The Best Week Of My Life

You would think that the most carefree you can remember yourself being would fall between the ages of 5 and 10, when responsibilities were still a lifetime away and you were 100% sure you would be a child forever. So, it seems a bit weird to say that the actual most liberating and carefree point of my life came when I just moved in to a new apartment, started a Master’s degree with over an hour commute each day, and am trying to balance household bills on a meagre student budget.

I reluctantly started taking sertraline about 3 months ago. I started on 50mg and was boosted up to 100mg after the first month. Whilst I had my reservations about treating this disorder with medication, it proved to be the best decision I’ve ever made, and I thought perhaps it would be good to start a discussion on a choice that a lot of OCD sufferers will have to face at some point or another.

First, a bit of context. I’m not a fan of taking pills, in fact they give me just as much anxiety as they are trying to treat. I also have a nasty habit of reading the side effects of any medicines I take, which is never a good idea [unless you know you are particularly susceptible to certain effects, everyone experiences different reactions] which creates a whole new set of anxiety. So, despite one of the first pieces of advice I got from the doctor being to start treating this condition with sertraline, it actually took over a year for me to finally down the first tablet.

A big part of this apprehension was an unwarranted sense of defeat – I was under the impression that if I started the pills, then the anxiety had won. I wanted to beat this thing myself, so I tried doing more exercise, eating healthily, meditation, getting a regular sleep cycle and all the other self-care strategies typically used as a first line of defence. I was hoping that with enough persistence, I would magically wake up one morning without that feeling of dread I’d become so accustomed to. But every time I opened my eyes in the morning, that panic and fear was still there, and after a while I lost the motivation to keep fighting against it. I tried a new approach: indulge. Let yourself be worried, and perhaps it will wash over you and the pass over like any other phase. Embrace the panic, practice those compulsions, if it wants to control your life then let it!

I probably don’t even need to tell you how badly that plan went.

The pivotal moment came one evening, when, in the grips of one of the worst panic attacks I had ever experienced, I could not move, I could get dressed, I could not eat or drink, all out of fear. I cried, wailed in fact, for nearly an hour, whilst my boyfriend tried his best to stop me from sobbing. It was then that I realised, this disorder is stronger than I thought. It’s my own mind working against me – how on earth would I be able to fight against myself to treat myself?! Not only that, but I started to realise the toll that my condition was having on other people. I had started to alienate my close friends, and demand demeaning tasks of them (“wash your hands before you come in my room”). I could see my parents trying their best to understand and care for me, but getting more and more worn out as my anxiety persisted. The doctors had run out of non-medical treatments for me, and couldn’t understand my apprehension for taking these tablets. I took the first pill that evening.

It’s important to remember that your mind is the only tool you have for perceiving yourself and the world around you, so when it, for lack of a better term, fucks up, you really don’t have a choice but taken along with it. Medication is a necessary intervention for regaining control of yourself.

Starting medication is not a sign of defeat but rather a method of bringing your mind back in to line. There is no point trying to manually bring your mind under control when your mind itself is what is giving you grief in the first place. Taking medication gave me a chance to reset, to bring me back to the starting point to start my journey to healthy and effective recovery from a stable beginning. I don’t intend to be on these tablets for the rest of my life, but if that’s how it goes then so be it, I like not worrying all the time. It’s nice.

Since being on sertraline (one of the many types of medicine available) I’ve felt my world open up. Before I felt tight, claustrophobic in my own body, too afraid to venture out of my own imaginary bubble of safety. Now I can sense the infinite possibilities that are out there, and they are actually exciting! It’s hard to describe what it’s like to go from anxious to calm, it’s not like euphoria, its simply returning to normal, which in comparison does initially feel like euphoria because seriously, anxiety is hell and not worrying all the time is actually living the dream. I suppose the best way to communicate it is to imagine all those things that scare you, and all those habits you’ve made to control those fears; when you start medication, they just don’t seem to bother you, and you start to see them for what they really are; illogical, unnecessary and unhealthy. You can brush them aside with ease and the balance of power is shifted, you become the controller of yourself once again.

I know that recovery is not a constant upward gradient, and there will be times when the anxiety comes racing back, but each time it will be easier and easier to deal with. I just wanted to mark this one week I’ve had free from the grip of OCD, and just take a deep breath and enjoy it.

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Catastrophising

A key player in perpetuating compulsions is the OCD tendency to catastrophise situations. If the present situation is not enough to induce anxiety, an individual with OCD may look towards possible future consequences, find the worst one imaginable, and fixate on that. Note that, this isn’t voluntary, as in a previous post I spoke about how these thoughts come from outside of you. Your mind goes on some kind of road trip from hell and you are pulled along for the ride.

