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.

Exercise Makes a Difference

At my second therapy session, my therapist was extremely concerned for me. I had taken to spending days at a time in my apartment because I didn’t want to encounter the dirt outside and because I didn’t want to have to deal with all my OCD rituals. I was also feeling depressed and had no desire to get out of bed. Everything felt overwhelming, and I just didn’t want to face it. She told me I was becoming agoraphobic.

When you have agoraphobia, you avoid situations that will cause you anxiety, that could cause you to have an anxiety or panic attack in public, where you feel trapped, embarrassed, or weak. This leads some people to become trapped in their own homes. I was on the path there. I was still going out when necessary, but if I didn’t have to go out, I didn’t.

Her assignment to me that week was to spend at least thirty minutes every day outside of my apartment, just walking. This would force me to deal with the dirt on the street and get me back in the habit of being in public. She wanted me to use the walk as exercise.

I cheated. I did spend at least thirty minutes outside of the apartment every day, but I wasn’t exercising each time. In fact, usually I was just finding stuff to do.

The next week, she told me to increase my exercise to an hour daily. She continued to say this for weeks. But I wasn’t doing it. I was getting out of the house, but I didn’t feel like I had time to exercise. My schedule has been crazy busy, and I was certain I couldn’t fit one more thing in. Plus I hate exercising. I used to be in shape in high school because I was taking dance classes and I was a cheerleader, but in college, that all changed. I’ve tried to get into exercise, but I’ve never been successful.

I also didn’t believe exercise could really have that much impact on my mental health. How could exercise possibly help with OCD? My brain is screwed up. Exercise isn’t for the brain, I thought. It’s just for your body.

But finally, I started feeling bad about lying about exercising. Rather than admit it, I just started exercising. On the first day, I tried Ease Into 5K. I’ve tried this before but never stuck with it because it didn’t give me the results I wanted. As an OCD person who struggles with perfectionism, I have a bad habit of wanting instant gratification. When my body wouldn’t do what I wanted it to when I wanted it to, I usually gave up. Also, it was harder on my body than I thought. I was pushing myself too hard. I hated day one.

On the second day, I decided to just try power walking. After all, I wasn’t exercising for fitness; I was doing it to appease my therapist. Walking would be good enough. I downloaded an app that tracked my walk so I’d know how many miles I went. I decided I’d head to the park to walk, since it’s by the water and has a great view of the Manhattan skyline. If I was gonna do this, I was determined to enjoy it.

I walked three miles and actually kind of enjoyed it. I didn’t maintain a steady pace, but I still walked it in about 45 minutes. I loved seeing the water and the trees and being around other people who were exercising. It was relaxing to just spend that time listening to music and getting fresh air.

That weekend, my husband, a few friends, and I headed to my in-laws’ place in Maryland. I brought along my workout gear so I could make sure to get some exercise in. I’m so glad I did, because I woke up Saturday morning with an enormous amount of anxiety. The night before, we’d been enjoying cocktails, and I made the mistake of not eating enough, not getting enough water, and taking my Prozac with alcohol. The combination made me sick, and I woke up terrified that everyone would think less of me, that they were all judging me and thinking I have a real problem even though I never get sick from drinking, that they didn’t like me as much as a result. I was shaking with the anxiety and fear. My chest hurt. My heart was racing. I was convinced I’d been the biggest idiot, and I didn’t know how I’d face it all weekend. Finally I decided that I’d go walk it off. I put on my workout clothes and headed outside. The time alone was just what I needed. During the first part of the walk, I was obsessing about the night before. But I slowly began to let go, to focus on the music playing in my ears, to notice the beauty of the country around me, to observe how my body was carrying me down the road, to feel my even breathing and recognize that I was strong. By the end of the walk, the anxiety was almost gone. I still felt a little nervous as I entered the house, but I found myself better able to let go and expose myself to the situation.

No one said anything about the night before. No one cared, except that I was all right. It didn’t change their opinion of me one bit. My anxiety had been for nothing. And so what if this had changed their opinions? I’m only human, and that’s what I’ve got to start realizing. Everyone has a night like that, so it’s no big deal.

The point is, the exercise helped me deal. I wasn’t exercising to get fit; I was exercising to reduce anxiety. I don’t quite understand yet why it works, but it does. Maybe it’s because it helped me get out the nervous energy. Maybe it’s the fact that exercise does something to your brain chemicals. It works. That’s what’s important.

I went out again the next day. I felt so good at the end of my 45 minutes and three miles that I decided to keep going–just because it felt good, not because I was pushing myself. I was out a little over an hour and got in 4.5 miles. I felt great–strong, positive, calm. And it finally clicked: this is the benefit of exercising for people with OCD. I was listening to my body, not to other people’s ideas of what I should be. I was doing something that I didn’t have to be perfect at. I wasn’t doing this for image. I was allowed to do it just to feel good.

Later that week, I joined the gym down the street so I’d have a place to go when it’s dark out or raining or snowing or too cold. I don’t want any excuses for not going out. I went for walks outside and at the gym five times that week. I’ve been averaging about four days a week, an hour at a time, getting at least four miles in, if not more. There have been days when I’ve had to force myself into the gym or outside, but I find that it results in me waking up the next day feeling calm, positive, and ready to meet the day. It’s an amazing feeling. I’m proud of what my body can do, and it makes me feel more like I can conquer OCD. Exercise is helping me to recognize how to be my personal best for me, rather than spending all my time worried about everyone else’s perception of me. Exercise gives me time to myself, when I don’t have to be burdened with the worries of the many things I can’t control.

I even just signed up for a 5K Run/Walk. I’ve always wanted to do it but never thought it would actually come to fruition. I’ll probably walk most of it, but I’m doing it this time because I know I can walk three miles, even if it takes 45 minutes. I’m not in it to be the fastest or to race; I’m in it to participate, to help a good cause, and because I know it’s an achievable goal that will boost my confidence. I’m starting to think that someday I’d like to start a 5K for OCD, if one doesn’t already exist.

If you have OCD, I’d strongly recommend exercise. It doesn’t have to be walking, but it’s what I do because it’s easy and I can go at my own pace, rather than beating myself up for not perfectly executing a workout DVD or class conducted by people who are way more fit than I am. Find an exercise you don’t have to be perfect at. Just enjoy it. It will change your mind-set. After doing it, I’m a believer. The key is your reason for doing it. Do it for your mental health, not to reach some fitness goal or to lose weight or to be perfect. Do it because it will help your OCD. Do it at your own pace. Do what works for you, even if you can only get in 30 minutes. It actually does make a difference in your treatment. And just as with your hierarchy, you many find yourself doing things you never thought possible.