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Hi all, and thank you in advance to anyone who takes the time to read this post.

I'm a twenty one year old male who has had motor tics since childhood. Around the age of fourteen, I was diagnosed with moderate OCD via the Yale Brown Obsessive Compulsive Scale. I took Zoloft for a while, but once I started to feel that it might be working, I stopped taking it. After that, when I was fifteen, I started taking Risperdol for the tics, but it made me gain weight and I eventually stopped taking it. I haven't been on medication since then.

Recently I've been wondering if I might have ADD (inattentive type). Out of curiosity, I took an online survey which consisted of sixty or so questions, and based on the results, I almost certainly have it. However, I'm still not at all convinced, because: a) I'm not sure if the survey was legitimate; b) even if it was legitimate, it certainly wasn't administered in a controlled setting; and c) I don't have confidence in the diagnostic power of such surveys in general. I was skeptical of the Yale Brown OCD Scale when I took it, and I'm still skeptical.

The following is a summary of the things which I've been experiencing which may (or may not) be symptoms of ADD or OCD:

First and foremost, I [I]constantly[/I] have some song or snippet of speech or melody stuck in my head. I know that everyone gets songs stuck in their head sometimes, but it's virually all the time for me (I would say 95% of the time; it's rare for my mind to be totally quiet).

This may not seem like such a big deal if you try to imagine it, because you'd probably resort to imagining having a nearby audio source playing things over and over. However, this would not be an analagous situation, because when an [i]external[/i] source is playing music, you don't have to pay attention to it. It may take a while for you to "tune it out", but eventually you'll be able to and it will just be a minor nuisance. But when you are [i]remembering[/i] a song, you are [i]necessarily[/i] paying at least some attention to it, or else you wouldn't be able to sustain it. A much better analogy would be feeling compelled to remember a phone number that someone just gave you by using your short-term memory to place it in a never-ending loop. You can't tune out your own memory loop, or you'll forget what you're trying to remember. These loops are sometimes accompanied by teeth-clicking or the shifting of the attention from one finger to the next (to differentiate from actual counting, which implies actually moving the fingers and keeping track of a sum) in synchronicity with the beats or syllables of the loop.

When I [i]am[/i] able to force these loops out of my mind, my attention latches on to any sound in my environment, preferring rhythmic sounds. When it's totally quiet, I hear what sounds like some piece of electronics equipment droning faintly. I can't tell if this is my imagination, a hearing problem, or something neurological. If it makes a difference, I "hear" it in my left ear, never in my right.

I don't read as much as I used to when I was a child, because whenever I try to picture a described scene it inevitably begins to morph, to become distorted. People and things start to rotate as if caught up in some sort of gravitational distortion, objects change shape, and my perspective of the scene itself starts to change, as if I were watching a movie and the cameraman were being jerked and whipped around at random. This is extremely frustrating, and if I'm really into the story that I'm reading I'll sometimes just not try to picture anything and just read the words.

When I'm reading non-fiction for information (and sometimes when I'm reading a boring part of a fictional story), my reading pace slows to a crawl. I constantly have to backtrack, and sometimes I just stop and zone out for a second or two. The weirdest thing about this is that when I took the ACT, I scored a perfect 36 in the reading comprehension section. I can't recall if I experienced the sorts of difficulties I've just described during the test or not, which I took about four years ago. However, the test was structured in such a way that you could go back and re-read parts of the story for each question that was asked, and the questions were multiple choice. Also, the testing room was almost totally silent and I was making a special effort to concentrate due to the importance of the test.

Probably the next most annoying possible symptom is my tendency to become totally fixated on certain concepts or ideas to the point where I see it everywhere. These are like obsessions, but they're really more like fixations. Lately, I'm unable to watch a movie or a television show without trying to predict what's going to happen next and figure things out before they're revealed. It can actually be sort of fun, but it's gotten to the point where watching anything makes me feel anxious.

The basic thought pattern that keeps repeating itself is: "Okay, make a note of everything you see. If anything seems out of the ordinary, try to think of why it seems unusual, and what might cause it. Don't just assume the first cause, but try to brainstorm as many possible causes as you can. Then, for each possible cause, think of all the other effects that it would produce. If the possible cause would produce an effect that isn't evident, eliminate it and move on to the next cause." Or, if I'm just trying to predict things, it's, "Okay, that just happened. What is that going to cause the other characters to think or do?"