Catastrophising is say, where you graze you knee from falling. You then worry it might get infected. This is reasonable enough, you can act on this. Then the OCD kicks in. What if the infection gets serious? What if you get sepsis? That can be fatal you know. Think about everyone you love mourning you after you died, think about all the opportunities you would have missed. Can you feel the misery, the guilt, the pain? An OCD mind can be hooked on this thought for weeks, catastrophic thoughts like this usually pass with time, that time is the most miserable state of existence.

Catastrophising is surprisingly easy to fall into, and you may not even realise you are doing it. It’s often helpful to tell someone what you are worried about specifically, and if their response is “what the fuck, how do you think that could ever happen?” chances are you are probably catastrophising.

There is a good technique I learned from my CBT advisor that can really help in these situations, and that is to analyse your anxieties and decide if they are practical or hypothetical.

Practical anxieties are healthy anxieties. These are concerns that present a physical and tangible problem, that can be dealt with accordingly. Examples, did I lock the front door? Go back and check. Is that graze at risk of infection? Keep it clean and stick a plaster on it. What if I don’t wake up for work on time? Set an alarm. Practical anxieties have a practical solution and go away once they have been resolved. You may have a lot of practical anxieties that hit all at once and this can start to feel like Generalised Anxiety Disorder, however, taking the time to analyse your worries and seeing if there is a practical solution to them, means they can all be dealt with in turn. Try writing them out in in a list of most to least worrisome. Then write next to each one a practical action you could take to resolve the issue. Then try it, does that feel better? If so, great! If not, have a look into hypothetical anxieties.

Hypothetical thoughts can be harder to identify, because they disguise themselves as practical anxieties and seem very, very real to the person experiencing them. You can usually tell them apart because they involve the assumption of one or more things happening first, and also usually start with “what if”? What if I left the door open and someone breaks in and steals all my belongings? What if this cut gets infected and I have to have my arm amputated? What if I accidently sleep in, am late for work, get fired, and can’t afford to feed my family? Hypothetical questions do not have resolutions, because there is nothing as yet to resolve. You can’t report your belongings stolen when they haven’t been stolen. You don’t want to buy a prosthetic when you still have your arm. You don’t need to worry about loosing your income when you still have your job. Without a resolution to act on, hypothetical worries just go round and round and round in your head. You might then find yourself trying to mimic resolutions by making a plan for your “worst case scenario”. For example, I found myself googling treatments for diseases I didn’t even have, just to prepare myself for what I feared I might go through. I would mentally prepare myself for major surgery, or for rehabilitation, or plan how I would live my life if I became blind. But these mock-resolutions only provide a little relief. It’s good to plan for the worst case scenario to some extent, but putting down a pre-payment for major eye surgery is going a little too far.

The real solution to hypothetical anxieties is simultaneously easy and difficult; ignore it. Sounds easy, right? Sit back and don’t do anything! But it’s far from plain sailing, to ignore a compulsion, especially a frightening one, is one of the hardest things to do. You might feel like the anxiety will last forever, but trust me it won’t. It will last a little longer than if you were to act on your compulsions, but it will dissipate by itself in time. And what’s more, when you allow it to go by itself once, it becomes easier and quicker to do it again and again!

Catastrophising robs you of your own sense of security, but just know that everything is going to be ok. The future hasn’t been written yet, and there are a million possibilities for every little detail of life, and there is no point worrying about all of that. Take each task as it comes, you might have left your door unlocked, but was your house broken into? No. So what as the point in worrying about being robbed? The thing is, no one can predict what’s going to happen in the future, and that’s fine, that’s a good thing and should be taken as a comfort! Even if your worst-case scenario does come true, you will have more energy to deal with it than if you had spent all that time prior in a state of anxiety.

Don’t waste your energy on worrying about what you can’t control, you are a fabulous and unique individual, and your energy should be put into doing what makes you happy. And if you’ve got energy left over, make other people happy too!

The tightrope

In my own experience, I have found OCD to be alienating and distancing. I feel separated and distracted, as if I was out of sync with everything around me. My mind is always on something else, even at important events, at my cousin’s wedding, I was worried about a mark on my skin, at my graduation, I was anxious that this headache might be a sign of an imminent stroke, on holiday I was so scared that I might have picked up a disease from a public restroom that I don’t remember much of the trip at all.

