OCD. Obsessive Compulsive Disorder. I have it. For over 40 years, I’ve been afflicted with an underlying problem that I didn’t fully realize I had until I was recently diagnosed. And it’s all new to me. Sure, I remember the “even number counting”, the rigid routines designed to calm my anxiety as a child and young adult. I made jokes about it, after I thought I had banished some outward symptoms in my early 20’s. What I didn’t know was just how deep it runs, how debilitating it can be, and how it has had an out-sized influence on my life. You see, it’s not just those outward physical manifestations (which I still have) that you associate with quirky TV show characters, it’s also very much internalized and that was not something I was aware of until now. It makes sense of a lot of things that have gone on in my life. In the case for me, and most other sufferers, your life is peppered with pathological doubt, inflexible anxiety, rumination, confrontation avoidance, and an overpowering inability to make small and most certainly, larger decisions. Oh, and let’s throw in “intrusive thoughts/obsessions” to…obsess over. Furthermore, OCD is merely a component of overall anxiety and they are both linked.
Let’s be clear – this is not an abdication of any responsibility, it’s merely an honest acknowledgment of a chronic condition I have, it’s influence on me and in turn, my taking responsibility in getting assistance. I cannot and will not understate that on various occasions the results of having this have been very painful and, at times, depressing. That being said, for the first time in my 40+ years, I finally have a face to place onto this constant dull, obsessive and lurking anxiety-laden presence that is in me, and that face is – OCD.
In a world where constant rumination, non-stop cyclical replaying of things done and where at times anxiety prevails, it’s pretty obvious that it’s not sustainable in the long term even if I’ve lived with it for decades. Seriously, who wants to deal with that sort of stuff for the rest of their lives? It’s tiring and the thought that “This is fine” isn’t an option at this point now that the genie is out of the bottle. It has to be addressed (full disclosure, I told a lovely woman once, that I needed to do some “Soul Searching”. It wasn’t a throwaway line, I knew something was wrong with my decision-making processes. I just didn’t know what). So, after setting up my story, I’ll write about a part of what this blog is about and that is that OCD…is like a douchey roommate thats always creating trouble, leaves dirty dishes in the sink, leaving unlocked doors, doesn’t flush…uhhh…I mean, it’s about seeking assistance and working on stuff…
Therapy – It won’t get better without professional help because how do you change something that is not completely fixable on your own? What are the treatment options? First off, after I’ve done quite a bit of research, and after a few tries, I found a therapist that deals specifically with OCD and Anxiety-related conditions (So, I work on both OCD and Social Anxiety). It won’t happen overnight and will take a lot of effort. So…here we go…
ERP – Exposure Response Therapy (the below quotes pulled from IOCDF.org):
“OCD takes over your body’s alarm system, a system that should be there to protect you. But instead of only warning you of real danger, that alarm system begins to respond to any trigger (no matter how small) as an absolute, terrifying, catastrophic threat.”
“The Exposure in ERP refers to exposing yourself to the thoughts, images, objects and situations that make you anxious and/or start your obsessions. While the Response Prevention part of ERP, refers to making a choice not to do a compulsive behavior once the anxiety or obsessions have been triggered. All of this is done under the guidance of a therapist at the beginning — though you will eventually learn to do your own ERP exercises to help manage your symptoms.”
“That said, this strategy of purposefully exposing yourself to things that make you anxious may not sound quite right to you. If you have OCD, you have probably tried to confront your obsessions and anxiety many times only to see your anxiety skyrocket. With ERP, the difference is that when you make the choice to confront your anxiety and obsessions you must also make a commitment to not give in and engage in the compulsive behavior. When you don’t do the compulsive behaviors, over time you will actually feel a drop in your anxiety level. This natural drop in anxiety that happens when you stay “exposed” and “prevent” the compulsive “response” is called habituation.”
