Having OCD Sucks

OCD is one of the most treatable mental illnesses. Fortunately, there are medications and treatments that can help significantly with this disorder. There are also some drugs in the works being tested for treatment resistant OCD that show a lot of promise. So, what pitfalls await us? It will usually come from ourselves. OCD is a disorder of pathological doubt (pathological in the sense that it interferes with our quality of life). If you check to see that the stove is off, say twice, not such a big deal, you are probably normal, if a bit neurotic: five times- we’re starting to waste our time: ten times – we have a problem. Coming to terms that we have a bonafide mental illness is both relieving and scary at the same time. The fact that there is a name for it and others recover from OCD, is a source of hope, but the stigma of mental illness still haunts many people in modern society. The truth of the matter is, we did nothing to deserve this. Evidence suggests OCD to be a disorder that is biological in origin. Children can develop OCD after certain bacterial infections.  Pediatric Autoimmune Neuropsychiatric Disorders Associated with Streptococcal Infections otherwise known as PANDAS is being researched to figure out how the bacteria disrupts brain function. So, here are some steps to get one started for the road ahead.

1. Come to terms with the fact that you have a diagnosed mental illness (ICD 9 code 300.3)
2. Realize you aren’t to blame for the illness.
3. Familiarize yourself with http://www.ocfoundation.org/ which is an absolutely invaluable resource. You can find Therapists, Information and Support Groups in your area as well as stories of various peoples triumphs and tribulations with OCD.
4. Familiarize yourself with the different treatments available to you (medication, cognitive-behavioral therapy, ERP etc…)
5. Come to terms that medication may be necessary. This one was hard for me and in retrospect it really shouldn’t have been. The medication available is great. The side effects are few for most people and go away after a period of time. The benefits are truly wonderful, I still kick myself for not going on medication sooner.
6. Find a therapist versed in ERP. If Scrupulosity is involved, talk to a spiritual adviser of your choice whom you trust AND understands what OCD is to go over what ERP exercises are acceptable. Do NOT go clergyman hunting. Stick with one!
7. Find a support group like OCA (Obsessive Compulsive Anonymous), (yes even atheists). I have found that as a support group, most people are fairly open minded. I’m not particularly excited about the God and Higher Power stuff that gets talked about, but as long as you have the desire to get better and you are comfortable sharing your story I have found it to be particularly healing.

As others have suggested, you will need to find a Cognitive Behavioral Therapist, particularly one versed in ERP/EXRP (Exposure and Response Prevention). Many therapists are trained in psychodynamic analysis. I do not recommend this approach simply because one can’t talk oneself out of a broken leg. What I mean by this is that OCD is has a biological component that can’t be talked out of. If one is suffering from intrusive thoughts, a psychodynamic therapist will ask you to figure out the meaning behind the thoughts. Figuring things out is a compulsion that feeds OCD. If OCD was purely a problem of reason then this method could work, but it isn’t. The OCD brain has a problem filtering out thoughts. Most people go about their day dismissing intrusive thoughts that are not part of their values. Just because one has the thought or urge to drive into oncoming traffic, doesn’t mean you have some innate secret desire to do so. Most people can relate to this thought because it is fairly common. Most people interpret it as nonsense and dismiss it. The OCD mind doesn’t. It keeps wanting to process thoughts that most would dismiss. The idea of whack-a-mole is a perfect analog to this. So, instead of allowing the thoughts and feelings to pass, someone with OCD will try to neutralize the thought through another thought or some overt compulsion.

Most people have had the experience of a song that won’t go out of your head. Well, that’s what OCD is like except that the content involves thoughts of an unwanted, disturbing nature (obsession) that produce anxiety which then compels (compulsion) one to either pray, reassure, count, arrange, wash, think, etc and round and around we go. The problem is that the compulsion does provide relief, so naturally one will want to continue the compulsion to decrease the anxiety, but this only happens in the short term. My particular compulsion is seeking reassurance, trying to figure out what the thought means and in the case of religious thoughts I would pray out loud or in my head.

I have had thoughts of harming the people I love, thoughts of blaspheming the Holy Spirit etc…. Really, really disturbing stuff. OCD seems to attack one’s sense of self-worth, deepest fears and insecurities. (i.e. thought of hurting spouse calls into question one’s love of their spouse; Having a blasphemous thought implies one hates God or is going to go to hell) OCDers wrongly conclude that “I am this because I think this” or a variation could be “thinking this is the same as doing this.” It is known as thought action fusion or mental fusion. Studies show that the content of the thoughts are not unique to people with OCD. Everybody has intrusive thoughts. Regular/Normal people simply dismiss their intrusive thoughts.

What makes OCD such a tragic comedy is that the OCD person would never act on these thoughts and the reason these thoughts cause anxiety is because they go against one’s values. OCDers try to suppress or neutralize these thoughts and derive anxiety from said thoughts. Some, including myself, would avoid sharp objects to protect the people I love well…from a fear of the possibility of hurting someone. Especially if your Pure-O like myself, group therapy was, for lack of a better word, a godsend. To meet people who suffer similar things and learn from them has been nothing but awesome. It validates one’s experience which is crucial to making sure you don’t isolate yourself, which can bring on more anxiety and even depression. Group almost makes one feel normal and accepted. I say almost because I wouldn’t be going to group if I didn’t have OCD. That said, OCD sucks! Having OCD Sucks!  I don’t like it, but unfortunately for me, I have to accept it and acceptance is where the healing/recovery is at.