Sure, I see other people not Dettol-ing every surface before they touch it (then cleaning the Dettol bottle, then washing their hands afterwards) and I wonder, “how are they doing it? Are they not scared of the possible diseases they could risk getting?” The best I can describe it is like you are walking across a tightrope – way high up, far away and separated from everyone else. You are scared of falling because the floor is everything you are afraid of and trying to avoid (for me, disease, dirt and contamination). Walking the tightrope is hard, and complicated, and exhausting, and you can’t move very fast or very far. But it is necessary to avoid the floor. Now, imagine you can see people strolling along the ground, they walk easily, and they do not struggle. They do not worry about the floor, and yet they do not get sick. You can’t imagine what it is like to be so carefree. But you could never join them, because you KNOW! You “know” that what they are doing is risky, and you “know” that your way of doing things is the only way to avoid getting ill, and you continue to struggle along this completely unnecessary tightrope, because you “know”.

I often find that I feel like I am right and everyone else is wrong, and what I do is necessary. When confronted with the evidence that other people don’t clean things like I do, yet they do not get sick, I always put it down to luck, or the fact that I already cleaned it, or they are just immune, or one of the other countless reasons OCD gives me as an excuse to rationalise my behaviour. I try to explain to my family how illogical my thought processes are, as a way to make them understand why I won’t wear clothes that have touched my bed, but that only makes things worse.

“If you realise its illogical, then why can’t you stop doing it?”

Christ, if only I knew.

That’s what makes this disorder so frustrating, you are at war with yourself. Say, I put a pair of freshly laundered socks on the bed, and in panic realise that two days before hand I had put a bag in the exact same place, and that bag had been outside and touched bus seats, public restrooms, restaurants and park benches. Now I imagine most people would think that those socks are fine to wear, there was no visible dirt on the bed, and they are only going on your feet anyway. That’s how one half of me would see it. The other half, the OCD half, would tell me I was an idiot, and that those socks now carry germs that will infect my skin. That infection could spread, ad your body could become riddled with disease (this is called catastrophizing, it’s a trait of OCD and anxiety – I’ll come back to it in a later post).

Now, I look at these socks, and see two completely different outcomes at the same time; they are clean, and everything is fine, but they are dirty, and something bad will happen. Both sides argue against each other in my head – I want so desperately for things to be ok, but the fear that everything could go wrong because I wasn’t careful enough is what pushes me to compulsive behaviours. Sometimes these internal arguments are so intense that I can start to cry. From the outside it looks like I’m crying over nothing, but my head in in a frustrating turmoil of panic and anxiety.

Is at this point that I usually go back to bed and stay there for the rest of the day.

To anyone going through this, I promise you, it’s going to be ok. It’s scary, but you are going to make it through this. Arguments and disagreements are times of heightened emotion and agitation; no one likes to be in a room when two people are arguing, but you can’t hide in the bathroom when that conflict is going on in your own head. When the two sides of your mind are shouting at each other, it is understandable to be overwhelmed, so forgive yourself, take the time you need. I tend to find that forcing your way through times like these isn’t that effective, and pleasant distraction is usually much better, so read a book, watch a film or paint a picture. Let yourself calm down at your own pace. Gather your strength to fight back harder. With either therapy, or medicine, or both, you will get through this. You will be able to climb down from that tightrope, and walk freely with everyone else again.

Outside of me

OCD is different for everyone, it tailors itself to your own personal hopes and fears so that each individual is dealt thier own custom cocktail of anxiety. This can make it really difficult to communicate your exact thoughts and emotions to other people, especially to those who do not experience the disorder. However, there are characteristics of the disorder that are common amoungst all sufferers.

I have just watched this video by the well known vlogbrothers, talking about his own personal experience of OCD, and found a lot of what he said to be very relatable (particulary, googling symptoms – dear God, never do that. If you are worried, speak to a medical professional). However, there was one particular point he raised that really resonated with me: obsessive thoughts “come from outside of me and seem to hijack my conciousness”. This is a point I have tried and failed to articulate since the very beggining, its like having someone whisper in your ear, but its coming from inside your own head. From speaking to other people with the disorder, and reading multiple books and articles on the subject, this appears to be a common trait of OCD.

Its hard to describe what its like to be mentally hijacked, you could imagine it as being a puppet, with your hands tied to strings that force your movements, or as if someone else has climbed into your skin and is walking you around. For me, it was like another person has just appeared in my psyche alongside regular me, and was fighting for the controls. There was a real dual system going on between what I would consider to be myself, and this entity that was OCD, and this constant battle between both sides was exausting. I did not relate to or identify with the thoughts and suggestions that came from this intruder, but they were in my own head, so that meant it was coming from me, right?

