“The intrusive thought. The needling lack of logic. The obsession. The anxiety. They do not yield, but you can get better at ignoring it.”Hayden Carroll
Hello, Readers! Welcome to my blog series, The My Mental Health Series. My hope with the series is to educate, advocate, and to let people know that they are not alone. For 38 years, I did not know or understand myself because I didn't have the knowledge that I needed. I decided that I wanted to share what I've learned in the hopes that maybe I can help someone else recognize themselves in my words. Be sure to check out the last installment, My Mental Health: Anxiety Disorder and stay tuned every Tuesday for a new installment. Also, you can reference My Mental Health: A Glossary and the My Mental Health: Busting ADHD Myths for more information. Thanks for stopping by!
I’ve been nervous about this post, only because Obsessive-Compulsive Disorder is the disorder that I knew the least about when I received my diagnosis in September 2020. As with ADHD, what I knew about it was only a small window into what obsessive-compulsive disorder really is. Symptoms that I either wrote off as depression or didn’t understand at all have plagued my life for years and I had no idea. Let’s take a closer look.
Low-level, Obsessive-Compulsive Disorder causes repeated, unwanted thoughts (known as obsessions) or the urge to do or think something over and over (known as compulsions). A person with OCD can have one or both, obsessions and compulsions. While many people have times where they have obsessive thoughts or feel compelled to behave in a certain way, Obsessive-Compulsive Disorder is marked by the following:
- thoughts or habits take up at least one hour of the day
- they are beyond your control
- they interfere with work, social, or other parts of your life.
There are many different types and forms of Obsessive Compulsive Disorder, too many to list in one blog. The 4 main types are:
- Checking – this can include checking alarms, locks, ovens, lights, etc.
- It can also include mental checking such as keeping and repeatedly checking mental checklists or continuously checking to make sure you haven’t harmed anyone. This can also be known as doubt and harm OCD.
- Contamination – this can include a fear of things being unclean or a compulsion to clean.
- Also includes mental contamination which is a fear of mental or internal uncleanliness.
- Symmetry and Ordering/Perfection- ordering or arranging things in a specific way; being obsessed with perfectionism
- Rumination – having an obsession with a line of thought
- This can include intrusive thoughts which are often disturbing, unwelcome thoughts that do not line up with your morals and values, which can be extremely distressing
Obsessions are unwanted, intrusive thoughts, images, or urges that can be intensely distressing. On the same token, compulsions are used as a way to try to ease the unpleasant, obsessive thoughts.
Obsessive thoughts can often include, but are certainly not limited to:
- worries about you or others being hurt
- constant awareness of blinking, breathing, or other automatic functions
- suspicion that a partner is unfaithful with no proof or discernable reason
- worries that you will hurt yourself or others
Compulsions can include:
- excessive cleaning or washing
- ordering and arranging things in a specific way; lining things up or stacking
- repeatedly checking locks, alarms, etc.
- mental compulsions like mental checklists, rumination, etc.
Symptoms of Obsessive-Compulsive Disorder can come and go away over time and symptoms can also lessen or worsen. In my experience, my OCD became much, much worse while I was going through trauma and during times of intense stress. I rarely have periods where I don’t ruminate at all, though they do happen, but my ruminations are not always scary, distressing, or out of control.
OCD and Me
I have a subtype of OCD called Rumination/Intrusive Thought Obsessive-Compulsive Disorder. Some of the symptoms of Rumination OCD can be:
- Obsessive thoughts
- Fear of hurting yourself or others
- Disturbing or taboo sexual thoughts
- Intense thoughts of perfection
- Philosophical and existential obsessions
Compulsions of rumination can include:
- Checking and rechecking mental checklists
- Checking to make sure you haven’t hurt anyone
- Avoidance – avoiding triggering people or situations
- Spending long periods reviewing past events and memories
- Long periods thinking about philosophical or existential topics
So that was a lot of lists. I assure you that these are not even close to exhaustive lists of symptoms, thoughts, and compulsions. There are so many different forms of Obsessive-Compulsive Disorder and so many different ways that it manifests that it would be impossible to list and explain them all. What I can do is speak for myself and on my own experience. Let me tell you about some of the times that Obsessive-Compulsive Disorder has impacted my life.
While I do have a few physical compulsions (I have to do the steps in the shower in a specific order; I have to mentally plan a traffic-friendly route in my head before I go *anywhere*). In fact, until I started researching this post, I didn’t even think I had any compulsions except for these 2 things, which led to a lot of confusion for me about how this really affects me. However, the more I read, it became clear to me all of the ways that OCD has reeked havoc on my brain and my thought process. As it turns out, most of my compulsions are mental.
Three years ago
Lets go back about three years. I had a lot of things going on in my life; work was so stressful that I was dissociating (I’ll talk more about that in a separate post), some changes were happening that I had no control over and did not sign up for, my family found out that my beloved Papaw was dying of cancer, I had friendships ending and family ties being severed, and I was increasingly isolated and alone. I started to feel my control slipping, little by little.
My ruminations started with obsessive thoughts about the situations that were currently hurting me or had hurt me. There were about five or six different topics from my past or present that I could not get out of my head, including being cheated on and the heartbreak from that betrayal, the situation with my friendships ending, my childhood abuse, the death of a beloved pet and the loss of another, and a growing rift in my previously close-knit family unit.
