30 Days of Mental Illness Awareness Challenge–Day 1

I found this challenge through a friend I made at the OCD conference and thought it would be a great way to kick off OCD Awareness Week. So for the next 30 days, I will post responses to this challenge from Marci, Mental Health, & More.

Day 1: What is/are your mental illness(es)? Explain it a little.

I have obsessive-compulsive disorder and anxiety disorder. I have also struggled with depression, and my psychologist also suspects PTSD.

There are many facets to OCD. The areas I struggle with are contamination obsessions and compulsions, checking obsessions and compulsions, protective compulsions, some aggressive obsessions, some sexual obsessions, perfectionistic obsessions and compulsions, movement compulsions, and mental compulsions. Some of these I have struggled with since I was a child.

Contamination obsessions and compulsions have to do with things being perceived as dirty and my need to either avoid getting dirty or clean up a ton. There is a high degree of illogical fear in this. The fear is that if something or someone, including myself, is contaminated, something bad will result–I could get sick, I could get really sick and die, someone else could get really sick and die, a terrible disease could be contracted. I also sometimes felt suffocated by perceived filth. When I was at my worst, I had a panic attack and cried over touching items in the trash. I took two showers a day, for an hour each time. I washed my hands after touching almost anything, or sometimes just if I couldn’t shake the obsession that I possibly had touched something. Each time I washed, I would soap, rinse, repeat at a minimum of five times, at a max of ten to fifteen times. I would be in the bathroom washing at least fifteen times each day. If I couldn’t soap, I used hand sanitizer. I could easily go through one bottle of hand soap in a day. I had to sanitize everything. Phone fell on the floor? It had to be wiped with a sanitizing wipe–but not by me, by my husband. I couldn’t put on my own shoes for fear of the germs. Walking down the street made me feel so filthy I was sure I needed a shower. Looking at a dirty homeless person made me want a shower, or at least to wash my hands. Looking a trash can made me want to wash. I made my mom and husband wash in specific ways, and I had them do tasks I couldn’t handle. I would ask them for reassurance if I was afraid I touched something.

Checking obsessions and compulsions have to do with obsessing about whether something was done or said and completing an action numerous times to alleviate the concern. I might go out with friends and start worrying later that I said something appropriate, and I would ask a trusted friend who was present several times if I said that. Or I lock my car about ten times. Just to be sure. And even then, I’m still not sure.

Protective compulsions have to do with my need to do certain actions to prevent harm from coming to myself or others. This hasn’t interfered in my life too much, but when it has, it has caused me to worry incessantly about friends or family. Like when my mom used to drive home from a visit to me, which took an hour and a half, and I would spend that time obsessed with the idea that something bad would happen to her and that I should have just driven her myself and that I should do something so she wouldn’t have to drive. I made her call me upon arrival home, like she was my kid instead of the other way around.

Aggressive obsessions cause me to think about unwanted violent images, like those of me hurting myself or someone else. It can be as simple as me standing by the train and suddenly picturing myself putting my foot between the concrete and the moving train and picturing what would happen after (which gets pretty disgustingly graphic in my brain). This image replays in my brain, like a CD stuck on some note of a song. I try to shake it off, but that makes it come back stronger. That’s the difference between OCD and just having a gruesome thought. Many people might think about this, but they don’t keep thinking about it. My brain can’t stop; trying to stop makes it worse. It’s why I can’t watch movies that contain even the smallest bit of gore. My brain disregards all imagery but the gore and then randomly replays the gore in my mind at later times. None of this means I would ever actually hurt myself or someone in this way. It’s just an irrational fear.

Sexual obsessions don’t play a big part in my OCD, but they have affected me from time to time. I’m not yet comfortable going into specific detail about my own experiences with this. Generally, it involves having unwanted inappropriate sexual thoughts and obsessing over them.

Perfectionistic obsessions and compulsions are fairly self-explanatory–it’s the obsession that something needs to be perfect or that something wasn’t perfect and completing actions to undo or alleviate the concern. Sometimes the obsession prevents the person from even starting on a project. I always put off writing papers until the very last minute because I obsessed over figuring out the perfect thing to write about, and how to say it, and whether it would be as good as someone else’s. The worst thing was going to class and hearing other people’s projects after we’d all turned ours in. I would spend the next week or two until the grades came back obsessing over what I should have done instead or better. I couldn’t focus on friends or my husband or anything enjoyable–all I could think about was the mistakes I was sure I’d made. Then I’d get my paper back and have an A, and all that time would be wasted.

