30 Days of Mental Illness Awareness Challenge–Day 3

MIA challenge

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.

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An Intro

Some of you know me well. Some of you don’t. Maybe someone reading doesn’t know me at all. But I’m sharing a big secret with you, one I’ve kept for many years and shared only once I felt brave enough to.

I have obsessive compulsive disorder.

This is accompanied by general anxiety disorder, with a side helping of depression caused by OCD.

No, I don’t mean I’m just neurotic about alphabetizing (I stopped doing that because it was overwhelming) or that I like my kitchen to be in order or that I have one eccentricity. It’s not that I just have sanitizer wherever I go or like to put a seat cover down on a public toilet.

You see, many people say “I’m OCD” casually, without understanding that it is a legitimate disorder that millions of people struggle with. It’s a disorder that takes over your life. It defines everything you do and everything you think. Sometimes it’s hard to separate OCD from one’s own personality.

I’m not upset at people who say it casually. I get it. I don’t believe anyone who says it casually is trying to hurt anyone. But I do know that those of us with real OCD hide behind the jokes. We pretend our compulsions are just funny eccentricities, or we hide them altogether and remain silent for fear that we might be judged. We know you don’t get it. We don’t get OCD either. That’s half the problem.

Obsessive compulsive disorder doesn’t make sense. Basically, in my mind, there are obsessions. These can pop up at any time or be triggered by something. My mind latches on and can’t let go, until I complete a compulsion to “undo” the obsession.

Example:

I’m walking down the street. A trash can is on the corner, which I have to walk by in order to get to the subway. People are standing nearby, making the path narrow. As I walk through, I try to avoid the trash can. But after I get past, I wonder if maybe I hit the trash can, even if it was just my bag or the toe of my shoe. This thought consumes me. I stop walking and look back to evaluate. I look at the narrow passageway, trying to determine if I could fit through without touching anything. Then I try to reason that I would have felt myself hit something. But that doesn’t work, because what if the corner of my shoe grazed it, or what if my sweater blew onto it? I try to tell myself it’s fine. I didn’t hit it. I’m fine. I didn’t touch those unclean-looking people either. I walk again.

I stop a few steps later. Maybe I did hit it. Maybe something touched the trash can. Should I go home and change? Where’s my sanitizer? I sanitize my hands with the sanitizer I carry for moments like this. But there’s nothing to sanitize my clothes. I wish I had a wet wipe to take care of my bag. I accept I’m dirty and move on. A few steps later, I use the hand sanitizer again because I can’t shake the idea that I touched the trash can in some way.

Once I reach the platform, I sanitize again. I see something dirty on the train. I sanitize again. This continues all day.

This is an example of a contamination obsession and decontamination compulsions. I see something dirty, and I become obsessed with the idea that somehow I will become contaminated. This contamination could lead to me becoming ill or even dying. No amount of logic will shake this idea. An OCD mind is illogical. In order to calm my anxiety about this, I complete decontamination compulsions. I mentally check what I did and try to convince myself I’m okay. But that doesn’t ease my anxiety, so I move to the physical compulsion of using hand sanitizer. I can’t stop until I believe I have eliminated the germs. But since you can’t really eliminate germs, I never feel completely comfortable.

They call OCD a doubting disorder. It’s perfectly accurate. I doubt so much.

OCD manifests itself in many other ways. As I continue writing in this blog, I’ll share some of the ways with you. I have started therapy for my OCD because I can’t keep struggling like this. It’s hard to enjoy life when you spend every moment consumed by doubt. Compulsions take an enormous amount of time. I know this can be conquered. It’s going to be really, really hard. Harder than anything I’ve ever done. I’ll be doing something called Exposure and Response Prevention therapy. What this means is that slowly, in baby steps, I will purposely expose myself to a situation I fear, and I must resist acting on my compulsions. The idea is to retrain my brain to stop engaging in the compulsions that only serve to increase my anxiety. It’s going to get extreme. So extreme that I’m actually afraid to say some of things I may be doing. But the point is that I’m not normal, so I have to do the abnormal to get over my fear.

I am going to be taking medication. Medication helps with OCD. Some people need meds for life; my goal is to use the meds to get started with therapy and eventually get off the meds as the therapy helps. I tried a drug called Luvox, but the side effects were awful, so I’m hoping to switch back to Prozac, a drug I tried a few years ago that worked to calm my symptoms. You can do this without meds, but the meds really help.

OCD is a biological disorder. I’m not crazy. My brain is just wired differently. Doctors are still trying to figure out what makes the OCD brain tick differently. Serotonin levels seem to have something to do with it, but we aren’t sure why.

There’s a lot to learn about OCD. It has been proven that ERP works. Even though I’m terrified of therapy because I’m afraid to confront my anxiety head-on, I know it can make me better. It will improve my quality of life. I invite you to come along on this journey with me. I’m warning you now: it’s gonna get real in here. I’m not leaving out the gory details, and it’s gonna get gory. Literally. But I can’t leave anything out. I want other people with OCD to find help in this blog. I want them to have a voice. If I can help one person, that will make me so happy.