Tag: ROCD

The Face

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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.

2 Shirts and a Shitty Santa

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“Since doubt is the cornerstone of OCD, sufferers often have the need to know, for certain, that all these decisions they are making are the right ones. This is much easier said than done… Perfection eludes us; there is always doubt.”- Mentalhelp.com

“OCD sufferers might also worry how their choices will affect others, and agonize (to the point of obsession) over even the most minor decisions.”- Mentalhelp.com

“…those with OCD might make a decision they are quite sure of, only to then have OCD sabotage it. A vacation (or Relationship – my edit) … you’ve been dreaming about for years can now finally be a reality, but OCD might force you to second-guess your choice. The weight attached to all kinds of decisions can be too much to bear, at which point OCD sufferers may avoid making decisions whenever possible. Unfortunately, avoidance is never the answer, and while this tactic may temporarily quell anxiety, in the long run it will make OCD stronger.” – Mentalhelp.com

Let me emphasize, and as the reader you should know – the above quotes, for me? Are…sigh…horribly spot on. OCD can have an overpowering influence on making choices, and in my case – create obsessive thoughts on how others will perceive you and your said choices (Note: My perception issues are definitely tied into Social Anxiety and worth the click through to illustrate my comorbidity), and the avoidance of even making a decision and all the consequences that might result. This is, by far, one of the worst manifestations that I have as it has negatively affected me and those close to me. This is not an understatement.

Before I go on, let’s keep this in mind – OCD is not just about being a “clean freak” or very “organized” because that is OCPD. It can, however, vary far and wide from person to person but many times the results are disastrous.

Okay, so here is, exactly, what it’s like to be me and why, many times, I avoid making choices – I go to buy a shirt but have money for one. After trying on a couple, I need to choose. Most people will just mull it over a bit, pick one and be content. Not me, my decision-making anxiety will start up, almost uncontrollably, and the compulsion to create an endless loop of decision making and doubt kick in. “This one works better for work…but this one looks a bit nicer…I think…maybe…this one seems like it’s better made…although this one would be better for more seasons…but this one people might judge me on…maybe I should wait and put it off…I dunno…” And on and on and on…It sounds funny, but it’s a real-life occurrence and not an analogy. It sucks and infuriating to feel this way. It’s not all the time but disturbingly frequent (which is why I have my default purchases and places…to avoid choice). Just to emphasize this is not “waffling”, or just “commitment issues” because it’s far more than that. It’s an internal mechanism driving me (one I am working to resolve).

Another example – it takes me years to buy a car. I get bogged down in the minute details of comparing features between different choices and that takes a lot of time. My enjoyment of cars just feeds the OCD and my obsessive need to get lost in the weeds of minutiae and to have all the “facts” (and with OCD you can never have enough facts) before making a decision, over and over and over again…obsessively. Doesn’t matter if you have all the information you could ever need, you cannot pull the trigger, you won’t just take a chance, so you keep going over the lists, “doing the math” and caught in a never-ending thought loop. It’s tiring, and many times, fruitless. Then I’ll just ruminate over a lost buying opportunity, years after the fact.

Look, sometimes I even get anxious making plans in advance of the weekend because I can’t make a decision on what to do, I get worked up and over-think. If I choose to stay home, I regret my decision and wonder if I should’ve gone out and that I’m missing out…until it’s too late to call someone, then the decision is made for me…by not making a decision. And then I ruminate.

These anxiety-inducing, risk-averse situations are fairly common and only becomes worse when involving…relationships. It’s brutal and infused with a far greater level of emotion and anxiety and can be paralyzing. Even if I know the answer, in my heart of hearts, it doesn’t matter because of a term that ties into OCD – “pathological doubting”, which is spot on. You see, I’ve been asked, more than once through the years, to make decisions on a relationship. Finding a definite answer is tough because of overpowering anxiety and indecision. In turn, that lurking OCD pounces and asks a sufferer to do something they might be, often, unable to do (again, untreated). This is because there are physical mechanisms in the brain (addressed a few posts down) that are causing being stuck in a non-stop, inescapable flowchart loop…for me, this is frustrating and quite often…sad.

So, making heavy and important decisions crushes me with doubt and fear even if I know 100% how I feel (it’s the brain, not the heart) and that starts a feedback loop of 2nd, 3rd and 4th guessing. Ultimately, the decision is made for you, and usually, the results please no one. If you’re reading this your gut response might be that it sounds lazy, weak, shifty or that I lack caring/empathy but I can assure you, it’s not that at all. It’s full of emotion and angst because OCD is tied into Anxiety after all. It’s taxing, tiring and physically/mentally unhealthy for everyone and that knowledge hurts even more…because I know I’ve hurt others too. And, again in relationships, even being in love, I can’t help but still find things to cast “doubt” upon and that reinforces the inability to make a choice (It’s OCD with a Relationship component, and if you follow this link  you can see how much it sucks). It’s profoundly hurt me, and as I’ve said,  – others too. So, think about it – if there is so much drama associated with buying a fucking measly shirt, anything beyond that can be more of a struggle. No…no…affairs of the heart can’t be broken down into lists, doubts and constant second guessing now can it? Nope! But OCD will demand it of you and you will comply and you will feed it. It’s always hungry.

So, in the end, if left untreated, it’s like a shitty Santa, checking his list twice to find out whose naughty or nice but going back and checking it 3, 4, 5, 6 times…to be sure…and then nobody gets presents in the end because time has run out. Screw you, Shitty Santa.

This is Fine…OCD is a Douche…Male Enhancement Ads

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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…

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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. 

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No, it’s not like this.

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.