Anxiety, Harm OCD, Intrusive Thoughts

OCD is not a disease that bothers; it’s a disease that tortures

For all the turbulence OCD brings, and I don’t think I’ll ever be able to fully describe its impact, you never get a better opportunity to learn about the mind and indeed yourself.

Crouching down in the corner of the pub, my back to my group of friends in a bid to conceal my strange behaviour, I focused my eyes intently on the cigarette-end lying on the wooden floor. Squashed flat, it couldn’t have been further extinguished, but still I reached down and picked it up, holding the cigarette-end at eye level and slowly rotating a full 360 degrees, pausing to check at every angle for any signs it was still alight.

Satisfied it was dead and posed no danger I hauled myself to my feet, pausing to mentally replay the sequence of events to ensure all bases were covered and any possible dangers averted. The situation is dealt with, I told myself, repeating it over and over again in the hope the mantra would eventually stick. My increasingly lively mind had other ideas, urging me to just run through the inspection one more time, just to be absolutely sure.

As I stood frozen to the spot, I tried desperately to ignore the urges, pleading with myself to head back to the bar and forget about it. The obsessive and catastrophic trail of thought grew in intensity, quickly overwhelming me and attacking my ability to think rationally – years of obsessive thinking had gnawed away at the line between rational and irrational thinking anyway. Just check the situation one more time, the mind urged me, put the matter to bed and get on with my night, and my life! Powerless to resist, I bent down, resting on my haunches and once again placed the cigarette-end carefully between my thumb and index finger, rotating it 360 degrees, pausing again at each turn to ensure every angle was covered – this time longer pauses with more intense scrutiny. A couple of minutes later, I finally placed it back down in exactly the same spot I found it and turned away.

Back at the bar, I apologised for deserting my friend mid-conversation and tried to put the episode to the back of my mind. As we chatted away, my mind was elsewhere: still transfixed on the cigaretteend and the possible dangers it posed, despite the fact I had investigated the situation twice already. Instead of quietening down, my mind was now in overdrive, breaking its promise that closure would be accomplished once I just checked that second time. Did I really check every side? I asked myself. I was quite stressed when I examined it, maybe my turbulent state of mind clouded my judgement!

I desperately tried to keep up with the conversation, running on a form of autopilot – something I did all the time in those turbulent years, whilst over-compensating for my inner turmoil by putting on a relaxed and jovial act – as catastrophic thoughts swirled incessantly around my head, my mind furrowing down another track of thought in a bid to ruthlessly exploit my state of anxiety and confusion. What if there were cigarette-ends under my rucksack? Any number of cigarette ends could be lying around, slowly burning away, about to catch light and send the whole pub up in flames. The responsibility would be mine as I was aware of it and could have prevented the danger! Any rational thinker would have checked and made absolutely sure, my mind kept berating me. Just go and check the whole area one last time and put an end to the whole affair. You can then start again, enjoy the evening and pretend the whole incident never happened!

Once again I made my excuses and headed to the toilets to try and gain control of the spiralling situation – an all too familiar scenario by now. As I sat in the cubicle, head resting in the palms of my hands, I tried to make sense of the situation, tried to rationalise whether this was a real danger or my mind playing tricks. What could go wrong? I asked myself. It’s not my cigarette anyway; I don’t even smoke. By now I was totally out of control. My mind had ruthlessly beaten me into submission, stripping me of my ability to come to any clear judgements on what was right or wrong, rational or irrational, danger or obsession. I could hear the laughter of a couple of blokes sharing a joke in the background, something that made me angry; that should be me, why can’t I be enjoying a relaxed night off at the end of a long week! Even more frightening, I was powerless to resist the compulsive urges driving me on to check, check, and check again, convincing me that one last inspection would put an end to it.

From the moment I entered the pub at about 8pm that evening and saw the cigarette-end lying on the floor as I went to put down my rucksack, to the moment I finally left the pub at about 11pm, I went over to check the cigarette-end, the rucksack and surrounding area over six times. To those present, I am sure I seemed my usual jovial self, overcompensating as I mention above, but inside I was in desperate trouble, becoming increasingly ‘cloudy’, and unsurprisingly frustrated and deflated.

Mentally exhausted, I left the pub and on arriving home slammed the front door in anger, performed the usual rituals – checking the taps, lights, oven and any other potential dangers, and slumped on my bed. I breathed a huge sigh, relieved to be back in the confines of my own room, a place where I was in control and everything around was just how I wanted it, just how I needed it.

Diagnosis

I was diagnosed with Obsessive Compulsive Disorder (often referred to as just OCD) in 2006, five years after my first recorded symptoms of obsessive and compulsive behaviour. For three years, I went to see psychologists and countless GPs, desperate for help and confirmation that it was more than just me and my inability to cope with life. Varying diagnoses were returned; from depression to general anxiety to nothing more than a phase. In the case of GPs, few had any deep insight into mental health issues and, in some cases, a worrying lack of sympathy. It took me several years to relinquish the anger I felt after breaking down in a senior GP’s office to be told it was just a reaction to a relationship breakup.

Those who struggle with OCD will, I am sure, identify with the cigarette episode above. As the title of this article, which was coined by an OCD expert, highlights, OCD isn’t a slight irritant or inconvenience; it is a torturous, brutal disorder that drives you to the point of despair. It manifests itself in a multitude of ways and I can recall hundreds of different scenarios over the years, be it with cigarette-ends, taps, locking doors, fear of disease, and many, many more diverse – and often bizarre and under-reported – examples.