This is an area I struggle with most strongly. It permeates every area of my life. I used to be unable to invite people to my house unless it was perfect–clean and neat and everything in its place. If people came over when it was a mess, I was sure they were judging me and obsessed over it. I become obsessed with my clothes fitting perfectly–if I’m having a fat day, I’ve been known to try on twenty outfits then burst into tears and profess I won’t go out because I just know someone will notice the teeny tiny bit I’m unhappy with. This wastes up to two or three hours of time, making me late for so many fun things. And even if I did go out after, all I could think was that I looked awful and that I should diet and how everyone else looked good but me. Basically, if it’s something someone can be “perfect” at, I obsess about it. This can be a good thing in moderation, but at the level I used to struggle with it, it was a bad thing, resulting in multiple nervous breakdowns and an inability to ever be satisfied. I still remember my therapist asking at the beginning of our work, “Are you satisfied with anything you do?” I answered no. I knew then it was going to be my biggest battle. (Good news: I’m not as bad as I used to be with this. I’m loads better. Not completely better, but getting there.)

Movement compulsions basically have to do with me repeating an action to ensure I did it correctly. For example, I worry about my hands touching something dirty after I wash them. So I’ll retrace my steps up five or six times, repeating the exact action I think I just took, to ensure I didn’t actually touch anything.

Mental compulsions involves me mentally checking or retracing to ensure I didn’t do something incorrectly. I could make it into my living room after washing my hands and retracing steps, but then mentally I will think about the entire cycle again, repeatedly. This mental checking has kept me from knowing what the people around me were talking about. I’ve put on a good show that I’m present in the moment, but I’ve been in my mind, completely obsessed with remembering every detail. If my mental compulsions don’t satisfy me, I resort to a physical compulsion.

So that’s pretty much my OCD. Anxiety disorder feeds into all that; I’ve been known to have intense anxiety attacks when feeling out of control in a situation or when my OCD is really bothering me. I have dealt with depression and suspected PTSD due to some events in my early life, which also happened to push my OCD into overdrive. I knew I was depressed when I stopped wanting to do anything that mattered to me in favor of just shutting myself off from everything. I don’t completely understand the potential PTSD diagnosis, but I haven’t argued it either. I believe it’s possible, but I’m not yet at a place where I feel I can really think about what led to it or how to deal with it. This one’s really hard because society has a tendency to say, “Well, we all have bad things happen, but we’re not freaking out. What makes you so special? You don’t have it that bad, people have experienced worse than you, etc.” To which I say yes, some people have had it worse. And I am sorry for those people. But that doesn’t mean what I experienced shouldn’t have caused me pain. I wish we lived in a world where we could just accept that everybody hurts and let people hurt instead of saying they should just deal with it.

We all hurt. That’s okay. Let’s just all accept it, and maybe we can get better.

Perfectionism: My Greatest Enemy

Perfectionism. There are a lot of people who want to be successful and do/look their best. For most people, that’s fine. For some people, like me, it becomes an obsession. Not all obsessions are alike. I’m obsessed with perfection because my OCD equates perfection with self-worth and evading risk.

I can’t remember a time in my life when I wasn’t obsessed with perfection–in myself, in my surroundings, in the people around me. I always just thought everything had to be perfect. A few examples:

• Ponytails were a nightmare. I had to have my hair pulled perfectly back, smoothly, no loops, with perfect symmetry on the back of my head. If I couldn’t get it right, I would be extremely upset. Sometimes I’d cry or throw a fit. Sometimes I would spend whole hours fixating on how terrible I must look and what a failure I was for not being able to do something that looked so easy when others did it.
• I was jealous of kids who had better handwriting than me. I worked so hard at having pretty handwriting, but when I saw someone else’s that was better than mine, I became obsessed with making mine perfect and always feeling like I didn’t measure up. I was in second grade when this started. It wasn’t just handwriting; it was everything–reading, writing, math, science, etc. There are subjects I’m just not good at, and when I couldn’t be perfect, I became distressed. The only time in my life I was ever comfortable with receiving a B grade was when I rebelled against a teacher who was trying to make me read for my grade. When I got a B in Algebra after trying my hardest, I decided to have nothing to do with math unless I had to absolutely take it–all because I wasn’t perfect.
• I didn’t like other children playing with my Barbie dolls. I needed my dolls to have perfect hair, perfect clothes, perfect everything. I saw other kids’ Barbies, with their hair going every which direction, limbs popped off, clothes in bad condition, and I felt this agonizing fear of what would happen if they played with my dolls. I couldn’t bear the thought of my toys being less than perfect.
• I hated getting a wrinkle in a page or dog-earing a page in a book. To this day I struggle to write in textbooks, or any book for that matter, and it freaks me out that people can do it so casually. To me, it’s like destroying the perfection of the book or magazine.