Well, no. I have read about a lot of people who have suffered with the idea that these bad thoughts are thier own, and tht this makes them a bad, or even dangerous person, but that couldnt be farther from the truth. Strange, or “outside”, thoughts are a part of life, think of it as your brain on tickover. Ask anyone if they have ever had a thought about jumping off a high cliff while on a hike, or stabbing a knife into thier own hand whilst chopping onions.  Ask them if they ever had the thought to kick a child as it ran past, or set fire to the carpet while they were lighting candles. Chances are, they will say yes, but that does not make them bad people. Wierd thoughts go through everyone’s mind, but the vast majority of people do not identify with them, or even retain them for more than a few seconds. They wash over minds like a wave on the beach, and then dissapear. But in OCD people, they seem to stick around. They get trapped and they ferment and putrify in our heads until they are so revolting, that we become scared of ourelves.

A key step in overcoming OCD is to learn that these thoughts do not define us. Your mind is a sanctury free from judgement, morals, and critisism – you are free to think whatever you want. You will not identify with these thoughts if you do not want to. You will not act out these thoughts if you do not want to. It is not the thoughts that define you, its what you do with them. Strange, intrusive thoughts are a natural part of a healthy mind, don’t try and prevent them or push them out, that only makes it worse. Instead, allow them. Let them flow freely into your mind and then out again, and relax in the knowledge that they do not affect you at all. They do not define you, and you are not commanded by them.

TL;DR: Brains are wierd, but thats ok.

Death by Dettol

My OCD started out as manageable, and somewhat compatible with everyday life. I had a fear of contamination that I could slyly pass off as just a heightened sense of hygiene, and a quirky love of Dettol (the grapefruit scented cleaning wipes were my favourite) but even then, the skin on my hands would crack and bleed from being washed too often.

Things started to get less manageable around exam season. Until that point, I was working under instructions from my CBT advisor to ignore compulsions – when you think you should wash something, don’t do it. Let me tell you now that is one of the hardest things I have ever had to do. But I persevered, and for the most part, I was doing alright. When exams came around I was hit with a new pressure: time. I couldn’t afford the time to be ill and miss studying. So I gave in. I told my partner “Im going to allow myself to act out my compulsions, just for a bit before exams, it will keep me calm and definitely make sure I don’t get ill”.

Big mistake.

Allowing myself to be commanded by the voices inside my head only made the compulsions stronger. It reinforced all obscenely unrealistic ways I believed diseases could be transmitted, and made me feel like what I was doing was necessary, not only for my health, but for those around me. To me, this wasn’t OCD, this was essential, I was saving people from disease.

But it didn’t stop at cleaning. Once I had ran out of surfaces to Dettol, my anxiety found a new focus: me. I was a vessel for germs. My hands were great lumbering meat pads the spread disease to whatever I touched. My feet carried all the dirt of London, and bought it into my house. I started to cordon off my body, restrict areas from one another; feet must never be touched and socks worn at all times, face must only be touched after disinfecting hands. Right hand was for personal hygiene and should avoid touching left had, which was to interact with my environment.

Eventually it got to a point where I was having multiple panic attacks a day, I couldn’t wash, eat or wear clothes for fear of getting ill. I would sit in my dressing gown, on a chair that I had Dettol-ed twice, and just, exist. I couldn’t go out, I couldn’t do chores, heck, I couldn’t even go to the bathroom without freaking out about imminent death. I punctuated my existence with occasional outbursts of crying, escalating up to wailing on special days. I felt so vulnerable. I felt so frightened. I felt so stupid. I felt so, useless.

On the day of my final exam, I couldn’t put on the trousers. I stood there, half naked, crying, holding the third pair of freshly laundered jeans, that just, weren’t clean. I had given in to my compulsions just to get by, so that I wouldn’t miss an exam. The irony was painful.

One million voices

OCD is like a having a million voices inside your head. Now, a million is a bit cliché, so let’s make this more realistic. Imagine a crowd of 20 people, who follow you around and aggressively criticize your every thought and action.

“Oh, you picked up that spoon? Did you wash your hand first? No? Well now you are going to get sick when you use it! Wash your hand! You absolute idiot.”

“Now wash the spoon and the place where the spoon was!”

“You are so fucking stupid.”

“Is that antibacterial soap? Does it kill viruses also? Even if you clean it you could get an incurable virus!”

