments or additional psychotherapy—particularly cognitive behavioral therapy (CBT) focused on social anxiety—may be beneficial if the symptoms persist.Since you are already engaged in ongoing therapy, it would be important to discuss these new concerns with your therapist so they can tailor treatment to address the underlying fears and avoidance behaviors. You can opt for personal consultation.
Hello
Your OCD has improved significantly, which is encouraging. Sometimes, when one set of symptoms improves, underlying anxiety becomes more noticeable rather than representing a completely new illness.
Your symptoms are most suggestive of:
* Social anxiety disorder – especially if you fear being judged, appearing unintelligent, or embarrassing yourself around people you perceive as smarter. * Residual OCD – if the fear is driven by obsessive doubts (e.g., “What if they realize I’m not intelligent enough?”) and compulsive mental checking or reassurance-seeking. * Less commonly, Generalized anxiety disorder or low self-esteem may contribute.
Since you are already taking Fluoxetine and Clomipramine, these medications can also be effective for social anxiety. However, if your symptoms remain severe after more than 6 months, your psychiatrist may consider optimizing the dose, adjusting medication, or focusing therapy more specifically on social anxiety.
I recommend discussing these new symptoms with your treating psychiatrist. They may ask whether your fear is mainly about negative evaluation by others (favoring social anxiety) or whether it involves intrusive obsessive thoughts and compulsions (favoring OCD), as this helps guide treatment.
In the meantime, continue therapy, avoid avoiding social situations, and practice gradual exposure to conversations with people you find intimidating, as this is one of the most effective treatments for social anxiety.
Take care
Hello,
First, I want to acknowledge the excellent progress you have made. Reducing your OCD symptoms from 35 to 7 with ERP therapy, clomipramine, and fluoxetine is a significant achievement.
The fear and anxiety you now experience around people you perceive as more intelligent could be related to social anxiety disorder, especially since it occurs in most social situations and leads you to avoid them. It may also represent residual OCD-related fears (such as fear of being judged, making mistakes, or not being “good enough”), or a combination of both. These conditions can overlap, so it is important to discuss this with your treating psychiatrist or therapist rather than assuming it is a completely new disorder.
The medications you are taking—clomipramine and fluoxetine—can also be effective for social anxiety disorder, but the dose or treatment approach may need adjustment depending on your symptoms. Since you are already in therapy, your therapist can help determine whether your current anxiety responds best to cognitive behavioral therapy (CBT) techniques, continued ERP, or social anxiety–focused exposure exercises.
Prescription / Advice:
Continue taking clomipramine and fluoxetine exactly as prescribed. Do not change the dose or stop either medication without consulting your psychiatrist.
Discuss these new symptoms with your psychiatrist and therapist, as your treatment plan may need to be adjusted.
Continue CBT/ERP, and ask your therapist about incorporating graded social exposure and techniques to address fear of negative evaluation.
Practice gradual exposure to social situations rather than avoiding them completely, starting with situations that cause only mild anxiety.
Maintain regular sleep, exercise, and stress-management strategies, as these can help reduce overall anxiety.
Seek prompt medical attention if your anxiety becomes overwhelming, significantly worsens, or you develop thoughts of harming yourself.
Overall, this is treatable, and many people with OCD also experience social anxiety that improves with the right combination of therapy and, when needed, medication adjustments.
Feel free to reach out again.
Regards, Dr. Nirav Jain Family Medicine Specialist
