Hi. In my first post I gave a brief overview of my OCD whilst discussing the disorder as a whole. I thought this time it would be useful to look at how my OCD came about and the gradual steps I took to get to where I am today. Today I feel good which is great to write! OCD is referred to as the “doubting disease” and a common fear is whether you will ever feel happy again. A real motivator for writing this blog is to help people suffering with OCD to start believing in all that good stuff again. I admit this is hard to think possible if you are in the thick of the “worry-go-rounds” (what I call the worst periods of the disorder). So, with that in mind, here’s how my story came about.
“Shit! I’m not evil!” Smiley face.
Growing up I used to worry a lot. About everything. I never told anyone though. I’m not sure if this was because I thought ‘If I don’t say it its not real’. Or maybe I didn’t want to seem weak? Or perhaps I didn’t want people to worry themselves? Probably all of those. It does not matter too much now. The fact is I had a load of anxiety taking a ride on never ending waltzers in my belly and, despite having a wonderfully supportive family, I never felt comfortable vocalizing its existence.
So where does this anxiety go? How is the pressure relieved? Unfortunately the natural mistake any child, teenager or adult can make is to try to work that feeling out. To try to think themselves out of that feeling. It can work briefly. But if that anxiety pot is always on the verge of brimming you have to keep thinking of more ways to reassure yourself that everything is going to be okay. Throw a frightful “intrusive thought” into the mix and its not too much of a jump to see what can happen next. The individual starts to dedicate their whole lives to convincing themselves that thought was not real. But the issue is the anxiety made it FEEL real. And so the cycle continues. OCD is born
I remember in my early 20s I used to say to myself “I will NOT have that thought today” and manage about 5 minutes at best. That track got stuck more than the NOW 54 CD that I used to use as a tea coaster and frisbee. And was even shitter. I was so desperate to have a ‘pure’ brain without ugly thoughts. But anything from a pair of scissors to a dark BBC News story would be enough to set me off into dreadful doubt and reflection. Of course all of this reassurance, coping and avoidance made things much worse. I had got to the point of planning how to ‘hand myself in’ (for crimes against the thinking world I suppose) and researching online to see if I had the same brain as the Moors Murderers. All was not well.
Then, whilst training for a new healthcare role at the age of 24, a little miracle happened. The woman taking the group mentioned “some people with OCD have repeated unwanted thoughts about hurting people”. I sat bolt upright. Straight after I raced home and jumped on Wikipedia and started reading about OCD, intrusive thoughts and compulsions. The relief I felt that day is still something I marvel at fondly. That there could be a reason for all this confusion and fear felt something close to being reborn.
I went to see my GP a few times over the next week or so. They were confused as I made long winded attempts to tell them the problem (I still had intense fear that if I uttered the nature of my thoughts I would be locked up instantly so it took me a while). Their almost nonplussed response to my eventual confessions was music to my ears! I learnt how common these thoughts were. How I was (relatively) normal! I just had an anxiety disorder. I was put on the waiting list for CBT.
My GP also started me on Prozac, a common antidepressant. Prozac, or to use its medical name Fluoxetine, is mostly known for treating depression but it can also be effective for anxiety disorders. A lot is said about the dangers of taking tablets to “feel better”. Critics say medication does not solve the problem but only masks it. To a certain extent I agree. Medication is not the answer with a full stop. Real therapeutic work and healthy lifestyle changes are necessary to bring about lasting change. I must add though that I believe at the right time, in a planned way, medication can be valuable for people when they need it most. Within two weeks of being on a relatively small dose of Prozac I felt much less anxious and was actually able to start enjoying everyday activities.
A major benefit of medication for me was that the tension of my disorder was eased whilst I waited for therapy. I was on a waiting list for CBT for over a year. This is a common phenomenon in the UK mental health system and is an issue that needs addressing. There are patients who are a lot more unwell than I ever have been who continue to wait on similar lists, which is a huge shame on our society and points towards our under resourced healthcare system.