My earliest experiences were with taps and ensuring they were completely turned off. I recall leaving work three times one week during my lunchbreak to return home to check I had turned off the bathroom tap. Over the years, I have been engulfed in hundreds of obsessions: from fear of signing off a letter in case I wrote something deeply offensive, to thinking I’d hit a bicyclist whilst driving, thinking I’d stolen a book from a bookshop, to a stage where I lost all trust in my memory. In short, every aspect of life and living, minute by minute, day by day, created potential dangers, from the moment I woke up to the moment I finally, exhausted, fell asleep.

Depression, in my case, is a by-product of OCD. I don’t want to go into this side too much as it is OCD that is my major challenge. What I will say, though, is the periods of depression I have experienced, in particular the serious relapses, have shown me the horror of depression. The feeling of being stranded down the bottom of a deep hole and unable to escape will stay with me forever.

Oh, I get that too

A major challenge with OCD is that we all have a certain degree of anxiety and, on occasion, need to check things we have done – turned the iron off, shut the windows, called a friend or completed a work task. Some even have rituals – placing shoes neatly together, lining up cutlery in a certain way, and so on. The issue with OCD is that every life situation – and I mean every situation – presents a potential danger, leading to the habitual process of obsession followed by compulsion to check, back to obsession again, followed by an irresistible urge to check once more. The result is ‘brain lock’, a spiral impossible to escape.

Seeking help

Overcoming the stigma surrounding mental illness and finding the right professional help are two of the greatest challenges OCD sufferers face. Of course, the two are closely connected as you have to be willing to seek help to deal with the problem. Even recognising the problem is far from straightforward given the havoc the disorder plays on the mind. The lack of understanding and tolerance surrounding mental illness, albeit slowly improving, does little to alleviate the stigma issue. Finding professional help, as I myself discovered, is a far from easy task. I have lost count of the number of stories I have heard of sufferers who have not received sufficient assistance despite efforts to obtain help.

Treatment

In 2006 I was finally diagnosed by a psychiatrist who placed me on a drugs programme to address the chemical imbalance in the brain. The treatment led to dramatic results and six months into the programme, I eventually pulled my head above the parapet for the first time in five years, though not before a few extremely turbulent months experimenting with different SSRIs and quantities necessary to adjust my serotonin levels. The treatment was heavily focused on medication as opposed to cognitive behavioural therapy (CBT), largely I think because I was being treated by a psychiatrist and not a psychologist. But looking back, I am not sure I was in the right space for the latter approach.

Over the next few years, I felt a huge improvement and was able to deal with day-to-day life to a much greater extent, though I still struggled with obsessions and compulsions and only now realise how caught up I was with it all. It wasn’t until 2014 that a serious relapse led to a huge breakthrough when by chance I found myself in front of an OCD specialist who properly understood my OCD. The course of CBT that followed was both exciting and terrifying as I began to understand the impact OCD had on my mind and my life. Whilst I picked up the concepts of the treatment quite quickly, It wasn’t until later that I fully recognised the power of CBT (and crucially, OCD-focused CBT).

Whilst on the subject of treatment, it seems that everyone has a different opinion on the CBT & medication debate. For me, CBT has been absolutely vital. However, I will never underestimate the contribution medication has made and continue to take it today. The balance the drugs have given me have provided the scaffolding for the therapy to take place.

It’s far from all negative!

OCD has undoubtedly changed my life, but in many ways for the better. The journey has humbled me and led me in directions I would never have gone, and it’s no coincidence I have found solace in classical music, writing and other creative outlets.

I recall watching a documentary presented by Stephen Fry on bi-polar disorder where a group of sufferers shared their experiences. When asked whether they would change their situation, every single participant said they were proud of who they were, how the disorder was part of them and had introduced them to a richer, more meaningful world. I’d have to agree! For all the turbulence OCD brings, and I don’t think I’ll ever be able to fully describe its impact, you never get a better opportunity to learn about the mind and indeed yourself. Once you have looked below the surface, life changes forever.

Embracing uncertainty & the future

Learning to relinquish control, deal with uncertainty, and not seek closure are, for me, the key to managing my OCD. In many ways, writing this article challenges all of the above. As I go through the process of managing my OCD, it is not clear where the journey will take me. Perhaps I will change my views on some of the above. Maybe the questions I will be asked will raise more doubt. But facing and embracing this uncertainty is what I need to do to continue moving forwards.

I might not seem like it, given it took me five years to get diagnosed and a further eight years to receive the full scope of treatment that has really put me in a position where I can manage the disorder, but I’ve been one of the lucky ones. Literature on OCD says it takes on average 7-10 years for OCD to get diagnosed. Many go undiagnosed for a lot longer. Given the complexity of the disorder, I can now see why this is the case.

Where am I now?

While I still have obsessions and, to an extent, am dealing with long-running obsessions that have mushroomed over the years, the knowledge and strategies acquired have allowed me to largely manage it and resist the urge to check. I can look to the future with excitement, not utter fear and confusion.

The only way to tackle OCD appears to be by going through the ‘fire’ and not around it. Ironically, it is this action that that is ultimately allowing me to take up challenges that I probably wouldn’t have taken on had I not had OCD in the first place!

An understanding of the disorder, coping strategies and a professional who truly understands OCD have taken me to a level I never thought I’d reach (and was previously told I wouldn’t reach), and I’d urge anyone struggling with OCD to seek help (or keep trying to find the right help). The alternative doesn’t bare thinking about.

Further Information: There is plenty of literature on OCD out there. The best description of OCD and what it takes to beat it, for me, is Dr Fred Penzel’s “Ten things you need to know to overcome OCD.

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