The list goes on and on. To most people, these appear to just be quirks of my personality. Even my mother is surprised by how much of this is actually OCD. The way my therapist puts it is this: “If you think it could be OCD, it almost certainly is.”

Until I started learning about OCD, I thought my perfectionist traits could be easily explained by other things, like my environment. But the truth is, it’s always been the OCD. My parents always encouraged me to do my best, but they didn’t have a problem if I wasn’t good at something. I just felt like I had to be the best at everything. I have always quit anything I didn’t take to quickly, because I knew I couldn’t be perfect and couldn’t handle the stress of not being perfect. Even writing, the thing I’m probably best at, is extremely difficult for me. I don’t believe I’m any good, despite what people tell me, because I’m not perfect.

For years, I haven’t known how to allow imperfection in myself, and this has led to a slew of compulsions to deal with it. One thing I struggle with is asking for reassurance. I ask everyone around me how I did on a project or a social situation, and I keep asking until I feel like the anxiety has lessened some. For example, a couple of my friends are in class with me. When I give a presentation, I end up asking them several times afterward how I did. And it’s not just “How did I do?” My questions get very specific. Or I’ll say negative things about myself, which I know will result in them saying positive things to make me feel better. Sometimes the anxiety I’ve had over a presentation lasts days, with my chest feeling tight and me being unable to focus on anything else. Sometimes the reassurance compulsion helps. Usually it doesn’t. But it’s so hard to stop it.

If my brain were able to be logical, I would recognize that not getting a perfect grade would not end the world. I would cause no disasters. My family and friends would not consider me to be a failure. I would not be ruining chances at jobs. I would not be destroying my entire future. But OCD tells things differently. It says, If you get a B or lower, you are a failure. You’re not good enough. You’re supposed to be perfect. How will you ever get a job with a B? No one will respect you. You look like you’re just not trying hard enough. Or maybe you’re not smart enough. You’re supposed to be perfect. Maybe you should just give all this up. You’re not perfect. You need to be perfect though. It’s a requirement.

My OCD brain tells me similar things for practically everything I do. It’s an exhausting way to live. For years, I’ve tried to keep up the appearance that everything’s fine, that I balance things well. But I don’t, because everything I do causes me this level of anxiety. I feel this way about every paper, every job task, every social situation, even getting dressed in the morning. And it’s finally led to a near-complete breakdown.

This is how so many people with OCD live. They work really hard, and you think they’ve got it together. You might even envy them. But the truth is, it’s a miserable existence, especially when suffering in silence. Many people with OCD will never get the help they need for this; they may not even know it’s OCD, just as I didn’t for years. We just feel this need to be perfect, that we are personally responsible for so much more than we could possibly have control over. We feel that if we aren’t perfect, we’re letting someone down, or we’re causing harm to befall ourselves or others.

I’ve often thought that if I do badly or people see me be imperfect, it will reflect terribly on everyone I know, and it will cause all kinds of damage. In my old job as an editor, I believed that if readers found one mistake in a book I edited, they would think the author was a total failure, and I would know it was my fault. That author’s career would be over because of me. No one would know except me–and the author, of course. But that would be enough. I knew I would hate myself for destroying that career. But how could that possibly be my fault? And how many people really write off an author because of one mistake? I just finished a Stephen King book in which I found a character name error. Is anyone ignoring Stephen King now? No. Because imperfection isn’t as bad as my OCD makes it out to be.

This is how I lived my life. I don’t know what life is like without the constant pressure of needing to be perfect. I know that I’ve felt at the end of my rope several times over the last few years. I know that I haven’t been myself this past year. For the first time this semester, I didn’t experience anxiety about my grades on papers, not because of treatment, but because I’m actually too tired of fighting to care. That is extremely unlike me. But the anxiety is too much. Many people with OCD are procrastinators because they know the anxiety will come with the task ahead, and they don’t want to deal with it. Procrastination is a sort of avoidance compulsion. That’s me. Always been a procrastinator, but I always finish my tasks because the fear of not finishing is greater.

Basically, my life is defined by fear–especially the fear of imperfection.

Working on this in therapy is slowly starting to help. Therapy has been hard because I want to be perfect, but this is not a therapy one can be perfect at. I need to be imperfect. I need to allow myself to take time with therapy. My therapist keeps reminding me that it’s okay to be imperfect, that it’s okay to be human. It’s not as hard to believe now. It’s still not an easy belief; I have to tell myself in every situation, “You don’t have to be perfect.”

I’m a little scared of who I will be when this is all over. I don’t know how to be my best without perfectionism and fear. That’s always been my MO. But I know whatever I will be, I will be healthier. I will be capable of taking on challenges without going absolutely crazy with stress. And that’s a very good thing, something I really need.