“Wait, did you use THAT sponge? That’s sponge was just on the side! Anyone could have used it before!” “It could have raw meat juice on it! Get a new sponge! Christ, how did you get this far you idiotic shit?”

“Now clean your hand, the spoon, the place where the spoon was, and the place you are going to put the sponge.”

“But wait, now THIS sponge is dirty! Get a new sponge! You are an idiot, how did you not realise this?!”.

Cut to me in the kitchen, frozen in panic, holding a spoon.

A single event such as this would seem comical, and in all fairness, I see it too! I bestow such impossible survival and transmission abilities to bacteria that, were it true, the human race would have been wiped out a long time ago. But this isn’t a one time event. This is every day. Every waking second, even those few moments before you open our eyes in the morning. Worry. Anxiety. Panic. Fear. That nauseating tightness in your chest. Because these actions aren’t just compulsions for their own benefit, to me they are necessary to avoid a much worse outcome. They are to avoid contracting, tetanus, HIV, cancer, or even some hitherto unrecognised skin infection that will ultimately spread over your entire body and render you disfigured and miserable for the rest of your painful existence. This is how I live my life. Disease and infection are everywhere, but I am the only one who sees it.

To me it makes a lot of sense to imagine OCD as a crowd of people, because the voices in my head never felt like mine. My voice was the one that just wanted to make a cup of tea, and not begin a two hour epic adventure into just how much antibacterial spray can I use before the fumes burn my throat? No, the voice of the compulsions was always someone else, they started out as suggestions “has that been cleaned properly? Could someone else have left it dirty? What if a fly has landed on that? That could make you ill you know, you can’t afford to be ill right now…” They were powerful, and compelling arguments, and I followed them. I cleaned, oh my how I cleaned, and disinfected and washed and bleached and scrubbed. The suggestions became commands, instructions, threats “clean this else you’ll get sick” “you are so stupid for not realising this before, you deserve to be ill”.

 

Where to start?

2007: “It’s a sunny day, but it would be best to take an umbrella, just to be sure, y’know.”

2008: “Now I know I locked the door, but I need to go back and check again!”

2011: “I am not familiar with the hygiene standards of this restaurant, so I’m not going to order any meat or rice.”

2015: “Ah damn, my clean trousers touched the chair that I sat on earlier with the clothes I wore on the bus – now they are dirty too. Best wash them again.”

2016: “I wash my hands 27 times a day.”

2017: “I have different flip flops to wear in different rooms of the house, so that germs from the floor don’t get spread around, and also my feet then don’t tough the floor.”

2017: “I can’t hug my mum, I will get ill.”

 

Did you notice that gradual increase in intensity there? Because I sure as hell didn’t. It’s hard to pinpoint where anxiety/OCD starts, especially if you, like me, would identify as a naturally “anxious” person to begin with. By the time I was diagnosed in 2016 it was too late to look for the cause as a way to resolve the issue. My CBT (Cognitive Behavioural Therapy) adviser told me that OCD is a behaviour we teach ourselves; we are anxious of unpleasant scenarios, so we obsessively act out procedures that we believe will prevent it from happening. This quells the anxiety, but that lovely reassurance is addictive, and makes us do it again and again and again. Before you realise, you can’t stop.

I was told that with focus and determination, it takes two months to unlearn a behaviour for every year that you’ve done it, but how long was that?! I couldn’t see a distinction between the real me and the OCD, we were one and the same, I’ve been anxious since I first opened my eyes, obsessively compulsive was just my personality. How would I know when to stop? Would there be any of me left at the end?

I can say now, that I have had a glimpse of an OCD-free life, I’ll get on to that in a later post, but I can tell you, its wonderfully, brilliantly, and excitingly normal. Removing OCD did not erode any part of my personality, or leaving a gaping hole where worry used to be. In fact, I didn’t even notice the change at first, I simply became aware the that tightness in my chest that used to greet me first thing in the morning, was suddenly gone. I realised that I didn’t have to wash clean plates before I used them, and that trousers, could in fact be worn more than once (if not obviously dirty). I used to think that OCD and my personality were one and the same, then I realised they were two different entities, fighting for dominance in my head. When the disorder was controlled, I was left with, well, me.

OCD-free is not worry-free. Worrying about things is fine and normal, as long as you can control it. You could look at it as being the difference between choice and command; personality is motivated by choice, it is malleable and controlled by you. OCD is a command, it strict and immovable and it controls you. Being OCD-free is to go about your day to day activities by choice, and its delightfully pleasant. Living life OCD-free after being restrained for so long is liberating, even if I do still choose to take an umbrella on sunny days.