30 Days of Mental Illness Awareness Challenge–Day 3

Day 3: What treatment or coping skills are most effective for you?

Medication: I struggle to fight any of my illnesses with Prozac. Medication isn’t for everyone, but Prozac really helps me. I tried Luvox for my OCD, but it had horrible side effects and made my anxiety worse, so I was glad when a new doctor switched me back to my tried-and-true Prozac. Prozac helps me stay calm and blocks some of the obsessions and anxiety. This keeps me from engaging in compulsions and feeling so down all the time. Right now, I’m not taking my Prozac because I’m between school and jobs and have no medical insurance, thus rendering me unable to afford a visit to my psychiatrist. I’m out of refills on my meds. I stopped taking them before I ran out so I would have them on hand if I absolutely could not manage anymore. Thankfully, I’ve been staying better than the previous times I went off meds, but that’s because so far, nothing huge and dramatic has happened in my life to trigger the anxiety that throws my OCD into overdrive. I’m not doing as well as I was on the meds, but I’m doing okay.

I also occasionally take Klonopin for anxiety attacks. I’m terrified by all the things I’ve read about how easy it is to become addicted to that type of med, so I work really hard to only take it if other methods won’t calm a serious anxiety attack (read: hysterically crying and shaking, unable to concentrate, total freakout meltdown mode).

ERP (exposure and response prevention): This has been key to fighting my OCD. I previously tried talk therapy (it did nothing for me) and a combination of medication management and talk therapy (only the meds made much of a difference). Once I knew I had OCD, I knew I would need to use practical measures to get better. I’m just that kind of person: theory doesn’t do much for me, but practice makes a huge difference. For OCD, this is a highly effective treatment because it forces you to live with the obsession without engaging in the compulsion. As you are able to live with the obsession without the compulsion, the obsession’s hold on you weakens, until it becomes more of a whisper or nag than something you feel has taken control of you.

I used this for contamination, checking, and perfectionism. My therapist and I used the SUDS scale (subjective units of distress). I talk more about that in detail here. We set up a hierarchy, and I completed the tasks starting with what would cause the least amount of anxiety, increasing to tasks that caused more anxiety once I had a handle on the lower items. This made a huge difference, but I still have to work on some areas.

Exercise: I have a hard time relaxing. I often don’t feel like I have time to relax, and even when I do, it’s hard to shut my thoughts off. I always want to be thinking about something. Doing something. Exercise is one of the things that helps me relax. I do want to lose weight, but I use exercise to keep my mental health good. It really does work. I go out for a power walk (well, now I can jog for part of that, something I couldn’t do before) and turn on my music, or I do some dancing with my Dance Central game. When I walk, I’m able to just focus on what songs I’m listening to, the environment around me, and my body. Sometimes I use that time to think through an issue without the pressure of other people around. Exercise is sort of a natural medication–it helps regulate the chemicals in the brain. (Read more in this post.)

Talking about it: I didn’t always talk openly about OCD. I hid it for a long time. I felt ashamed and embarrassed and didn’t want anyone to think I was “crazy.” Trying to keep it secret caused me even more anxiety. My heart would race if someone walked into the public restroom while I was washing my hands, because I knew they might speak to me about my hand washing (and sometimes they did–hello, more anxiety). I was terrified coworkers thought I was doing icky things in the bathroom because I spent so much time in there, when in reality I was washing my hands about 10 times a go. I didn’t want to admit that the raw redness of my hands was caused by me, not some allergy. But when I finally just started telling everyone, I felt free of that anxiety. Not everyone understands OCD. Not everyone will be accepting. But it still helps me so much to just be open. It alleviates the pressure caused by trying to hide. The less anxiety I have, the better, because if I don’t have much anxiety, my OCD can’t be fed.

Back to the Start

When I last posted, I had made so much progress in my OCD therapy. But as my schedule became hectic, the holidays neared, and my routine changed, I encountered a number of setbacks. Now I am in a place where I feel almost as much anxiety as when I started therapy.

I have maintained my progress in not using sanitizer, putting on my own shoes…and well, that’s about all I can think of. I’m trying not to beat myself up and remind myself of what my therapist has told me: “I would be surprised if your OCD wasn’t affecting you right now.”

Why the setbacks? Well, first a hurricane hit New York City. Fortunately, my apartment wasn’t in serious danger. But it still meant school being closed for a week, the office where I was an intern being closed for a week, and numerous other businesses being difficult to get to. I spent a week on my couch. I did make some progress, in that I cooked, but I haven’t maintained it. I couldn’t get out to the gym or work out outside much, so I started to lose the exercise habit that had been so good for my mind.