So, this involves slowly introducing scenarios that might trigger OCD, in essence confronting them directly and sitting through them. For instance, I’d need to purposely put myself in an uncomfortable thought position that requires making a choice. Let’s say – “going out and purchasing a shirt” and experiencing the uncomfortable feeling of choice, or driving my car, in the rain, after I washed it the day before (I’ve cancelled plans because of worrying about getting my car dirty). It could be deciding on a phone without getting lost in over-thinking the purchase, or forcing myself to step on sidewalk seams or catching myself doing even number movements when anxiety spikes. Let’s add – avoid seeking “reassurance” from others that “everything is fine” over and over again (which you will hear about later) or maybe just choose take a vacation to a specific location without over-thinking and, hopefully, in the end being somewhat “comfortable” that there is not a 100% answer to everything. So, you just sit with that uncomfortable scenario, acknowledge it and experience it till you start to inoculate yourself against that particular obsession/compulsion/anxiety spike after doing it so many times. Seems counter-intuitive but by constant exposure you get used to it. And doing this treatment while being fully aware it could pop up somewhere else…including the danger of becoming obsessive about OCD….no joke.
Mindfulness: If you hear me talk about OCD, in person, you’ll see me “spin up”. It puts the anxiety into overdrive and I start talking much faster and louder (because it’s not fun to discuss and as I said earlier, I’m pretty guarded and self-protecting). And the same could be said about just about anything that promotes anxiety (although sometimes my conflict avoidance causes me to shut down instead, since my anxiety and emotions will skyrocket, out-of-control and off to Mars, over personal, or heated, discussions). But what it entails is, basically, mellowing out. Just focusing on the here and now and the environment around you, at that moment in time, and throwing in relaxing things like Diaphragmatic Breathing.
Medicinal: I’ll have to take Selective Serotonin Reuptake Inhibitors (SSRIs) to assist in stabilizing my anxiety and compulsions until such time I can ween myself off. Think of anti-depressants like Zoloft, Lexapro, etc. People with OCD/Anxiety do commonly deal with depression from time to time (as do a lot of people) and occurs at a higher rate with OCD sufferers, so SSRIs help address those issues (remember – I originally sought out help for Situational Depression). But it also, coincidentally, helps with OCD symptoms, when taken in higher doses than you would normally take an SSRI. This is because of the aforementioned lower levels of seratonin that sufferers with OCD, typically, have. It’s not 100% deal. You can’t just treat it with a magic pill but it does add a little additional help. So, you can think about SSRIs, and their relation to OCD, sort of like Viagra. It covers more than one thing aside from it’s original intent. For instance – Viagra was originally supposed to be a cardiovascular pill, but “big surprise!” It just happens to allow the patient to…ummm…throw footballs through tires, work on lawnmowers or compels people to sit in separate tubs…in front of a lake…or something…
Sleep: My mind races at night, so for many years to quell my over-thinking and rumination I have relied on an average of 75 mg of Benadryl (which is a lot) at night to shut my mind down to get sleep. Well, once my anxiety/rumination is under control, there should be healthier methods I can employ to get proper shut eye. Good sleep does make a big difference on how I feel but I need to back off the self-medicating…then again…maybe all that Benadryl is why my allergies don’t bug me so much.
Group: I found a group here, locally, and that has been good in that seeing people who also have OCD (with differences in how their compulsions present themselves) I’m able to compare notes and not feel alone with this. I’ve learned a lot talking with people that have had years of working with this and has allowed me some important insights. I’ve only had a couple of months, so it’s a constant learning experience and that’s been great. When you’re telling someone what you’re going through and they nod their head in acknowledgment, you feel like you’re not the only one experiencing things and that’s been reassuring. These groups are all pretty informal. Conversations come and go naturally and it’s not odd feeling or anything. Let’s just say, it’s not the dark, weird and somber environment as it’s presented in a movie like Fight Club.
Support: Sharing it with friends and family that can offer a bit of support or understanding is extremely helpful. I don’t expect empathy, as most people I know likely don’t have it but hopefully some understanding. It’s a bit distressing because you’ll wonder how they’ll treat you. So far, it’s been fine and I’ve had a strong base of support. I’m thankful to have these people in my life, they haven’t treated me any differently, have been extremely supportive and many just shrug it off as “no big deal”. It’s been a nice thing to have.