It's basically the sort of thinking that I imagine a detective or a diagnostician might use, and in and of itself it's not such a bad thing, but I have a hard time [i]not[/i] doing it. If I don't do it and something happens that comes as a surprise, I feel stupid and chastise myself. Yet the thought process itself is interfered with by the above-mentioned repetitive audio-loops, and by the fact that I'm anxious and not relaxed.

Other fixations/obsessions that I've experienced are:

- a fixation with the idea that lesbian women think that they are spiritually superior to men (crazy, I know...and embarrassing to admit)

- obsession with my own intelligence/sense of humor; once I became very anxious for a month or so because I felt like I needed to be thinking something signficant at all times

- a prolonged preoccupation with death that I went through when I was sixteen and which was so severe that I couldn't sleep and became very depressed

- miscelaneous minor oddball things, like ordering things with more toppings than I really want because otherwise my order won't be significant, which is quite strange, and other small things like that

The other two things which seem abnormal to me are my extreme difficulty stopping something once I've started and the almost superhuman effor it seems to take to start anything; and my frequent wild mood swings, from wonderfully optimistic to desperately depressed to enraged to giddy over the course of a few hours. I'm sometimes moved to tears by television shows or even commercials.

This may not be a symptom, but ever since I hit puberty I've found it exceedingly difficult to both fall asleep and wake up. Until last Monday, I was staying up until five or six in the morning and getting up at three thirty or four in the afternoon after hitting the snooze button on my alarm for two, sometimes three hours. This changed on Monday because I finally decided, on the preceding Saturday, to stay up for over twenty four hours and go to sleep on Sunday at a reasonable time. Since then, I've been going to bed at 9:30 PM and getting up at 6:25 AM. At first I was waking up without an alarm, but it's becoming more and more difficult for me to both wake up and fall asleep. Whereas originally I was falling asleep in fifteen minutes or so, for the past couple of nights I've laid awake for an hour or so before falling asleep (this is, of course, an estimate, as it's difficult to know exactly how long it takes one to fall asleep).

Throughout my adolescence, I would routinely oversleep (sometimes sleeping as long as twelve or thirteen hours), and then lie awake in bed for hours trying to fall asleep the next night (well, the next "sleeping cycle", I suppose). I guess it shouldn't be surprising that I can't fall asleep after having slept for so long the night before, but even when I was going to school and therefore forced onto a more normal schedule I had great difficulty waking up. Sometimes I feel like I keep hitting the snooze button because only when I'm asleep am I free from my constant ruminations and the endless audio-loops, but at other times I feel like that's just an excuse for laziness.

For the past month or so I've felt extremely lethargic and depressed, significantly moreso than usual. During this period of time I've been unemployed, having just left a temporary assignment at which I was working twenty hours per week. After "fixing" my sleep schedule I've been feeling better for the past week, but I still feel like I'm in a fog. The most concrete and persistent manifestation of this feeling has been my recent (within the past year or so, if I had to guess) loss of the ability to have a smooth conversation. Although I may come off as articulate in my writing, I have been having extreme difficulty expressing myself verbally, something which I've never experienced before. I grope for words, lose my train of thought mid-sentence, and sometimes speak ungrammatically and haltingly. Though the preceding sentence may seem to contradict itself, it took me probably two minutes to write, and I had to stop several times.

My motor tics are mild to moderate, and are not my primary concern. If I have to, I can suppress them for extended periods of time, though not without effort and some discomfort.

I live in Denver, and I'm pessimistic about getting treatment because I don't have faith in the ability of a psychiatrist or psychologist to successfully diagnose and treat me, and I know that I'd have to choose a provider covered by my mom's insurance plan. Actually, that's part of the reason why I haven't made an appointment with a psychologist or a psychiatrist yet. I'm thinking about contacting local universities and requesting a complete psychological evaluation. In fact, I might get tested at two different universities without telling either about the other. That may sound a little paranoid, but I really have more faith in objective tests than in individual clinicians.

Any advice?

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