Because of the hurricane closing work, I had to work extra days the next two weeks. I had no time to exercise between work and school, so my routine really fell off. I need the workouts like medicine, and without them, I just lost what had kept me going.

My husband had to leave town for a weekend, and for that weekend, I had to scoop the cat’s litter and take out the trash. These items were very high on my hierarchy, much higher than anything I’d worked on so far. Seriously, on a SUDS scale, they were in the 80-90 range. But they had to be done, because there was no one else to do them. I managed okay, but I haven’t maintained it.

My mom arrived the next week. She has been staying with us for the holiday season. Six weeks. At the time we booked the trip, I had been making so much progress that I thought it would be fine. But then everything went haywire, and it turns out it might have been a bad idea at this time. I’m just not strong enough yet. I don’t know how to deal with stress, especially massive amounts, in a healthy way yet. But I’m trying.

After Thanksgiving, I had a horrendous few weeks of school as I prepared for finals. I have never been so stressed. There were all-nighters, tears, and a hell of a lot of guilt because I wasn’t able to take my mom out. All this is too much for someone suffering from perfectionistic obsessions and compulsions.

On top of this, there was some other news that has thrown my world completely off. It’s a very stressful time for my little family, and there’s not much I can do to help. I hate feeling powerless, and even more, I hate that I feel like no one truly understands or cares how this bit of news affected and still affects me. I understand why what’s happening is happening, and I’m not angry. Just scared. Scared that I’ll have to give up my therapy. Scared that I will never be granted the opportunity to get better from OCD. Scared that I will spend every day of my life crippled by this disorder. Scared that every minute will be consumed by anxiety and that I will eventually break and lose everything I ever wanted.

No wonder my OCD is in high gear.

My mind is filled with obsessive thoughts again. I can’t get a handle on them. I’m washing my hands a ton because I can’t shake the anxiety. I can’t clean, I can’t do trash. I feel closed in all the time. I wake up and want to stay in my bed. I mentally check and repeat everything. I’ve started checking the locks again. I lock the car door multiple times again. I’m still not exercising regularly. The other day, I nearly broke into tears when some washcloths were out of place. I feel like I’m falling apart again, like I am made of glass and can shatter at any moment with just a tiny disturbance.

But I’m hopeful things will get better. My mom is about to head home, so my home life will return to normal. I love my mom dearly, and I adore spending time with her. But it’s very difficult to have three people in a one-bedroom apartment in New York for more than three weeks. It gets cramped, living styles clash, and it becomes stressful. I’m also about to go visit my friends in Oklahoma, who are like family to me. I see them as sort of a healing balm for my soul. Every time I’m with them, it’s like everything in the world is all right again. They make my burdens feel light, and I need that so much right now.

I’m also not taking on an internship this semester, and I’m not starting a job until I graduate. I have enough money from school to live on. Hopefully the situation doesn’t change, because I really need this time off. I only took internships in the first place because I felt like something was wrong with me if I didn’t. Everyone else seems to have one, or to be working, and I felt like a loser. But the truth is, I need some time off to really work on conquering my OCD. Working and going to school makes my schedule too full, and I can’t do all the things on my hierarchy as a result. This is the best time in my life for me to focus on conquering OCD, and I need to do it for my future. I keep trying to remind myself that I have to do this for my mental health, that I am not being lazy or selfish or anything negative. It’s hard, because I feel like I’m not being perfect. But I’m not supposed to be perfect, so says my therapist.

I’m working on not being perfect. I’ve finally realized that perfectionism is the strongest area where I struggle. I have had perfectionistic obsessions and compulsions since I was a child. A degree of perfectionism can be good, but people who struggle with this in terms of OCD go overboard, feeling like the world falls into chaos or that no one likes them if they’re not perfect. This is incredibly hard for me, and generally it’s what has caused numerous nervous breakdowns over the years. I have tried and tried to be perfect, and I feel like I have to be. I just always have felt like I have to be perfect. There’s always some burden on me. And I’m finally realizing most of those burdens have been created by me. It’s time to learn how to let them go.

So I’m back to the start now. I’m going to try working my way back through my hierarchy and start working on perfectionism. I’m going to make exercise a priority again. Most importantly, I’m going to accept that setbacks will always happen. That’s what my therapist keeps reminding me. I will always have times when my OCD gains a little control again, when life gets stressful and my brain wants to rely on the old routines. But it’s important at those times to remind myself of what I’m doing well (I’m not using sanitizer, and I can put on my own shoes) rather than berate myself for what I’m not doing well. My therapist also told me I should just accept the anxiety at these times, rather than thinking I should be doing better at fighting it, because thinking negatively about it only makes it worse. That’s very hard for me to do, but I’m trying.

So here’s to a new year, in which I hope to conquer my OCD and begin a new life, without all the stress and anxiety.