I obsessed over these things from the time I woke up in the morning until the time I finally fell asleep at night — a sleep that would only come once I’d cycled back through whatever my obsession of the day happened to be. I had no control over it and it caused severe emotional pain and anxiety. There were nights when I would go to bed at 6:00 pm, just to make them stop.
It’s important to note here that, like with many mental illnesses, there weren’t a lot of outward signs that I was suffering. I could distract my brain for periods. I still worked, took care of my daughter, and I could still laugh and joke with the friends that I had left. My most trusted companions, however, knew that something was wrong because they were the ones that I felt free to vent to and my venting, like my thoughts, was obsessive. I almost felt like I needed to talk about them to get them out of my head, though it never really worked. Even then, as soon as I was alone again, my thoughts would spiral back into dark rumination.
I started questioning everything about myself. Was I a good friend? A good person? A good parent? Could I really get through this life with this brain? I knew depression had me in it’s grip, but I couldn’t get control of my mind or my thoughts. It wasn’t long before things took a turn for the worse and intrusive thoughts took the stage.
My intrusive thoughts tend to be about the things that have or are hurting me, thoughts of self-hate and low self-esteem, and thoughts and images of me hurting myself. One important thing to remember about intrusive thoughts, before I go on with my story, is that they are ego dystonic, which means that they are not in line with the thinkers real feelings, beliefs, and values. They are, essentially, our worst fears plaguing our brains.
I started feeling as though I didn’t want to exist anymore; my brain telling me every second of the day that it would be easier if I just…wasn’t. I started seeing disturbing images in my head; several times a day, during mundane tasks, I would see in my mind’s eye…me, slitting my own wrists. Over and over again the graphic image would flash into my brain. Let me clear here, I did *not* want to do this to myself. It was like my brain wanted to keep reminding me that I had options, even though suicide is never an option and cannot be an option in my life. I would never leave my child alone on this planet by choice. It wouldn’t stop.
This went on for several months. My thoughts got darker and more obsessive. I didn’t know that I had Obsessive-Compulsive Disorder, or even what OCD really was, but I knew that something was very, very wrong. I was unmedicated at the time and not actively in therapy so I immediately made an appointment with my PCP. He was able to get me on a medication for treatment resistant depression (I have tried dozens of other antidepressants, to no avail) and my mind started to clear. Eventually I was able to stop obsessing over hurtful and distressful things and my mind stopped attacking me at every turn. Soon after this episode, my mind started to get healthier and I realized that I desperately needed to find my way to some sort of recovery.
Just a few months ago, I started to lose my grip again. Things at work were extremely stressful. My job job is very productivity centered and I had barely been treading water for months, each cycle getting more and more stressful. I started having extreme anxiety for 12 hours a day, several days a week. Looking back, I was barely functioning at home and work. The intrusive thoughts came on hard and quick this time. However, for the first time in my life, I knew what was happening.
Knowing did not make things much easier, less scary, or less distressing. Again, my brain started telling me that I wasn’t good enough, I didn’t want to exist, my daughter would be better off without me. It said that I was worthless; a total failure at everything. There was something different this time and I truly believe that it happened because I knew and understood my brain. In the past, it had always been my voice that said these awful things to me. It was always my hand in the intense images that flashed through my mind. This time, it was someone else’s voice.
This is going to sound funny, but it was the voice of Rumpelstiltskin. I know that is ridiculous, but I think it was my brain’s way of giving it a voice apart from myself so that I could fight it when I needed to. Honestly, having that voice in my head scared the shit out of me. It made me feel like I was losing my mind completely. I fought it though. Every day I would tell it to shut it’s ugly mouth; leave me alone, I didn’t want to hear it anymore. I think more than anything I was afraid of the moment when I couldn’t fight back on it anymore; when I lost control of the situation.
Luckily, I was already under the care of 3 different doctors for my mental health. After about a week of these terrible thoughts in my head, I reached out to them and we were able to get my medications adjusted and discuss what has happening in therapy. Dr. R agreed that this new “voice” in my head was my brain’s way of using my newfound mental illness knowledge to contain the situation. The next time he shows up, and I’m sure there will be a next time because relapse happens, I’ll know who he is and I’ll fight him again. These thoughts won’t win out…I will never stop fighting.
It’s been several months and several med changes since my last episode. I still have the random intrusive or obsessive thought. As I discussed in my regrets post, I think that they have been making an appearance in the form of imposter syndrome and ruminating over my regrets. I’m fighting them with all of my might and, honestly, writing about them takes a little more of their power away. Knowing that people are reading about them and resonating with what I say about them takes even more power. Every day I strip a little more of it away. Recovery, my friends. One day at a time.
I hope that reading this helped you as much as writing it helped me. I have learned so much about myself and my brain, just researching in the last 24 hours. OCD is insidious and misunderstood, but we are not alone; Obsessive-Compulsive Disorder affects 2.2 million adults in the US. Together, we can tell our stories, break stigmas, and educate people on what OCD is and how it affects people’s everyday lives.
Stay tuned for next week’s installment of My Mental Health: C-PTSD. Can’t wait to see you there!
Love and light. Keep fighting the good fight! 💜💜