Whilst waiting for CBT I learnt a lot online about ways to improve my interactions with intrusive thoughts. I learnt ways to “watch” them pass by and to let them go. I was also greatly helped by the online support forums on OCDUK where it can be so useful to speak to others going through similar experiences. I would recommend checking these out here if you are interested: http://www.ocdforums.org/
By the time CBT came around that first time a lot of the material actually felt like more of a helpful refresher than any new groundbreaking approach. There are two ‘levels’ of CBT offered by the NHS, the first being more basic and the second an advanced version. I completed the first and did not feel, at that time anyway, as though the advanced therapy was necessary. I understood OCD so much more. Medication had helped. All seemed well.
Not you again.
The next few months rolled by nicely. It felt like life was flourishing. I loved my new job in substance misuse and the purpose it gave me every day. I was far more at ease with any thoughts of harm that came up which in turn made them arise much less. I learnt that when you show your brain that you are not going to react to thoughts it eventually stops bothering to throw them at you. What a wonderful revelation.
But then something changed. At night I would start to be very aware of my heartbeat. I would have the thought “Perhaps I’m having a heart attack” followed by intense anxiety. This would speed up my heart rate and I would check my pulse (compulsion). I would feel so anxious that I thought something must be wrong (obsession) so I went online to check symptoms for cardiac arrest (obsession). I would convince myself mentally that nothing was wrong (compulsion) and finally get to sleep. But then the next night it came back. So I went to the doctors with lists of symptoms (compulsion) and felt relieved when they said I was okay. Then thought came back again. And again and again and again. I had a new “theme”.
So I was anxious all the time once more. I could not understand it. I thought I had pretty much conquered anxiety!
I tried to reason with myself that maybe this time was different. Maybe it had been a bit far fetched fearing I was evil, but anyone could certainly die at any time in an instant…maybe I was critically unwell? Perhaps all this checking and ruminating was healthy? I am not the first person who has ever excused their OCD or felt it had some use. Unfortunately that is another way the insidious disorder sticks around, by convincing you of its importance to your safety. “If I keep washing my hands at least I won’t have germs and there’ll be less chance I infect people…”, “If I keep checking my pulse at least I’ll know if my heart beat is irregular and I can call an ambulance if I need to…”. Tricky little bugger is OCD.
My fear of becoming unwell and dying spread to cover all parts of my body. I would become aware of my breath and then feel like I could not breath. A stomach ache would instantly be stomach cancer. A sneeze could send me to the doctor asking about Ebola. Poor bloke. Along with these fanatical health worries I was also experiencing existential trauma about the size of the universe, my place in it and whether I actually believed in anything. Dark times. I was exhausted by the obsessions. I swallowed up my pride and asked to go back on the waiting list for the more advanced CBT.
A New Dawn
This brings me up to last year. I had waited 5 months this time for therapy. My therapist was fantastic. She was consistently firm with my reassurance-seeking behaviour which was incredibly helpful. She taught me how strict I needed to be with my brain. Concerning my existential fears I would ask “So maybe all this worrying about the universe and meaning means I do really care about things?” She would shrug her shoulders and say “I’m not going to answer that question and what are you doing by asking me that?”. I was performing a compulsion of course!
For my health fears we did some Exposure and Response Prevention (ERP) therapy to great affect. This is where you simply expose yourself to a fear and do not respond as your brain is screaming out for you to do. One example was when I was instructed to breath very deeply and aggressively for a minute which provoked tons of anxiety. But then (because I did not die, as expected) I have not worried about breathing since. In another exercise I had to continuously spin round on a chair until I felt sick. Again a horrible experience but fears of stomach cancer have reduced dramatically since that day. If I had still been terrified of hurting people at the time of ERP I would have most likely been slicing up vegetables and raw meat next to my therapist. Hats off to anyone going through that right now you are soldiers!
So in January this year I was discharged. I felt fresh with a whole new toolkit at my disposal to keep those OCD demons at bay. I have kept my CBT ‘homework’ from therapy to look over. I will go over some of that in future posts. After therapy there was still one more psychological banana skin waiting to trip me up. But that ‘slip’ and the beautiful realisation that followed it is for my next post. In the meantime here is a lovely video featuring Alan Watts that reminds me to not always follow the mind when it asks me to walk down paths that lead to nowhere.
Thanks for taking the time to read this. Share this with anyone who you feel may benefit.